摘要
目的:检测不同年龄组患者宫颈上皮内瘤变Ⅱ～Ⅲ(CINⅡ～Ⅲ)高频电刀锥切术(LEEP)治疗后高危型人乳头瘤病毒(HPV)及亚型清除的情况,评价手术疗效及随访价值。方法:336例因CINⅡ～Ⅲ接受LEEP手术治疗的患者,随机将随访资料完整的101例患者按年龄分为3组,术前HPVDNA检测证实高危型HPV感染。治疗后6个月再次检测HPVDNA及液基细胞检测(TCT),如为高危型HPV持续感染再次行活检病理学检查。比较各组HPV术后清除率及HPV亚型持续感染率及残存率。结果:①3个年龄组LEEP治疗后HPV清除率分别为93.8%(30/32)、71.4%(25/35),64.7%(22/34)。21～30岁组治疗后HPV清除率与其他两组比较差异有统计学意义(P<0.05),后两个年龄组差异无统计学意义(P>0.05)。②术后6个月41～50岁组HPV16亚型持续感染率与21～30岁组相比差异有统计学意义(P<0.05);HPV16亚型与其他亚型相比持续感染率差异无统计学意义(P>0.05)。③术后6个月41～50岁组HPV16亚型持续感染残留率与21～30岁组相比差异有统计学意义(P<0.05)。结论:LEEP是一种简单安全的手术。可在切除病变的同时清除HPV。术后6个月HPV分型检测是一种较好的随访方法。对年龄较大尤其是术后HPV16亚型持续感染人群应密切长时间的随访。
Objective：To assess the clinical effectiveness and follow-up value by testing the clearance rate of human papillomavirus （HPV） after loop electrosurgical excision procedure （LEEP） treatment in different age patients with cervical intraepithelial neoplasiaⅡ-Ⅲ （CIN Ⅱ-Ⅲ ）. Methods ：336 cases with CIN Ⅱ-Ⅲ underwent loop electrosurgical excision procedure were enrolled. All patients were randomly assigned into three groups with each of 101 cases, accordina to different aae. which were oroved to be hiah risk HPVDNAinfection preoperatively. Thin Prep liquid based cytology test （TCT） and HPVDNA detection were performed at 6th month postoperatively. The biopsies were done if necessary. The clearance and residual rate of HPVDNA were compared between groups. Results：① The clearance rate of three groups after Leep was 93.8%, 71.4% and 64.7% respectively. The clearance rate of HPV after Leep treatment was higher in the group ranging from 21 to 30 years old than that in the latter two groups（ P〈0.05）. There was no statisticaldifference between the latter two groups（ P 〉0.05）. ②There were statistical differences in the group of 41 to 50 years old groups in persistent HPV16 infection, when compared to the group of 21 to 30 years old groups （P 〈0. 05）. However there was no statistical difference in persistent HPV16 and other HPV subtypes infec- tions （ P 〉 0.05）. ③The residual rate of persistent HPV16 infection in 41 to 50 years old group was higher as compared to 21 to 30 years old group （P 〈 0.05）. Conclusions：Leep is a simple and safe method that caneffectively resect cervical lesion while clear HPV. We suggest the follow up patients by six-month repeat HPV subtypes detection for the women after Leep. Also, it is reasonable to propose a longer and closer fellow-up in 41 to 50 years old age population with persistent HPV16 infection after Leep.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2012年第3期226-229,共4页
Journal of Practical Obstetrics and Gynecology
基金
国家自然科学基金资助(编号:81101555)
关键词
宫颈上皮内瘤变
人乳头瘤病毒
高频电刀锥切术
Cervical intraepithelial neoplasia
Loop electrosurgical excision procedure
Human papillo-mavirus
