论文部分内容阅读
目的:探讨宫颈电圈环行切除术(LEEP)治疗宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)疗效,特别是高危型人乳头瘤病毒感染(HPV)是否消失,以此评估该治疗方法对CIN治疗的有效性。方法:对56例超薄液基细胞学(TCT)涂片异常并经阴道镜检病变小于2 cm,组织学检查证实为CIN 1~3的妇女实行了宫颈电圈环行切除术(LEEP),治疗后3个月随诊时再次行TCT检查并采用HC-2法检测高危型HPV。结果:①CIN 1组HPV转阴率为72.5%(29/40),病变残留(切缘阳性)率为5%(2/40),病变残留与HPV持续阳性成正比。②CIN 2~3组HPV转阴率为44%(7/16),病变残留率为31%(5/16),病变残留与HPV持续阳性成正比。③CIN 1组治疗后HPV阴转率及病灶彻底切除率均高于CIN 2~3组,经统计学处理有显著意义。结论:①高危型HPV感染率与CIN程度成正比,在CIN 2~3中高于CIN 1。②LEEP不仅可以有效的治疗CIN 1,而且可以使其伴行的HPV感染消失;③LEEP治疗部分CIN 2~3尚不够充分,应加大宫颈组织的切除范围和深度。④LEEP治疗后残留病变和HPV持续阳性密切相关;⑤TCT和HPV检测不仅可以评价宫颈疾病治疗效果而且可以作为CIN治疗后追踪随访的有效手段。
Objective: To investigate the efficacy of cervical loop excision (LEEP) in the treatment of cervical intraepithelial neoplasia (CIN), especially whether high-risk human papillomavirus (HPV) disappears, so as to evaluate the effect of this treatment on CIN The effectiveness of treatment. METHODS: Fifty-six cases of ultrathin liquid-based cytology (TCT) smears were abnormal and colposcopic lesions were less than 2 cm. Cervical electrical ring circumcision (LEEP) was performed in women with histological findings of CIN 1 to 3, Three months after treatment, follow-up again TCT and HC-2 test for high-risk HPV. Results: ① The negative rate of HPV in CIN 1 group was 72.5% (29/40), the rate of residual lesions (positive margin) was 5% (2/40), and the persistent lesions were directly proportional to HPV. ②CIN 2 ~ 3 HPV negative conversion rate was 44% (7/16), the disease residual rate was 31% (5/16), residual lesions and positive HPV is continuously proportional to. ③CIN 1 group after treatment, HPV negative rate and complete removal of lesions were higher than the CIN 2 ~ 3 group, the statistical significance. Conclusions: ①The prevalence of high-risk HPV is directly proportional to the degree of CIN, higher than CIN 1 in CIN 2 ~ 3. ② LEEP not only effective treatment of CIN 1, but also to accompany the disappearance of HPV infection; ③ LEEP treatment part of CIN 2 ~ 3 is not sufficient enough, should increase the scope and depth of resection of cervical tissue. ④ LEEP residual disease and persistent positive HPV is closely related; ⑤ TCT and HPV testing can not only evaluate the effect of cervical disease treatment and can be used as follow-up after CIN treatment effective means.