摘要
目的:探讨子宫颈上皮内瘤变Ⅲ级(CINⅢ)患者行子宫颈冷刀锥切术后病理升级为子宫颈癌的高危因素。方法:回顾性分析2015年6月至2018年8月325例因CINⅢ于首都医科大学附属北京妇产医院妇科微创中心行子宫颈冷刀锥切术患者的临床资料,按照术后病理情况分为病理升级组31例,未升级组294例,分析其术后病理升级的高危因素。结果:325例患者中,31例患者锥切术后病理检查提示子宫颈早期浸润癌(9.54%),单因素分析结果显示,升级组产次≥2、子宫颈薄层液基细胞学检查(TCT)提示高级别病变、病变累及点数≥3点及累及腺体发生率显著高于未升级组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,病变累及腺体(OR6.342,95%CI1.728~23.273)及病变数≥3点(OR13.428,95%CI3.715~48.534)是锥切术后病理升级的高危因素。结论:病变累及腺体及病变数≥3点是子宫颈冷刀锥切术后病理升级的高危因素,在CINⅢ患者术前制定手术方式时应予以重视。
Objective: To explore the risk factors associated with upgraded pathological results in patients undergoiong cervical conization surgery.Methods: 325 cases of women with cervical intraepithelial neoplasia Ⅲ who underwent conization during June 2016 to August 2018 in our hospital were recruited in this retrospective study.Their clinical characteristics and pathological differences were analyzed,retrospectively.All patients were divided into two groups according to their pathological results after cervical conization,the upgrading group and the non-up- grading group. Results: Among the 325 cases,31 patients were detected as microinvasive cervical cancer ( 9. 54%).Results from univariate analysis showed that upgraded pathological results were correlated with delivery times more than 2,the higher grades of TCT screening,more lesions and high rate of glandular involvement( P< 0. 05).Multivariate logistic analysis showed that high rate of glandular involvement( OR 6. 342,95%CI 1. 728 - 23. 273) and lesions≥3( OR 13. 428,95%CI 3. 715-48. 534) were independent risk factors associated with upgraded pathological results.Conclusions: Glandular involvement and lesions≥3 were independent risk factors of upgraded pathological results after cervical conization.The surgical methods should be set prudently for these patients.
作者
聂明月
叶红
NIE Mingyue;YE Hong(Department of Gynecology Minimal Invasive Center,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2019年第7期518-521,共4页
Journal of Practical Obstetrics and Gynecology
基金
首都医科大学附属北京妇产医院中青年学科骨干培养专项(编号:FCYY201719)
关键词
子宫颈上皮内瘤变
子宫颈锥切术
病理升级
高危因素
Cervical intraepithelial neoplasia
Conization
Upgraded pathological results
Risk factors
