摘要
目的：探讨检测高危型人乳头状瘤病毒（HPV）对评估宫颈电圈切除术（LEEP）治疗宫颈上皮内瘤样病变（ON）预后的意义。方法：对560例经阴道镜下宫颈活检证实为CIN的患者进行LEEP治疗，治疗后随访1年．检测治疗前后高危型HPV的负荷量，对病灶持续存在或复发等情况进行回顾性分析总结。结果：术前病理为CINⅠ、CINⅡ和CINⅢ的三组患者，其高危型HPV感染率分别为32．63％、90．85％和98．13％。前组（低度宫颈上皮内瘤样病变组）与后两组（高度宫颈上皮内瘤样病变组）高危型HPV感染率差异均有统计学意义（P〈0．001），高危型HPV感染率随宫颈病变严重程度的加重而上升。术后6个月CINⅠ、CINⅡ、CINⅢ三组患者高危型HPV感染率分别为2．54％、12．80％和25．23％，术后1年三组患者高危型HPV感染率分别为0．88％、9．15％和22．43％，与术前比较，三组高危型HPV感染率均显著下降（P〈0．001）；CINⅠ、CINⅡ、CINⅢ三组患者术后的病变持续存在率分别为1．69％、6．71％和12．15％，复发率分别为0、7．32％和10．28％．前组与后两组术后病变的持续存在率和复发率差异存在显著性（P〈0．001），术后高危型HPV持续阳性可提示病变的持续存在或复发。结论：LEEP能显著降低CIN患者高危型HPV感染率，有效治疗宫颈上皮内瘤样病变．术后检测高危型HPV病毒负荷量能判断疾病预后。
Objective To explore the significance of detecting high-risk human papillomavirus （HPV） for evaluating the prognosis of cervical intraepithelial neoplasia （CIN） after loop electrosurgical excisional procedure （LEEP）. Methods LEEPwas performed on 560 women with CIN confirmed by cervical biopsy. Loading dose of HPV before and after LEEP was detected. All the patients were followed 1 year. The persistence or recurrence of the lesions was reviewed. Results Before LEEP, the rate of high-risk HPV infection was 32.63% in CIN Ⅰ patients, 90.85% in Ⅱ , and 98.13% in Ⅲ and differed significantly between the CIN I group （low-grade squamous intraephhellal lesions） and the other two groups （high-grade squamous intraephhellal lesions） （P 〈 0.001 ）. The rate of high-risk HPV infection elevated with aggravation of the cervical disease. 6 months after LEEP, the infection rate was 2.54%, 12.80% , and 25.23%, respectively. And it was 0.88%, 9.15%, and 22.43% 1 year later. The infection rate declined significantly in all the three groups after LEEP （P 〈 0.001 ）. The persistence rate of the lesions was 1.69%, 6.71%, and 12.15%, and the recurrence rate was 0%, 7.32%, and 10.28% in the three groups, respectively. A significant difference was observed between CIN I group and the other two groups （P 〈 0.001 ）. Persistent HPV infection suggested persistence or recurrence of the disease. Conclusions Loop electrosurgical excisional procedure can significantly decrease the rate of high-risk HPV infection rate and is an effective method for CIN. High-risk HPV detection after LEEP is an available approach for evaluating prognosis.
出处
《实用医学杂志》
CAS
北大核心
2010年第13期2308-2310,共3页
The Journal of Practical Medicine
关键词
宫颈上皮内瘤样病变
电圈切除术
高危型人乳头状瘤病毒
loop electrosurgical excisional procedure
cervical intraepithelial neoplasia
high-risk human papillomavirus
