高度宫颈上皮内瘤变行宫颈电热圈环切术治疗后随访时的检测方法  

Detection method during follow-up of patients with high-grade cervical intraepithelial neoplasia after treatment with loop electrosurgical excision procedure

作　　者：丘瑾[1] 钱春妹[1] 陈玉英[1] 秦锦龙[1] 杨志勇[1] 吴逸[1] 

机构地区：[1]同济大学附属第十人民医院妇产科,上海200072

出　　处：《上海医学》2010年第7期631-635,共5页Shanghai Medical Journal

摘　　要：目的探讨高度宫颈上皮内瘤变(CIN)在经宫颈电热圈环切术(LEEP)治疗后随访时的检测方法。方法 50例高度CIN患者在LEEP治疗后完成了12～36个月的随访,比较液基薄层细胞学检测(TCT)、高危人乳头瘤病毒(HR-HPV)检测及P16ink4a过表达检测在随访中的价值。结果随访发现高度CIN患者的治愈率为88.0%。术后TCT结合HR-HPV检测可发现所有复发患者。HR-HPV检测在随访中检测CIN的敏感度(100.0%)高于P16ink4a过表达检测(33.3%),但特异度(75.6%)稍低于后者(88.2%)。结论 HR-HPV检测结合TCT对高度CIN患者而言是一种有效的随访手段,P16ink4a过表达检测能提高其特异性。Objective To investigate whether human papilloma virus （HPV） testing and P16ink4a overexpression can be used to predict residual/recurrent disease like repeat cytological test during follow-up of high-grade cervical intraepithelial neoplasia （CIN） after treatment by loop electrosurgical excision procedure （LEEP）. Methods Fifty women with CINⅡ-CINⅢ who had been treated by LEEP were followed up for 12-36 months. Values of repeated cytology as well as high-risk HPV testing and P16ink4a immunostaining were analyzed during follow-up as screening tools for recurrence. Results The overall curative rate was 88.0% in this study. Combination of HR-HPV detection and repeated cytology was used during follow-up to detect all patients with residual/recurrent disease. HR-HPV detection showed higher sensitivity （100.0% vs. 33.3%） and a lower specificity （75.6% vs. 88.2%） than P16 ink4a overexpression.Conclusion HR-HPV test combined with thinprep-liquid-based cytological test （TCT） is an effective follow-up method for patients with high-grade CIN after LEEP treatment; detection of P16ink4a overexpression can improve the specificity of HR-HPV test.

关 键 词：宫颈上皮内瘤变 随访 液基薄层细胞学检测 人乳头瘤病毒 宫颈电热圈环切术 

分 类 号：R737.33[医药卫生—肿瘤]