LCT联合高危型HPV检测对CIN治疗后的随访意义  

Significance of LCT Joint High-Risk HPV Testing for Follow-up after CIN Treatment

作　　者：干晓琴[1,2] 张凌[1,2] 林海[1,2] 刘江[1,2] 周萍[1,2] 王骧 黄瓒[1,2] 杨冬泉[1,2] 扎西[1,2] 陈颖[1,2] 代倩苓 辜定纤[1,2] 

机构地区：[1]成都市妇产科医院 [2]成都市第九人民医院,四川成都610015

出　　处：《华西医学》2009年第10期2627-2629,共3页West China Medical Journal

基　　金：四川省卫生厅科学研究项目(060174)

摘　　要：目的:探讨联合LCT和高危型HPV检测对CIN宫颈治疗后的随访意义。方法:对200例LCT异常,高危型HPV阳性,阴道镜活检证实为CIN1～3的患者行LEEP治疗或宫颈冷刀锥切,治疗后进行严格随访,包括LCT和高危型HPV检测,阳性病例行组织学检查。结果:(1)所有病例经治疗后均无病变残留,其治愈率为100%。(2)从治疗后3个月起,CIN1组高危型HPV转阴率为100%。在随访的第3个月和6个月,CIN2～3组高危型HPV转阴率分别为73.17%和90.85%,显著低于CIN1组,差异有统计学意义(P<0.05)。(3)从随访12个月起,一直有2例病例持续HPV阳性,均为CIN3患者,但LCT和阴道镜检查未发现细胞学异常,继续随访。结论:CIN治疗后高危型HPV的转阴时间及转阴率与CIN的级别有关;高危型HPV持续阳性,但LCT和阴道镜检查无异常者可继续严格随访;LCT联合高危型HPV检测是CIN治疗后临床追踪随访的有效手段。Objective：To investigate the Significance of LCT joint high-risk HPV testing for follow-up after CIN treatment.Methods：200 cases that high-risk HPV infection were tested by real-time PCR and CIN1~3 were confirmed with LCT and colposcopy biopsy were considered.The patients were treated with LEEP treatment or cold knife conization.After treatment,all cases were strictly followed up with LCT and HPV test,and the patients with positive results were examined by histology.Results：1） After treatment,there was no residual disease in all cases,the cure rate was 100%.2） From 3 months after treatment,high-risk HPV negative rate was 100% in CIN1 cases.While at 3rd and 6th month after treatment,high-risk HPV negative rate in CIN2~3 cases were 73.17% and 90.85%,which were significantly lower than those in CIN1 cases,the difference was statistically significant.3） From the 12th monthafter treatment,there are still two cases of sustained high-risk HPV positive but normal with LCT and colposcopy biopsy.All cases are still strictly followed-up.Conclusion：After treatment,the negative rate and time of high-risk HPV concerned with the grade of the CIN;the patients with persistent positive high-risk HPV,but without abnormalities detected by LCT and colposcopy biopsy could continue to strictly follow up;LCT joint high-risk HPV detection is an effective clinical means for follow-up after CIN treatment.

关 键 词：宫颈上皮内瘤变 LCT 人乳头瘤状病毒 随访 

分 类 号：R737.33[医药卫生—肿瘤]