温州医科大学学报
溫州醫科大學學報
온주의과대학학보
Journal of Wenzhou Medical University
2015年
9期
665-670
,共6页
高级别宫颈鳞状上皮内病变%环形电切术%病理阴性
高級彆宮頸鱗狀上皮內病變%環形電切術%病理陰性
고급별궁경린상상피내병변%배형전절술%병리음성
high-grade cervical squamous intraepithelial lesions%loop electrosurgical excision procedure%negative pathology
目的：探讨高级别宫颈鳞状上皮内病变（CIN2-3）患者宫颈环形电切术（LEEP）后病理阴性的相关影响因素。方法：选取自2011年3月至2012年12月间嘉兴市妇幼保健院因宫颈病变经阴道镜下活检诊断为CIN2-3而行LEEP术的患者263例，并对年龄、宫颈细胞学、HPV病毒载量、阴道镜下活检病理分级等进行回顾性分析，评价上述因素与CIN2-3患者LEEP术后病理阴性的相关性。结果：单因素分析显示HPV低病毒载量（＜400 RLU/CO）、液基细胞学检查（TCT）低级别组、镜下活检CIN2与CIN2-3患者LEEP术后病理阴性结果相关（P=0.008，P=0.012，P=0.02），而年龄与阴性病理结果相关性无统计学意义（P=0.172），多因素分析显示低HPV病毒载量为术后病理阴性的独立影响因素（P=0.019，OR=3.752，95%CI 1.247～11.293）。三因素（HPV病毒载量、TCT、活检病理诊断）共同预测CIN2-3术后病理阴性发生的受试者工作特征曲线（ROC曲线）曲线下面积（AUC）为0.727。结论：HPV低病毒载量与LEEP术阴性病理结果相关。联合术前HPV低病毒载量、TCT低级别、镜下活检CIN2三因素具有较高预测术后病理阴性的效能。
目的：探討高級彆宮頸鱗狀上皮內病變（CIN2-3）患者宮頸環形電切術（LEEP）後病理陰性的相關影響因素。方法：選取自2011年3月至2012年12月間嘉興市婦幼保健院因宮頸病變經陰道鏡下活檢診斷為CIN2-3而行LEEP術的患者263例，併對年齡、宮頸細胞學、HPV病毒載量、陰道鏡下活檢病理分級等進行迴顧性分析，評價上述因素與CIN2-3患者LEEP術後病理陰性的相關性。結果：單因素分析顯示HPV低病毒載量（＜400 RLU/CO）、液基細胞學檢查（TCT）低級彆組、鏡下活檢CIN2與CIN2-3患者LEEP術後病理陰性結果相關（P=0.008，P=0.012，P=0.02），而年齡與陰性病理結果相關性無統計學意義（P=0.172），多因素分析顯示低HPV病毒載量為術後病理陰性的獨立影響因素（P=0.019，OR=3.752，95%CI 1.247～11.293）。三因素（HPV病毒載量、TCT、活檢病理診斷）共同預測CIN2-3術後病理陰性髮生的受試者工作特徵麯線（ROC麯線）麯線下麵積（AUC）為0.727。結論：HPV低病毒載量與LEEP術陰性病理結果相關。聯閤術前HPV低病毒載量、TCT低級彆、鏡下活檢CIN2三因素具有較高預測術後病理陰性的效能。
목적：탐토고급별궁경린상상피내병변（CIN2-3）환자궁경배형전절술（LEEP）후병리음성적상관영향인소。방법：선취자2011년3월지2012년12월간가흥시부유보건원인궁경병변경음도경하활검진단위CIN2-3이행LEEP술적환자263례，병대년령、궁경세포학、HPV병독재량、음도경하활검병리분급등진행회고성분석，평개상술인소여CIN2-3환자LEEP술후병리음성적상관성。결과：단인소분석현시HPV저병독재량（＜400 RLU/CO）、액기세포학검사（TCT）저급별조、경하활검CIN2여CIN2-3환자LEEP술후병리음성결과상관（P=0.008，P=0.012，P=0.02），이년령여음성병리결과상관성무통계학의의（P=0.172），다인소분석현시저HPV병독재량위술후병리음성적독립영향인소（P=0.019，OR=3.752，95%CI 1.247～11.293）。삼인소（HPV병독재량、TCT、활검병리진단）공동예측CIN2-3술후병리음성발생적수시자공작특정곡선（ROC곡선）곡선하면적（AUC）위0.727。결론：HPV저병독재량여LEEP술음성병리결과상관。연합술전HPV저병독재량、TCT저급별、경하활검CIN2삼인소구유교고예측술후병리음성적효능。
Objective: To investigate the related factors of the negative pathological results of loop electro-surgical excision procedure (LEEP) in patients with high-grade cervical squamous intraepithelial lesions (CIN2-3).Methods: Totally 263 patients diagnosed as CIN2-3 by colposcopy-assisted biopsy and treated with LEEP in Jiaxing Maternity and Child Care Hospital from March 2011 to December 2012 were selected, and the relation of the negative pathological results of LEEP with age, cervical cytology, HPV load and pathological grading was analyzed.Results: Univariate analysis showed that low HPV load (<400 RLU/CO), low-grade of TCT, biopsy-conifrmed CIN2 were associated with the prediction of the negative pathology of LEEP specimens (P=0.008, P=0.012,P=0.02), however, age was not related to the negative result of LEEP (P=0.172). Multivariate logistic analysis showed that low HPV load was the independent factor of the negative pathological results of LEEP (P=0.019, OR=3.752, 95%CI 1.247~11.293). The area under ROC curve was 0.727 for three factors (HPV load, TCT and biopsy pathology diagnosis) predicting negative pathological result of LEEP.Conclusion: Low HPV load is related to the negative pathological results of LEEP. Combining low HPV load with low-grade of TCT and biopsy-conifrmed CIN2 has a high predictive effect on negative pathological results of LEEP.
