≥50岁女性子宫颈锥切术后ECC在预测HSIL及以上病变残留或复发中的作用  

Role of post conization ECC in predicting HSIL+ residue or recurrence lesion in women aged 50 years and older

作　　者：毕蕙[1] 米兰[1] 徐子杰 张岱[1] BI Hui;MI Lan;XU Zijie;ZHANG Dai(Department of Obstetric and Gynecology,Peking University First Hospital,Beijing 100034,China;不详)

机构地区：[1]北京大学第一医院妇产科,100034 [2]北京市朝阳妇幼保健院

出　　处：《中国妇产科临床杂志》2022年第2期127-130,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨≥50岁子高级别鳞状上皮内病变(HSIL)及以上病变(HSIL+)患者子宫颈锥切术后宫颈管搔刮术(ECC)在预测HSIL+残留/复发中的作用。方法回顾性分析2013年1月至2019年12月在北京大学第一医院≥50岁行子宫颈锥切术,且在锥切术后行ECC,并有至少6个月随访结果的151例患者的临床资料,分析锥切术后ECC预测HSIL+残留/复发的作用。结果 151例患者中,锥切术后HSIL+残留/复发率为13.91%(21/151),其中切缘阴性者为7.27%(8/110),切缘阳性者为31.71%(13/41),二者比较,差异有统计学意义(P=0.00);锥切术后ECC阴性患者HSIL+残留/复发率为6.35%(8/126),阳性患者为52.00%(13/25),二者比较,差异有统计学意义(P=0.00);在切缘及锥切术后ECC双阴性患者、任一阳性患者、双阳性患者中HSIL+残留/复发率分别为4.00%(4/100)、22.22%(8/36)和60.00%(9/15),三者比较,差异有统计学意义(P=0.00)。在切缘阴性及切缘阳性患者中,锥切术后ECC阴性与阳性者HSIL+残留/复发率比较,差异均有统计学意义(P=0.00及P=0.01);在锥切术后ECC阴性及阳性者中,切缘阴性与阳性者HSIL+残留/复发率比较,差异均无统计学意义(P=0.06及P=0.43)。结论≥50岁女性子宫颈HSIL锥切术后ECC阳性者中HSIL+残留/复发风险极高,应加强管理。Objective To investigate the role of post conization ECC in predicting residue/recurrence of HSIL+in patients aged≥50 years old.Methods The clinical data of 151 patients aged≥50 years old who underwent cervical conization in Peking University First Hospital from January 2013 to December 2019 were analyzed retrospectively,and the results of at least 6 months follow-up were analyzed,and the role of post conization ECC in predicting HSIL+residue/recurrence was analyzed.Results The residue/recurrence rate was 13.91%(21/151) after cervical conization.The residue/recurrence rate of HSIL+was 7.27%(8/110) in patients with negative margin and31.71%(13/41) in patients with positive margin,which was statistically significant (P=0.00).After conization,the residue/recurrence rate of HSIL+was 6.35%(8/126) in ECC negative patients and 52.00%(13/25) in ECC positive patients,which was statistically significant (P=0.00).The residue/recurrence rates of HSIL+were 4.00%(4/100),22.22%(8/36)and 60.00%(9/15) in both ECC and margin negative,any positive and both positive patients respectively,with statistical difference (P=0.00).In those with negative and positive margins,the residue/recurrence rate of HSIL+in ECC negative and positive patients was significantly different (P=0.00 and P=0.01).Among those with negative and positive post conization ECC,there was no significant difference in HSIL+residue/recurrence rate between margin negative and positive patients (P=0.06 and P=0.43).Conclusion The risk of HSIL+residue/recurrence in post conization ECC positive women over 50 years old is extremely high,management should be strengthened.

关 键 词：高龄女性 子宫颈锥切术 宫颈管搔刮术 宫颈上皮内病变 病变残留/复发 

分 类 号：R713.4[医药卫生—妇产科学]