摘要
目的探讨南京地区宫颈单纯非HPV16/18感染行阴道镜筛查的必要性,并通过建立风险预测模型探讨其罹患高级别病变的风险。方法选取2015年1月至2019年12月南京市江宁医院进行宫颈筛查的900例样本人群作为研究对象。宫颈高级别病变患者纳入高级别组(n=210),低级别病变患者纳入低级别组(n=690)。采用单因素及多因素Logistic回归分析探讨宫颈高级别病变的危险因素,并通过诺莫图评价不同临床因素预测宫颈高级别病变的价值。结果高级别组中流产次数≥3次、特殊类型HPV感染、宫颈锥切病史、性伴侣数量≥2人的发生率明显高于低级别组,差异具有统计学意义(P<0.05);Logistic回归分析可见,流产次数≥3次、特殊类型HPV感染、宫颈锥切病史、性伴侣数量≥2人均为宫颈高级别病变的风险因素;将流产次数、特殊类型HPV感染、宫颈锥切病史、性伴侣数量纳入诺莫图分析,结果可见流产次数≥3次、性伴侣数量≥2人的分值较高;通过内部校准模式进行诺莫图预测效能的评估,其一致性系数C-Index=0.956(0.915~0.997),一致性评价较为理想。校准曲线平均误差为0.03,预测宫颈高级别病变的准确性较高。结论对于部分宫颈单纯非HPV16/18感染的门诊人群,特别是对于流产次数≥3次、性伴侣数量≥2人的人群,转诊阴道镜具有重要的价值。
Objective To explore the necessity of colposcopy screening for cervical non-HPV16/18 infection in Nanjing,and the risk of high-grade lesions by establishing a risk prediction model.Methods 900 sample subjects who underwent cervical screening in Nanjing Jiangning Hospital from January 2015 to December 2019 were selected,and divided into the high-grade group(n=210)and the low-grade group(n=690).Univariate and multivariate Logistic regression analysis was used to investigate the risk factors of high-grade cervical lesions,and Nomograph was used to predict the value of high-grade lesions.Results The frequency of abortion≥3 times,HPV infection of special type,history of cervical coning and number of sexual partners≥2 in the high-grade group were significantly higher than those in the low-grade group(P<0.05).Logistic regression analysis showed that abortion≥3 times,HPV infection of special type,history of cervical coning,and sexual partners number≥2 were risk factors for high-grade cervical lesions.The number of abortions,special types of HPV infection,history of cervical coning,and sexual partners number were included in the Nomograph analysis.Results showed that the number of abortions≥3 times and number of sexual partners≥2 had higher scores.The internal calibration model was used to evaluate the prediction efficiency of Nomograph,and the consistency coefficient C-index was 0.956(0.915~0.997),which indicated that the consistency evaluation was ideal.The average error of calibration curve was 0.03,indicating a high accuracy in predicting high-grade cervical lesions.Conclusions Colposcopy is of great value to some outpatients who are infected by non-HPV16/18,especially those who have more than 3 abortions and more than 2 sexual partners.
作者
周红梅
熊爱为
刘巧玲
ZHOU Hongmei;XIONG Aiwei;LIU Qiaoling(Department of Gynaecology and Obstetrics,Nanjing Jiangning Hospital,Nanjing 211100,Jiangsu,China;Department of Gynaecology and Obstetrics,Najing Second Hospital,Nanjing 210003,Jiangsu,China)
出处
《中国性科学》
2021年第7期80-83,共4页
Chinese Journal of Human Sexuality
