CIN3宫颈环形电切术后病变残留与复发的相关因素分析  

Analysis of factors relevant to residual disease and recurrence post CIN3 loop electrosurgical excision procedure

作　　者：朱红云 宋梅 周洪英 王军 秦秀英 Zhu Hongyun;Song Mei;Zhou Hongying;Wang Jun;Qin Xiuying(Yizheng People’s Hospital,Yizheng 211400,China)

机构地区：[1]仪征市人民医院,江苏仪征211400

出　　处：《甘肃医药》2019年第12期1057-1060,共4页Gansu Medical Journal

摘　　要：目的:探讨宫颈上皮内瘤变(CIN)宫颈环形电切术后病变残留与复发的相关危险因素。方法:回顾性分析仪征市人民医院2016年1月至2018年12月因CIN3而行宫颈锥形切除术(LEEP)的190例患者,其中125例LEEP术后选择子宫切除术,65例选择密切随访。对190例患者年龄、症状、HPV感染、LEEP方法、LEEP术后宫颈上皮腺体累及、LEEP术后切缘进行病变残留或复发相关因素分析。结果:190例CIN3患者HPV感染率为90%,病变残留率为18.42%,宫颈上皮腺体累及率为83.68%。单因素分析显示,CIN3宫颈环形电切术后病变残留与LEEP术后切缘阳性、LEEP手术方法、患者术前症状、年龄有关,与HPV感染、宫颈上皮腺体受累无关。多因素Logistic回归分析显示,症状、手术方法、LEEP术后切缘是病变残留与复发的危险因素。结论:CIN3 LEEP术切缘阳性、LEEP1圈法、术前即有症状是LEEP术后病变残留的高危因素。Objective:To investigate the risk factors of residual lesion and recurrence following CIN3 after loop electrosurgical excision procedure(CIN3).Methods:Statistical data from 190 hospitalized patients that received the LEEP treatment from January 2016 to December 2018 at Yizheng people’s hospital were collected,of which 125 patients were subjected to hysterectomy and the rest 65 individuals accompanied by close follow-up following LEEP.Six factors including age,symptom,HPV infection,LEEP,cervix uteri epithelium gland involvement and incisal edge relevant to residual disease and recurrence post LEEP were analyzed.Results:In terms of the 190 samples,HPV infection rate amounts to 90%(171/190),lesion remaining rate accounts for 18.42%(35/190),and circa 159 individuals suffered from cervix uteri epithelium gland involvement,up to 83.68%.The single factor analysis showed that post CIN3 LEEP,positive incisal edge,surgical methods,symptoms before operation as well as patients’age were involved in the residual disease,which the HPV infection and gland involvement did not implicate.Multivariate logistic regression analysis further demonstrated that aside from the incisal edge,surgical methods and symptoms were risk factors responsible for residual disease and recurrence.Conclusion:One-loop LEEP,pre-operation symptoms,positive incisal edge post operation are the three primary risk factors eliciting residual disease and recurrence post CIN3 LEEP,especially the top three.

关 键 词：宫颈上皮内瘤变 CIN3 宫颈锥切术 LEEP术 切缘残留 

分 类 号：R737.33[医药卫生—肿瘤]