高频电波刀电圈切除术治疗宫颈高危型人乳头瘤病毒感染的效果

Loop electrosurgical excision procedure in the treatment of high-risk human papillomavirus infections

目的探讨高频电波刀电圈切除术(loop electrosurgical excision procedure,LEEP)对宫颈高危型人乳头瘤病毒(human papillomavirus,HPV)感染的临床疗效。方法对86例高危型HPV感染合并不同程度宫颈病变患者进行LEEP治疗,术前及术后3个月通过杂交捕获二代(hybridcaptureⅡ,HC-Ⅱ)方法分别定量检测其宫颈HPV-DNA的含量,同时行阴道镜检查及宫颈活检。结果不同CIN分级的术前HPV含量差异无显著性(χ2=1.143,P=0.565)。术后HPV转阴率47.7%(41/86)。术后宫颈HPV-DNA含量下降幅度在50.1%-99.9%者占77.9%(67/86),其中下降幅度>90%者51例(59.3%);下降幅度<50%者占10.5%(9/86);未降反而上升者占11.6%(10/86)。不同CIN分级的HPV变化幅度差异无显著性(χ2=6.418,P=0.170)。术前HPV-DNA负荷量越高,术后HPV下降幅度越大(χ2=17.373,P=0.008)。结论LEEP术是治疗宫颈癌前病变,降低宫颈HPV-DNA负荷量的一种有效治疗方法。

Objective To investigate the clinical effect of loop electrosurgical excision procedure(LEEP) in the treatment of high-risk human papillomavirus(HPV) infections. Methods A total of 86 cases with high-risk HPV infections and cervical intraepithelial neoplasia(CIN) was treated by LEEP.The cervical human papillomavirus load was measured by hybrid capture 2(HC2) 3 months before and after the operation.At the same time,the cervical biopsy and colposcopy were performed.Results The preoperative HPV content among different grades of CIN was not significantly different(χ2=1.143,P=0.565).After the treatment,47.7%(41/86) of the cases showed a negative turn of HPV.The HPV content was decreased by 50.1%~99.9% in 77.9%(67/86) of the cases(>90%: 51 cases,59.3%) and by 0~50% in 10.5% (9/86) of the cases,while,on the contrary,the content was increased in 11.6%(10/86) of the cases.The range of variation of HPV content among different grades of CIN was not significantly different(χ2=6.418,P=0.170).The more load preoperative HPV content had,the more decrease postoperative content was found (χ2=17.373,P=0.008).Conclusions Loop electrosurgical excision procedure is an effective method for treating cervical lesions and lowering cervical load of HPV-DNA.