LEEP术后宫颈上皮内瘤变复发病因分析

Retrospective analysis the reason of recurrences in cervical intraepithelial neoplasia after loop electrosurgical excision procedure

目的:通过随访宫颈上皮内瘤变(CIN)LEEP术后病情变化,分析LEEP术后宫颈病变复发的原因,以指导临床治疗与随访。方法:回顾性分析重医附一院宫颈门诊因CIN行LEEP术的患者747例,术后定期随访TCT、HPV、阴道镜及病检;结果:LEEP术后复发与CIN病变严重程度无关,与切缘阳性、术前HR-HPV感染有关。HPVl6型的复发率为4.37%(11/252),58型为3.28%(3/122),33型为1.23%(1/81),HPVl6型的复发率明显高于非16型HR-HPV亚型感染(P<0.05);讨论:CIN患者复发与HR-HPV感染有关,且HPVl6型感染有较高的复发率,提示HR-HPV感染致CIN复发的能力可能存在型别差异,持续性HPV16型感染应视为LEEP术后复发的一个高危因素。

Objective： To analysis the reasons of recurrences in CIN after LEEP,in order to guide treatment and follow-up.Method： LEEP were performed for the diagnosed 747 CIN cases.8 to 32 months after LEEP,TCT,HPV DNA detection,colposcope or biopsy were performed.Results： The recurrence rate did not differ by the degree of CIN.However,the recurrence rates were significantly higher in patients with HR-HPV DNA positive before LEEP and positive resection margins（P0.05）.The difference of recurrence rate between HPV16 and the other HR-HPV was statistically significant（P0.05）.Discuss： There may be a correlation between recurrence and HR-HPV infection.That was high recurrence rate in HPV16 genotype means persistent infection with HPV16 genotype should be considered a risk factor for developing recurrent CIN.