宫颈上皮内瘤变LEEP术后残留或复发相关因素分析  

Analysis on relevant factors of cervical intraepithelial neoplasia residual or recurrence after loop electrosurgical excision procedure

作　　者：龙馨[1] 杨君[1] 秦婷婷[1] 周德平[1] 

机构地区：[1]重庆市妇幼保健院妇科门诊/重庆市宫颈病特色专科,400013

出　　处：《重庆医学》2016年第3期372-374,共3页Chongqing medicine

摘　　要：目的分析宫颈环形电切术(LEEP)治疗宫颈上皮内瘤变(CIN)术后病变残留与复发的相关因素。方法选取2006年1月至2012年9月在该院经病理组织学诊断为CIN并行LEEP术的515例患者,追踪观察其术后随访情况,探讨术后病变残留或复发的相关因素。结果 (1)515例患者在经过至少2年的随访检查后发现有26例残留或复发,残留率为0.97%,复发率为4.08%。(2)残留或复发后整体病变程度有所减轻,但术前病变程度越高复发病变程度越重,呈正相关(r=0.354 0,P<0.05)。(3)年龄、是否吸烟、术前高危型人乳头瘤病毒(HR-HPV)负荷量、术后同一型别HPV是否持续感染、颈管是否累及、病变象限累及数目、术后TCT异常在复发组与未复发组比较,差异有统计学意义(P<0.05)。结论 CIN LEEP术后病变残留与复发受多因素影响,治疗方案应个性化。Objective To analyze relevant factors of cervical intraepithelial neoplasia residual or recurrence after loop electri- cal excision procedure（LEEP）. Methods We observed the patients who were histopathologically confirmed CIN and treated with LEEP in our hospital from January 2006 to September 2012, and investigated the postoperative residual and recurrence. Then we an- alysed relevant factors of residual or recurrence. Results （1）After at least 2 years of follow-up,26 cases showed residual or recur- rence（the residual rate was 0.97% and the recurrence rate was 4.08 %）. （2）Overall severity of residual or recurrence had been re duced, but the severity and recurrence of preoperative severity was positively correlated（r= 0.354 0, P〈0.05 ）. （3） Age, smoking, preoperative high-risk HPV load, post-operative the same type of HPV continuous infection, endocervical involvement,lesions in- volving quadrants,and post-operative TCT results between the recurrence group and non-recurrence group were statistically signifi- cant different（P〈0.05）. Conclusion CIN residual or recurrence after LEEP might be affected by many factors,and the treatment should be individualized.

关 键 词：宫颈上皮内瘤样病变 乳头状瘤病毒科 子宫颈 宫颈环形电切术 残留 复发 

分 类 号：R737.33[医药卫生—肿瘤]