| 刘植华,刘小玲,陈国斌.子宫颈环型电切术治疗子宫颈上皮内[J].中国肿瘤,2015,24(12):993-997. |
| 子宫颈环型电切术治疗子宫颈上皮内 |
| Study of Curative Effect of Loop Electrosurgical Excision Procedure on Intraepithelial Neoplasia |
| 投稿时间：2015-08-28 |
| DOI：10.11735/j.issn.1004-0242.2015.12.A007 |
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| 中文关键词: 子宫颈上皮内瘤变 子宫颈环形电切术 治疗效果 |
| 英文关键词:cervical intraepithelial neoplasia loop electrosurgical excision procedure curative effect |
| 基金项目:深圳市科创委基础研究项目（JCYJ20130402094702481） |
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| 摘要点击次数: 2015 |
| 全文下载次数: 870 |
| 中文摘要: |
| 摘 要：［目的］ 分析子宫颈环型电切术（LEEP）治疗子宫颈上皮内瘤变（CIN）的疗效及其影响因素、术后随访时机，为LEEP规范化治疗CIN提供科学依据。［方法］ 选择2009年6月至2010年12月在深圳市妇幼保健院因CIN行LEEP治疗病例1535例作为研究对象，并在术后随访2年，观察LEEP治疗效果。［结果］ 1535例患者中排除确诊为浸润癌的13例患者，随访2年时间共1297例，随访率为85.2%（1297/1522），其中持续存在或复发35例（含浸润癌1例），病变持续存在或复发率2.7%；治愈1262例，治愈率97.3%。术后切缘阳性组病变持续存在或复发率明显高于阴性组（P＜0.01）。术前HPV16/18亚型感染患者LEEP治疗失败风险是其他亚型感染患者的3.383倍。术后第6个月HR-HPV载量≥1.0×105 copies/ml的患者病变持续存在或复发率明显高于< 1.0×105 copies/ml者（OR=23.851，P＜0.01）。术后第6个月HR-HPV阳性率和细胞学检查阳性率明显下降，较术后第3个月明显降低 (P<0.05)，与术后6个月后的HR-HPV阳性率和细胞学检查阳性率无统计学差异(P>0.05)。［结论］ LEEP治疗CIN的治愈率较高，并发症的发生率相对较低；切缘阳性、HPV16/18亚型感染、术后第6个月HR-HPV载量≥1.0×105 copies/ml是本组研究对象LEEP治疗后子宫颈上皮内瘤变持续存在或复发的影响因素；LEEP治疗后6个月是评价疗效的起始时间。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the effect of LEEP treatment for CIN，its influencing factors and postoperative follow-up time to provide scientific basis for LEEP standardized treatment of CIN. ［Methods］ A total of 1535 cases with CIN underwent LEEP treatment were followed for 2 years to research the effect of LEEP treatment during June 2009 to December 2010 in Shenzhen Maternity & Child Healthcare Hospital. ［Results］ 13 patients with invasive carcinoma were excluded in 1535 cases，1297 cases (accounted for 85.2%) were followed-up. The rate of cases with persistence or recurrent lesions(including 1 case of invasive carcinoma) was 2.7%(35/1297).The cure rate was 97.3% (1262/1297). There were significant difference between groups with positive margins and negative margins (OR=9.306，95% CI：4.440～19.505，P＜0.01)，between patients with HPV 16/18 and those with other HPV genotypes before LEEP treatment (OR=3.383，95%CI：1.414~8.091，P=0.003)，and between observers with a high-risk human papillomavirus (HR-HPV) DNA viral load ≥1.0×105 copies/ml and those with a viral load of ≤1.0×105copies/ml (OR=23.851，P<0.01) . The HR-HPV-positive rate and the cytology-positive rate were significantly differed between the post-LEEP treatment groups at the third and sixth months(P<0.05). ［Conclusion］ The cure rate of LEEP treatment for CIN is high. Positive margins，HPV 16/18 infection，and HR-HPV DNA viral load ≥1.0×105 copies/ml at the sixth month are risk factors for persistence or recurrent lesions. Gurative effect analysis starts from the six months after LEEP treatment. |
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