影响改良冷刀宫颈锥形切除术后宫颈上皮内肿瘤残留/复发因素分析  

Analysis of the affecting factors of residual/recurrence of cervical intraepithelial neoplasia after modified cold knife conization

作　　者：简萍 马丽丽[1] 贺笑茜 魏雅娜 石伟奇 JIAN Ping;MA Lili;HE Xiaoqian;WEI Yana;SHI Weiqi(Daxing District People's Hospital, Beijing, 102600)

机构地区：[1]北京市大兴区人民医院,102600

出　　处：《中国计划生育学杂志》2021年第12期2692-2695,共4页Chinese Journal of Family Planning

摘　　要：目的:探究影响改良冷刀宫颈锥形切除术(CKC)后宫颈上皮内肿瘤(CIN)残留/复发的可能因素。方法:回顾性分析2019年1月-2020年6月在本院行改良CKC治疗的153例患者病历资料,完成随访1年,根据术后残留/复发情况分为存在残留/复发组或非残留/复发组。比较两组患者年龄、颈管累及、腺体累及、绝经情况、性伴侣数、腺体累及、CIN分级、人乳头瘤病毒(HPV)术前术后阳性情况,分析CIN术后残留/复发影响因素。结果:随访1年,153例患者术后残留4例(2.6%)\复发12例(7.9%),未残留/复发137例(89.5%)。因素分析,术后CIN残留/复发与患者年龄、颈管累及、绝经、性伴侣数、是腺体累及、CIN分级、术前术后HPV阳性等有关(P<0.05),与象限累及个数无关(P>0.05)。结论:针对改良CKC术后CIN残留/复发的危险因素应采取相应预防措施,提高手术治疗效果。Objective:To investigate the affecting factors of residual/recurrence of cervical intraepithelial neoplasia(CIN)after modified cold knife conization(CKC).Methods:The data from the medical records of 153 patients who underwent modified CKC from January 2019 to June 2020 were analyzed retrospectively,and all enrolled subjects had been followed up for 1 year.These patients were divided into two groups according to their postoperative residual/recurrence situation of CIN after modified CKC.The patients with residual/recurrence of CIN were in group A and the patients without residual/recurrence of CIN were in group B.Age,CIN involvement situation of cervical canal,CIN involvement quadrant of Cervix uteri,menopausal status,number of sexual partners,CIN glandular involvement status,CIN grade,preoperative human papillomavirus(HPV)infection,and postoperative HPV infection of the patients were compared between the two groups.Multifactorial logistic regression was used to analyze the factors influencing the residual/recurrence after CKC of CIN.Results:After the followed up for 1 year of 153 patients,there were 4(2.6%)cases with postoperative residue of CIN,12(7.9%)cases with recurrence of CIN,and 137(89.5%)cases without residue/recurrence of CIN.Univariate analysis showed that postoperative CIN residual/recurrence was associated with the age of the patients,and the situations of CIN cervical canal involvement,menopause,number of sexual partners,CIN involvement of cervical canal gland,CIN grade,preoperative and postoperative HPV infection of the patient(P<0.05),but was not associated with the CIN involvement situation of cervical canal quadrant(P>0.05).Conclusion:The corresponding preventive measures should be taken based on these independent risk factors of the residual/recurrence of CIN to improve the effect of modified CKC.

关 键 词：宫颈上皮内肿瘤 改良冷刀宫颈锥形切除术 残留 复发 影响因素 

分 类 号：R737.33[医药卫生—肿瘤]