宫颈上皮内瘤变宫颈锥切术后复发的影响因素分析  

Analysis of Influencing Factors of Recurrence After Cervical Conization of Cervical Intraepithelial Neoplasia

作　　者：彭雪琴 PENG Xueqin(Department of Obstetrics and Gynecology,Yongfeng County People's Hospital,Yongfeng 331500,Jiangxi,China)

机构地区：[1]永丰县人民医院妇产科,江西永丰331500

出　　处：《医学信息》2025年第5期136-139,共4页Journal of Medical Information

摘　　要：目的分析高级别宫颈上皮内瘤变患者宫颈锥切术后复发的影响因素。方法选取2020年1月-2023年8月永丰县人民医院收治的120例宫颈上皮内瘤变患者为研究对象,所有患者均行宫颈液基细胞检查、HPV基因型检测、阴道镜病理活检,并于宫颈锥切术后随访。比较不同分级宫颈上皮内瘤变患者高危型HPV感染率和感染类型,以及高危型HPV感染与低危型HPV感染患者宫颈锥切术后HPV转阴率;另采用多因素Logistic回归分析宫颈上皮内瘤变患者宫颈锥切术后复发的危险因素。结果120例宫颈上皮内瘤变患者中,59例患者为高危型HPV阳性,主要为HPV16、HPV18、HPV52、HPV58四种高危型HPV类型,不同分级宫颈上皮内瘤变患者高危型HPV感染类型比较,差异无统计学意义(P>0.05),但宫颈上皮内瘤变级别越高,高危型HPV感染率越高(P<0.05);高危型HPV感染的宫颈上皮内瘤变患者宫颈锥切术后转阴率低于低危型HPV感染患者(P<0.05);在随访期间,60例患者复发,复发的宫颈上皮内瘤变患者与未复发的宫颈上皮内瘤变患者在年龄、绝经、宫颈锥切术前HPV感染类型、宫颈上皮内瘤变分级、腺体累及和宫颈锥切术后HPV持续感染比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,宫颈上皮内瘤变3级、腺体累及、宫颈锥切术前高危型HPV感染和宫颈锥切术后高危型HPV持续感染是宫颈上皮内瘤变复发的独立影响因素。结论宫颈上皮内瘤变宫颈锥切术后复发与宫颈上皮内瘤变级别、腺体累及、宫颈锥切术前高危型HPV感染和宫颈锥切术后高危型HPV持续感染密切相关,针对存在上述影响因素的患者,宫颈锥切术后应加强随访。Objective To analyze the influencing factors of recurrence after cervical conization in patients with high-grade cervical intraepithelial neoplasia.Methods A total of 120 patients with cervical intraepithelial neoplasia admitted to Yongfeng County People's Hospital from January 2020 to August 2023 were selected as the research objects.All patients underwent cervical liquid-based cell examination,HPV genotype detection,colposcopy pathological biopsy,and were followed up after cervical conization.The infection rate and type of high-risk HPV in patients with different grades of cervical intraepithelial neoplasia,and the negative rate of HPV after cervical conization in patients with high-risk HPV infection and low-risk HPV infection were compared.Multivariate Logistic regression analysis was used to analyze the risk factors of recurrence after cervical conization in patients with cervical intraepithelial neoplasia.Results Among 120 patients with cervical intraepithelial neoplasia,59 patients were positive for high-risk HPV,mainly HPV16,HPV18,HPV52,HPV58 four high-risk HPV types.There was no significant difference in high-risk HPV infection types in patients with different grades of cervical intraepithelial neoplasia(P>0.05),but the higher the grade of cervical intraepithelial neoplasia,the higher the infection rate of high-risk HPV(P<0.05).The negative conversion rate of patients with high-risk HPV infection after cervical conization was lower than that of patients with low-risk HPV infection(P<0.05).During the follow-up period,60 patients relapsed,there were significant differences in age,menopause,type of HPV infection before cervical conization,grade of cervical intraepithelial neoplasia,gland involvement and persistent HPV infection after cervical conization between patients with recurrent cervical intraepithelial neoplasia and patients without recurrent cervical intraepithelial neoplasia(P<0.05).Multivariate Logistic regression analysis showed that cervical intraepithelial neoplasia grade 3,glandular involvemen

关 键 词：高级别宫颈上皮内瘤变 宫颈锥切术 高危型HPV感染 HPV转阴率 

分 类 号：R737.3[医药卫生—肿瘤]