宫颈高级别鳞状上皮内病变患者LEEP手术后复发的相关因素分析  

Analysis of related factors of recurrence of cervical high-grade squamous intraepithelial lesion after loop eletrosurgical excision procedure

作　　者：王玲伟[1] 王秀秀 柴泽英[1] WANG Lingwei;WANG Xiuxiu;CHAI Zeying(Department of Gynecology,Taizhou Municipal Hospital of Zhejiang Province.Zhejiang Taizhou 317000,China)

机构地区：[1]浙江省台州医院妇科,浙江台州317000

出　　处：《中国妇幼健康研究》2020年第7期965-968,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的 探讨宫颈高级别鳞状上皮内病变(HSIL)患者环形电极切除(LEEP)手术后复发的相关因素.方法 选取2014年1月至2016年12月在浙江省台州医院妇产科门诊因HSIL行LEEP手术的患者310例为研究对象,根据随访6~24个月是否复发分为复发组(15例)和未复发组(295例),比较两组患者的临床资料,并采用多因素Logistic回归分析HSIL患者LEEP手术后复发的影响因素.结果 310例患者行LEEP手术,复发者15例,复发率为4.84%,其中4例为随访6~12个月复发11例为随访13~24个月复发.复发组和未复发组患者年龄、性伴侣数、术前HPV感染、CIN分级、累积腺体、切缘阳性比较差异均有统计学意义(χ2值分别为4.278、7.420、5.823、14.706、6.393、4.047,均P<0.05),而两组患者孕次、产次、LEEP术(椎体高度、锥底宽度、锥切周长)比较差异无统计学意义(t值分别为0.897、0.908、0.317、0.573、0.336,均P>0.05),绝经状态比较差异无统计学意义(χ2=1.941,P>0.05).Logistic回归分析显示年龄(≥40岁)、性伴侣数(>1)、术前HPV阳性、CIN分级(≥2级)、累积腺体、切缘阳性是宫颈HSIL患者LEEP手术后复发的危险因素(OR值分别为1.908、1.976、3.332、2.993、3.112、2.167,均P<0.05).结论 高龄、性伴侣数多、术前HPV阳性、CIN≥2级、累积腺体、切缘阳性是宫颈HSIL患者LEEP手术后复发的危险因素,在临床中要引起足够的重视,以降低复发风险.Objective To investigate related factors of recurrence of cervical high-grade cervical squamous intraepithelial lesions(HSIL)after loop eletrosurgical excision procedure(LEEP)operation.Methods 310 patients with HSIL who underwent LEEP in gynecology and obstetrics clinic of Taizhou Municipal Hospital of Zhejiang Province from January 2014 to December 2016 were selected in this study.15 patients were divided into recurrence group and 295 patients were divided into no-recurrence group according to whether they had or not had recurrence of cervical HSIL during follow-up for 6 to 24 months.The clinical data of the patients in the two groups were compared,and the influencing factors of recurrence of cervical HSIL after LEEP were analyzed by multivariate logistic regression.Results 310 patients underwent LEEP surgery,of them 15 patients recurred and the recurrence rate was 4.84%.4 patients recurred at 6-12 months of follow-up,and 11 patients recurred at 13-24 months of follow-up.In age,number of sexual partners,preoperative HPV infection,CIN grade,cumulative glands and positive incisal margin,there were statistically significant differences between the recurrence group and no-recurrence group(χ~2=4.278,7.420,5.823,14.706,6.393 and 4.047 respectively,all P<0.05),but there were no statistically significant differences in gravidity,parity,vertebral body height,bottom width of the cone,cone cutting circumference in LEEP between the two groups(t=0.897,0.908,0.317,0.573 and 0.336 respectively,all P>0.05).Also,there was no significant difference in the postmenopausal status(χ~2=1.941,P>0.05).The multivariate logistic regression analysis results suggested that age≥40 years old,number of sexual partners>1,preoperative positive HPV,CIN classification≥2,cumulative glands and positive incisal margin were risk factors of postoperative recurrence of cervical HSIL after LEEP(OR=1.908,1.976,3.332,2.993,3.112 and 2.167 respectively,all P<0.05).Conclusion Elderly maternal age,having more sexual partners,preoperative positive HPV,CI

关 键 词：宫颈高级别鳞状上皮内病变 LEEP手术 复发 相关因素 

分 类 号：R737.33[医药卫生—肿瘤]