宫颈上皮内瘤变LEEP预后与HPV感染的关系及影响因素分析  

Analysis of the relationship between the prognosis of cervical intraepithelial neoplasia and HPV infection and its influencing factors

作　　者：孙晓静[1] 杨志海[1] 石红[1] Sun Xiaojing;Yang Zhihai;Shi Hong(Department of Obstetrics and Gynecology,The FirstAffiliated Hospital of Dalian Medical University,Dalian,Liaoning,116011,China)

机构地区：[1]大连医科大学附属第一医院妇产科,辽宁大连116011

出　　处：《当代医学》2019年第10期41-44,共4页Contemporary Medicine

摘　　要：目的分析宫颈上皮内瘤变LEEP预后与HPV感染的关系及影响因素情况。方法选择2014年5月至2017年5月本院妇产科门诊就诊的92例CINⅠ～Ⅲ患者为研究对象,受试者均开展LEEP手术,分析其预后和HPV感染关系以及影响因素情况。结果在92例患者中,共计17例为阴性,HPV16 25例,HPV18 12例,低危1例,其他高危23例,未分类14例。在接受LEEP手术之后,共计73例获得随访资料。HPV18型8例,HPV16型20例,其他高危型20例,阴性12例,未分类13例。HPV18型以及HPV16型以及HPV阴性者手术切缘阴性和阳性组内分布情况比较差异有统计学意义(P<0.05)。HPV 18感染组内的手术切缘阳性者发生率最高,详细为62.50%。其次为:HPV 16感染组45.00%,其他高危组30.00%,未分组23.08%,HPV阴性组8.33%。经单因素结果分析证实:术后切缘阳性者的预后情况比阴性者好(P<0.05)。HPV基因型组间患者LEEP术后预后比较差异有统计学意义(P<0.05)。多因素结果分析证实:手术切缘为CIN患者LEEP术后独立风险因素(P<0.05)。结论 HPV基因型和患者的CIN严重水平存在关联性,实施HPV筛查,方便为宫颈病变提供早期预后判断。HPV基因型引起患者术后阳性率存在差异,以HPV 18患者手术切缘阳性率较高,所以,感染HPV18型CIN术后更需要仔细追踪。Objective To analyze the relationship between the prognosis of cervical intraepithelial neoplasia and HPV infection and the influencing factors. Methods A total of 92 CIN i-iii patients admitted to our hospital from May 2014 to May 2017 were selected as subjects. All subjects performed LEEP surgery to analyze their relationship with HPV infection and the influencing factors. Results Of the 92 patients, a total of 17 were negative, including 16 cases of HPV16, 25 cases of HPV18, 12 cases of HPV18, 1 case of low risk, 23 cases of medium risk and 14 cases not classified. After LEEP surgery, a total of 73 patients were followed up. There were 8 cases of HPV type 18, 20 cases of HPV type 16, 20 cases of intermediate risk, 12 cases of negative, and 13 cases without classification. There were differences in the distribution of the positive and negative surgical margins between the negative and positive groups of HPV types 18 and 16 as well as the negative and positive groups (P<0.05). The incidence of surgical margins in the HPV 18 infection group was the highest, with a detailed 62.50%. The second group was: HPV 16 infection group 45.00%, mediumrisk type 30.00%, not grouping 23.08%, HPV negative group 8.33%. The results of univariate analysis indicated that the prognosis of the patients with positive postoperative margin was better than that of the patients with negative margin (P<0.05). There were significant differences in the LEEP postoperative prognosis among the patients with HPV genotype (P<0.05). Conclusion There is a correlation between the HPV genotype and the severe level of CIN in patients. HPV screening was performed to facilitate early prognosis judgment of cervical lesions. There is a difference in postoperative positive rate in patients caused by HPV genotype. The positive rate of surgical margin is higher in patients with HPV18, so the infection of HPV18 CIN after surgery should be more carefully tracked.

关 键 词：人乳头瘤病毒 宫颈上皮内瘤变 基因型 LEEP术 预后 

分 类 号：R737.33[医药卫生—肿瘤]