基于Lasso-Logistic回归分析子宫颈高度鳞状上皮内病变锥切术后切缘阳性及病灶残留的影响因素  

Analysis of the influencing factors of the positive margins and residual lesions after conization for highgrade squamous intraepithelial lesions of the cervix based on Lasso-Logistic regression analysis

作　　者：杜素果 宋永祯 刘忠杰 赵宁 DU Suguo;SONG Yongzhen;LIU Zhongjie;ZHAO Ning(Department of Gynecology,People′s Hospital of Hengshui,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院妇科,河北衡水053000

出　　处：《中国性科学》2024年第10期96-100,共5页Chinese Journal of Human Sexuality

基　　金：2020年衡水市市级科技计划自筹项目(2020014077Z)。

摘　　要：目的探讨基于Lasso-Logistic回归分析子宫颈高度鳞状上皮内病变(HSIL)锥切术后切缘阳性及病灶残留的影响因素。方法选取2021年7月至2022年1月衡水市人民医院收治的160例子宫颈HSIL患者作为研究对象,均行宫颈锥切术治疗。根据是否存在锥切术后切缘阳性及病灶残留分为研究组(n=39)和对照组(n=121),术后切缘阳性或有病灶残留为研究组,术后切缘阴性为对照组。比较两组临床资料,采用Lasso-Logistic回归分析子宫颈HSIL患者锥切术后切缘阳性及病灶残留的影响因素。结果子宫颈HSIL患者锥切术后切缘阳性率为24.38%,切缘阳性患者中病灶残留率为48.72%。高危型人乳头瘤病毒(HR-HPV)、病变级别、累及象限、累及腺体、转化区类型、电切环形状、锥切深度、锥切宽度、锥切体积、接触性出血均为子宫颈HSIL锥切术后切缘阳性及病灶残留的独立影响因素(P<0.05)。结论HR-HPV、病变级别、累及象限、累及腺体、转化区类型、电切环形状、锥切深度、锥切宽度、锥切体积、接触性出血均为子宫颈HSIL患者锥切术后切缘阳性及病灶残留的影响因素,临床应结合相关影响因素优化治疗方案,以减少切缘阳性及病灶残留率。Objective To explore the influencing factors of positive margins and residual lesions after conization for high-grade squamous intraepithelial lesions(HSIL)of the cervix based on Lasso-Logistic regression analysis.Methods A total of 160 patients with cervical HSIL who were treated in Hengshui People′s Hospital from July 2021 to January 2022 were selected as the research objects,all of whom underwent cervical conization.Patients were divided into a study group(n=39)and a control group(n=121)based on the presence or absence of positive resection margins and residual lesions after conization.Patients with positive resection margins or residual lesions after surgery were included in the study group,while patients with negative resection margins after surgery were included in the control group.The clinical data of the two groups were compared,and Lasso-Logistic regression analysis was used to analyze the influencing factors of positive margins and residual lesions in patients with cervical HSIL after conization.Results The positive margin rate of cervical HSIL patients after conization was 24.38%,and the residual lesion rate in patients with positive margins was 48.72%.Highrisk-human papilloma virus(HR-HPV),lesion grade,involved quadrant,involved gland,type of transformation zone,shape of electrotomy ring,depth of conization,width of conization,volume of conization,and contact bleeding were all independent influencing factors of the positive margins and residual lesions after cervical HSIL conization(P<0.05).Conclusions HR-HPV,lesion grade,involved quadrant,involved gland,type of transformation zone,shape of electrotomy ring,depth of conization,width of conization,volume of conization,and contact bleeding are all influencing factors of the positive margins and residual lesions after conization in patients with cervical HSIL.Clinical treatment should be optimized based on the relevant factors to reduce the positive margins and residual lesion rates.

关 键 词：子宫颈 高度鳞状上皮内病变 宫颈锥切术 切缘阳性 病灶残留 

分 类 号：R711[医药卫生—妇产科学]