| 郎妙双,马陈美.子宫颈锥切术后切缘阳性的高级别CIN患者病灶残余的相关因素研究[J].肿瘤学杂志,2015,21(2):123-127. |
| 子宫颈锥切术后切缘阳性的高级别CIN患者病灶残余的相关因素研究 |
| Analysis of Related Factors of Residual Lesions in the High-grade Cervical Intraepithelial Neoplasia Patients with Positive Margin After Conization |
| 投稿时间：2014-08-16 |
| DOI：10.11735/j.issn.1671-170X.2015.02.B010 |
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| 中文关键词: 宫颈上皮内瘤变 子宫颈锥切术 切缘阳性 |
| 英文关键词:cervical intraepithelial neoplasia conization positive margin |
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| 中文摘要: |
| 摘 要：［目的］ 探讨子宫颈锥切术后切缘阳性的高级别子宫颈上皮内瘤变（CIN）患者病灶残余的相关因素，为其进一步诊疗提供依据。［方法］ 收集初次子宫颈锥切术切缘阳性并行二次手术的64例高级别CIN患者的临床资料，并对其病灶残留及相关因素进行分析。［结果］ 二次手术患者术后病理提示CIN共25例，其病灶残留率为39.1%。年龄≤35岁者病灶残留率为19.0%，年龄＞35岁者为48.8%，差异有统计学意义（P＜0.05）。术前子宫颈脱落细胞（LBC）检测提示高度上皮内病变组病灶残留率（52.5%）明显高于低度上皮内病变组（16.7%），差异有统计学意义（P＜0.01）。术前高危型HPV DNA＞300RLU/CO时病灶残留率明显高于≤300RLU/CO，两者差异亦具有统计学意义（P＜0.05）。多因素Logistic回归分析发现，年龄＞35岁、LBC提示高度上皮内病变是与初次锥切切缘阳性病灶残留高度相关的因素，其危险度分别为3.872、3.025。［结论］ 患者年龄和LBC结果与初次手术病灶残留有相关性，对于此类患者应予以高度重视。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate related factors of residual lesions in high-grade cervical intraepithelial neoplasia after cervical conization surgery（cold knife conization and LEEP surgery） with positive margins. ［Methods］ Clinical data of 64 high-grade cervical intraepithelial neoplasia patients who accepted cervical conization were retrospectively collected. The residual lesions and their related factors were analyzed. ［Results］ The postoperative pathology results of the second operation found that there were 25 cases with cervical intraepithelial neoplasia，and the residual disease rate was 39.1%. The residual disease rate of patients whose age was less than 35-year old was 19.0%，and older than that was 48.8%，with significant difference(P<0.05). The patients with preoperative high-grade cytology group the residual disease rate(52.5%) was significantly higher than that in low-grade group（16.7%）(P＜0.01). The residual disease rate in patients with preoperative HR-HPV DNA examination>300RLU/CO was higher than those with≤300RLU/CO(P<0.05). Multivariate Logistic regression analysis showed that older than 35-year old and cytology showed a high-grade of intraepithelial lesions (ASC-H，HSIL) closely related to residual disease. The relative risks were 3.872 and 3.025.［Conclusion］ Age>35 years old and cytologic ASC-H are high-risk factors associated with residual lesions. |
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