摘要
目的：对高危型HPV检测如何应用于宫颈癌癌前病变的随访进行探索,比较不同方法治疗宫颈病变患者的临床效果,为临床治疗提供依据。方法：选取在我院进行治疗的高危型HPV阳性、通过组织病理学进行确诊的宫颈癌变患者360例,按照患者病变的程度对其进行分组,一组为低度鳞状上皮内瘤变（LSIL）,其中包括炎症和CINⅠ的患者;高度鳞状上皮内瘤变（HSIL）,其中包括CINⅡ-Ⅲ的患者;宫颈CIN-III的患者（没有生育要求、年龄偏大者）。对于病变≥CINⅡ或者CINⅠ中没有随访条件的患者采取手术治疗,在治疗的第3、6、9、12、18、24个月进行随访,随访时均采取HPV、细胞学检查,并且有必要可以进行活检。结果：所有患者采取不同的治疗方式,其中干扰素栓治疗120例,宫颈锥切术治疗193例,全子宫切除术治疗47例,不同的治疗方式的HPV转阴率之间具有统计学意义上的差异。所有患者中,年龄≤35岁的患者的HPV转阴率为91.35%,年龄为35~50之间的患者的HPV转阴率为90.31%,年龄〉50岁的患者HPV转阴率为76.54%,并且其之间差异具有统计学意义（P〈0.05）。HPV不同程度载量组之间的差异没有统计学意义（P〉0.05）。三组治疗之后的转阴时间的中位数分别是7、7、4个月,其差异具有统计学意义（P〈0.05）。321例HPV转阴的患者都没有发现病变的残留并且均未复发。结论：高危型HPV检测对于不同程度的宫颈病变的随访有着重要的价值。本次研究所采取的不同治疗的方法可以有效清除宫颈病变并且治疗HPV感染,其中干扰素栓的治疗效果要比其余两种治疗方式差。在治疗之后患者如果HPV继续保持阳性说明患者有病变残留或者复发。
Objectives：To explore how to apply high -risk HPV detection in the follow -up of cervical precancer,and compare the clinical effect of different treatment methods of cervical lesions,to provide basis for clinical treatment.Methods：360 high -risk HPV -positive patients that have been confirmed through histopatholo-gy in our hospital were selected and according to the degree of lesion were divided into three groups：low -grade squalors intraepithelial lesions （LSIL）group,including patients with inflammation and CINⅠ;high -grade squal-ors intraepithelial lesions （HSIL）group,including CINⅡ -Ⅲ patients;and cervical CIN -III patients.Patients with lesions CINⅡ or no follow -up conditions for CINⅠ received surgery,and were followed up at the 3,6,9, 12,18,24 month after treatment by HPV,cytology and biopsy when necessary.Results：All patients received differ-ent treatments,including interferon treatment of 120 cases,conization treatment of 193 cases,hysterectomy treat-ment of 47 cases,with statistically significant difference in HPV negative rates between different treatment methods. For patients aged 35 -year -old,between the age of 35 -50,and 〉50 years old,the HPV negative rate was 91.35%,90.31% and 76.54% respectively,with statistically significant difference （P 〈0.05）.The difference in different levels of HPV load was not statistically significant （P 〉0.05）.The median clearance time of the three groups after treatment was 7,7,4 months respectively,with statistically significant difference （P 〈0.05）.All the 321 HPV negative patients found no residual lesions and no recurrence.Conclusions：High -risk HPV detection is of important value for follow -up of cervical lesions with varying degrees.Different treatment methods in this study can be taken to effectively remove HPV infection in cervical lesions and for treatment,where the interferon treatment effect is worse than the rest two treatment methods.If the patient is still HPV positive after treatment,there is resid-ual lesion or recurrence potential.
出处
《中国性科学》
2015年第9期40-43,共4页
Chinese Journal of Human Sexuality
关键词
高危型HPV检测
宫颈病变
转阴率
随访
High -risk HPV detection
Cervical lesions
Negative rate
Follow -up
