影响HSIL宫颈锥切除术后复发的相关性分析  

Correlation analysis of recurrence after HSIL cervical conization

作　　者：李静 张燕 王智宇 LI Jing;ZHANG Yan;WANG Zhiyu(Department of Gynecology,Yinchuan Maternal and Child Health Care Hospital,Yinchuan 750001,China)

机构地区：[1]宁夏银川市妇幼保健院妇科,宁夏银川750001

出　　处：《宁夏医学杂志》2021年第1期28-31,共4页Ningxia Medical Journal

摘　　要：目的研究高级别子宫颈鳞状上皮内病变(HSIL)患者子宫颈锥切术后人乳头状瘤病毒(HPV)感染随访观察对复发风险评估。方法回顾性分析子宫锥切术的90例HSIL患者临床资料,按照2组6个月内随访情况将其分为复发组(术后6个月随访期间内出现细胞学异常,且组织学证实有HSIL患者)22例和未复发组(术后6个月随访期间内复查细胞学正常,且经组织学检查无异常)68例,比较2组患者年龄、产次、是否绝经、HPV病毒载量、腺体是否累及、切缘是否阳性、随访3个月及6个月高危型HPV阳性情况、是否为可疑浸润癌等临床指标,将2组有差异信息纳入Logistic回归分析模型,进行量化赋值明确HSIL子宫颈锥切术后复发的危险因素。结果复发组HPV病毒载量>100、切缘阳性、随访3个月高危型HPV阳性、随访6个月高危型HPV阳性患者比例显著高于未复发组,差异有统计学意义(P<0.05)。经Logistic回归性分析证实,HPV病毒载量>100、切缘阳性、随访3个月高危型HPV阳性、随访6个月高危型HPV阳性是HSIL子宫颈锥切术后复发的危险因素。结论HPV病毒载量>100、切缘阳性、随访3个月/6个月高危型HPV阳性可以预测HSIL患者复发风险。Objective To study the value of follow-up observation of human papillomavirus(HPV)infection in patients with advanced cervical squamous intraepithelial lesions(HSIL)after cervical conization for risk assessment of recurrence.Methods The clinical data of 90 patients with HSIL who underwent conization of uterus were retrospectively analyzed.According to the follow-up within 6 months,the two groups were divided into recurrent group(cytological abnormality occurred during the follow-up of 6 months after operation,and histologically confirmed HSIL patients,n=22)and non-recurrent group(detailed follow-up within 6 months after operation).The cytology was normal and no abnormality was found by histological examination(n=68).The age,parity,menopause,HPV load,involvement of glands,positive cutting edge,3-month and 6-month follow-up of high-risk HPV,suspected invasive cancer and other clinical indicators were compared between the two groups.The risk factors of recurrence after HSIL cervical conization were determined by quantitative evaluation.Results The proportion of high-risk HPV patients in recurrence group was higher than that in non-recurrence group(P<0.05).Logistic regression analysis confirmed that the risk factors of recurrence after cervical conization were HPV load>100,positive cutting edge,positive high-risk HPV at 3 months follow-up and positive high-risk HPV at 6 months follow-up.Conclusion HPV load>100,positive margin and follow-up of 3/6 months have high value in predicting the risk of recurrence in patients with HSIL.

关 键 词：高级别子宫颈鳞状上皮内病变 人乳头状瘤病毒 子宫颈锥切术 

分 类 号：R737.31[医药卫生—肿瘤]