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目的:寻找宫颈上皮内瘤样病变(CIN)在宫颈的分布特征。方法:通过对575例CIN行宫颈锥切术后的组织病理学结果进行回顾性分析,将宫颈按最常见的点、发病最重的点、每个象限和象限的组合进行研究,寻找CIN在宫颈各部位的分布特征以及年龄组、HPV感染的分布特点并比较其差异。结果:575例中CIN1为146例,≥CINⅡ为429例。CIN主要分布在30～39岁年龄段,与其他年龄组相比差异有统计学意义(P<0.05)。宫颈病变的发病率伴随HPV阳性率高达92.72%,两者有非常显著的相关性(P<0.01)。在146例CINI和429例≥CINII两组病变中,均是12点出现的频次最高,分别为43.84%和37.06%;2点最低,分别为33.57%和27.74%,差异有统计学意义(P<0.05)。在两组病变中,CINI组病变最重点以8点出现频次最高(12.33%),≥CINII组病变最重点以7点频次最高(11.42%),两组均是2点最低分别为2.74%和4.43%,差异有统计学意义(P<0.01)。第2、3、4象限发病率与第1象限差异有统计学意义(P<0.01)。在146例CINI和429例≥CINII两组病变中,宫颈后唇分布分别为58.22%和54.55%,均比前唇41.78%和45.45%多见(P<0.01),宫颈右侧分别为54.79%和56.18%均比左侧45.21%和43.82%多见(P<0.05)。结论:要加强30～39岁年龄段和HPV阳性CIN患者的管理。CIN患者临床活检时,从病变某点分布上要重视对12、8和7点的取材,从病变象限分布上要重视宫颈后唇和右侧的取材,以提高CIN的活检率和临床诊治率。
Objective: To find the distribution of cervical intraepithelial neoplasia (CIN) in the cervix. Methods: The histopathological results of 575 cervical conization cases were retrospectively analyzed. Cervical lesions were studied according to the combination of the most common point, the most severe point, each quadrant and the quadrant in search of CIN The distribution characteristics of cervical parts and age groups, HPV infection distribution characteristics and compare the differences. Results: Among 575 cases, 146 cases were CIN1 and 429 cases were ≥CINⅡ. CIN mainly distributed in the age group of 30 to 39 years, with statistical significance compared with other age groups (P <0.05). The incidence of cervical lesions with HPV positive rate as high as 92.72%, the two have a very significant correlation (P <0.01). Among the 146 CINI patients and 429 patients with ≥CINII lesions, the frequency was the highest at 12 o’clock, which were 43.84% and 37.06% respectively, and the lowest was 2 (33.57% and 27.74%, P <0.05). In both groups, the highest frequency of lesions in CINI group was the highest (12.33%) at 8:00, and the highest frequency of lesions in ≥CINII group was the highest at 7 points (11.42%). The lowest incidence of CINI group was 2.74% at 2 points 4.43%, the difference was statistically significant (P <0.01). The incidence rates of the first, second, third and fourth quadrants were significantly different from the first quadrant (P <0.01). In 146 cases of CINI and 429 cases of ≥CINII lesions, the distribution of posterior lip of the cervix was 58.22% and 54.55% respectively, which were both more than 41.78% and 45.45% (P <0.01) of the anterior lip and 54.79% And 56.18% than the left 45.21% and 43.82% more common (P <0.05). Conclusion: To strengthen the management of patients aged 30-39 years and HPV positive CIN. CIN patients with clinical biopsy, distribution of lesions from a point should pay attention to the 12,8 and 7 points drawn from the lesion quadrant distribution should pay attention to the posterior lip and the right drawing, in order to improve the CIN biopsy rate and clinical diagnosis and treatment rate .