LEEP治疗伴高危型HPV感染的宫颈上皮内瘤变患者应用探讨

Efficacy analysis of the LEEP treatment in cervical intraepithelial neoplasia patients with the high-risk type human papilloma virus infection

目的探讨宫颈环形电切术(LEEP)治疗伴高危型人乳头瘤病毒(HR-HPV)感染的宫颈上皮内瘤变(CIN)患者的应用价值。方法回顾性分析2009年1月～2010年12月来我院妇科门诊经宫颈TCT诊断为ASCUS及以上的患者资料1 280例,其中对HR-HPV感染、阴道镜下多点活检组织病理学确诊为宫颈上皮内瘤变的患者329例行LEEP治疗,对术前HR-HPV亚型、术后HR-HPV转阴及CIN预后情况进行分析。结果本组病例中HR-HPV阳性率52.19%,最常见的HR-HPV为16、58、52型。各HR-HPV阳性检出率术后6个月和术后12个月分别下降为32.22%和10.33%,与术前比较差异具有统计学意义(χ2=318.89,P<0.01)。LEEP手术治疗HR-HPV感染的总有效率达72.34%。结论 LEEP治疗宫颈上皮内瘤变可以有效消除大部分HR-HPV感染,降低宫颈癌发生率。

Objective To discuss the efficacy of the loop electrosurgical excision procedure （LEEP） treatment in cervical in- traepithelial neoplasia （CIN） patients with the high-risk type human papilloma virus （HR-HPV） infection. Methods The clinical data of 1 280 cases of gynecologic clinic patients diagnosed with ASCUS by cervical TCT from January 2009 to De- cember 2010 were analyzed retrospectively. Among them, 329 cases of patients with HR-I-IPV infection and diagnosed with CIN by colposcopic multi-spot biopsy histopathology underwent routine LEEP treatment. The preoperative HR-HPV sub- types, postoperative negative turn and CIN prognosis were aoalyzed. Results The positive rate in this group was 52.19%, with HR-HPV types 16, 58, 52 being the most common, The HR-HPV positive rate was reduced to 32.22% and 10.33% respectively in 6 and 12 months after operation, showing statistical significance compared with the preoperative data （χ2 = 318.89,p 〈 0.01）. The total effective rate of LEEP treatment in HR-HPV infection reached 72.34%. Conclusion LEEP treatment of CIN can effectively eliminate the majority of HR-HPV infection and reduce the incidence of cervical cancer.