摘要
目的探究HR-HPV阳性的宫颈癌前病变及早期宫颈癌行宫颈锥切术后病理变化及术后宫颈HR-HPV持续阳性的相关因素。方法收集2017年1月-2020年6月克拉玛依市中心医院妇科因CINII、CINIII及宫颈微浸润癌行宫颈冷刀锥切术的患者359例,分析宫颈锥切术后病理诊断的变化,锥切术后HR-HPV持续阳性的情况,探究术后HR-HPV持续阳性的相关因素。结果行宫颈冷刀锥切术的359例患者中,锥切术后病理升级率为14.48%,降级率为37.33%;阴道镜下宫颈活检与宫颈锥切术后病理诊断完全符合率为48.19%,一致性检验Kappa值为0.353(P<0.01)。锥切术后HR-HPV持续阳性率为18.99%,HR-HPV转阴率为81.01%。单因素分析显示,年龄≤40岁、宫颈活检CINIII、病灶累及腺体及锥切术后病理升级与锥切术后HR-HPV持续阳性有关(P<0.05);Logistic多因素分析显示,宫颈活检CINIII、病灶累及腺体及锥切术后病理升级是锥切术后宫颈HR-HPV持续阳性的风险因素(OR=13.377、2.314、45.215,P<0.05)。结论宫颈病变锥切术前后病理诊断有一定变化,锥切术对指导宫颈病变的进一步治疗意义较大,锥切术后部分患者仍存在HR-HPV持续阳性,术后不容忽视宫颈癌的筛查。
Objective To investigate the pathological changes of HR-HPV positive cervical lesion before and after cervical conization and the related factors of continuous positive HR-HPV after the operation.Methods 359 patients who underwent cervical conization in the hospital from January 2017 to June 2020 were collected retrospectively.The pathological changes before and after cervical conization were compared,and the related factors of continuous positive HR-HPV after conization were analyzed.Results Among 359 patients undergoing cervical conization,the pathological upgrading rate was 14.48%,and the degradation rate was 37.33%;The complete coincidence rate between colposcopy cervical biopsy and pathological diagnosis after cervical conization was 48.19%,and the kappa value of consistency test was 0.353(P<0.01).After conization,the continuous positive rate of HR-HPV was 18.99%,and the negative rate of HR-HPV was 81.01%.Univariate analysis showed that age≤40 years old,cervical biopsy results,lesion involvement of glands and pathological upgrading after conization were related to continuous positive of HR-HPV after conization(P<0.05).Logistic multivariate analysis showed that cervical biopsy CINIII,lesions involving glands and pathological upgrading after conization were the risk factors of continuous positive cervical HRHPV after conization(OR=13.377,2.314,45.215,P<0.05).Conclusions There are some changes in pathological diagnosis before and after cervical conization.Conization is showing as great significance to guide the further treatment of cervical lesions.The patients have continuous positive HR-HPV after cervical conization.Cervical cancer screening should not be ignored after conization.
作者
贾小平
李韵霞
姜敏
周静
马彩玲
JIA Xiaoping;LI Yunxia;JIANG Min;ZHOU Jing;MA Cailing(Department of Gynecology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Gynecology,Xinjiang Karamay City Central Hospital,Karamay Xinjiang 834000,China)
出处
《新疆医科大学学报》
CAS
2022年第9期1010-1014,共5页
Journal of Xinjiang Medical University
基金
新疆维吾尔自然科学基金(2021D01A21)
克拉玛依市创新人才工程(2019RC001A-14)。
关键词
宫颈癌前病变
宫颈癌
宫颈锥切术
高危型HPV
cervical precancerous lesions
cervical cancer
cervical conization
high-risk HPV
