高危型HPV DNA检测在宫颈上皮内瘤变及宫颈早期鳞癌锥切术后随访中的应用及意义  

Application and significance of high risk HPV(HR-HPV) DNA testing in the follow-ups after cold knife conization in cervical intraepithelial neoplasia(CIN)and micro invasive cervical squamous cell cancer

作　　者：李岩[1] 崔竹梅[1] 娄艳辉[1] 刘丽芝[1] 唐蕊[1] 韩汶君[1] 

机构地区：[1]青岛大学医学院附属医院妇科,青岛266003

出　　处：《现代妇产科进展》2012年第8期600-603,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨高危型HPV(HR-HPV)DNA检测在宫颈上皮内瘤变(CIN)及宫颈鳞癌(ⅠA1期)患者经宫颈冷刀锥切术治疗后随访中的应用及意义。方法:2008年1月至2010年10月我院收治的308例CINⅡ～Ⅲ及宫颈鳞癌(ⅠA1期)患者经宫颈冷刀锥切术治疗后,采用第二代杂交捕获试验(HC2)检测HR-HPV DNA联合液基细胞学随访,观察术后HR-HPV清除及宫颈病变复发情况,并分析术后HR-HPV持续感染及病变持续或复发的相关因素。结果:至随访结束,宫颈锥切术后病变持续或复发者共10例。术后病变持续或复发在HR-HPV持续感染组中明显多于HR-HPV转阴组(P<0.001);术前HR-HPV DNA高负荷、病变累及3～4个象限为术后HR-HPV持续感染的高危因素;术前HR-HPV DNA≥500RIUs/CO是术后病变持续或复发的独立危险因素。结论:HR-HPV持续感染是宫颈锥切术后病变持续或复发的重要因素,术前HR-HPV DNA高负荷是术后HR-HPV持续感染及病变持续或复发的独立危险因素,术后应重点随访。Objective：To evaluate the application and significance of high risk HPV（HR-HPV） DNA detection in the follow-ups after cold knife conization（CKC）in cervical intraepithelial neoplasia（CIN）and cervical squamous cell cancer of Stage ⅠA1.Methods：A retrospective review was performed on 308 women who underwent of CINⅡ~Ⅲ and cervical squamous cell cancer of Stage ⅠA1 were treated by cold knife conization between Jan.2008 to Oct.2010 in our hospital.Then the patients were followed up by HR-HPV DNA testing（hybrid capture 2,HC2） and thin-layer liquid-based cytology（LCT）to observe the clearance of HR-HPV and recurrence of cervical lesions.The related factors of persistent infection of HR-HPV and persistent lesions or recurrence after CKC were analyzed.Results：By the end of follow-up,10 patients were evidenced persistent lesions or recurrence.The persistent lesions or recurrence were more likely to occur when the HR-HPV infection persisted（P0.001）.The pre-conization HR-HPV DNA high viral load and three-or four-quadrant disease involved were risk factors for predicting HR-HPV persistent infection after conization.HR-HPV DNA high viral load（RIUs/CO≥500）was the only significantly independent risk factor for the persistent lesions or recurrence after conization.Conclusion：HR-HPV persistent infection after conization is a significantly important factor of the persistent lesions or recurrence.The pre-conization HR-HPV DNA high viral load is the only significantly independent risk factor of HR-HPV persistent infection and the persistent lesions or recurrence.Patients with high viral load prior to conization should be closely followed.

关 键 词：宫颈肿瘤 宫颈上皮内瘤样病变 人乳头瘤病毒 高危型HPVDNA检测 宫颈锥切术 持续感染 病灶持续 复发 

分 类 号：R737.33[医药卫生—肿瘤]