宫颈环形电切术联合干扰素治疗老年妇女宫颈上皮内瘤变的临床应用

目的探讨宫颈环形电切术(LEEP)联合干扰素在治疗老年妇女宫颈上皮内瘤变(CIN)中的临床应用。方法对2010年1月-2013年1月经液基细胞学检查(TCT)、阴道镜定位活检、宫颈管搔刮术病理检查明确诊断为CINⅠ~Ⅲ的30例绝经后老年妇女,进行回顾性研究。对30例患者行LEEP前应用第二代杂交捕获试验(HC2)检测高危型HPV DNA,并于治疗后联合应用干扰素3个疗程。治疗后分别于3、6、9、12个月,行TCT及阴道镜下可疑病变部位活检,6、12个月行HC2检测,以判断疗效。本研究中患者随诊时间为13~28个月。结果 30例患者随诊中未发现CIN残留及复发。30例患者术后6个月复查,TCT 6例异常,HC2检测24例阴性,阴性率达80%;术后12个月治愈率达100%。结论宫颈环形电切术联合干扰素在治疗老年妇女宫颈上皮内瘤变中有双重阻断作用,提高患者一次性治愈率。

Objective To study The clinical application of combining loop electrosurgical excision procedure （LEEP） and interferon（INF） to treat cervical intraepithelial neoplasia（CIN） in elderly women. Methods From January 2010 to January 2013, retrospective study was progressed in thirty postmenopausal elderly women with CINI-CINIH diagnosed by liquid-based ThinPrep cytology test （TCT）, colposcopic site-specific biopsies, curettage of cervical canals and pathological examination. Before carrying out LEEP to these patients, all women were performed high-risk HPV DNA detection by the method of hybrid capture 2 （HC2）. All patients were added to use INF for three courses of treatment after LEEP. All patients were examined by TCT and colposcopic site-specific biopsies to doubtful focus of infection in the third, sixth, ninth and twelfth month after treating. And to judge the curative effect by using HC2 in the sixth and twelfth month after treating. The time of follow-up was from 13 to 28 months. Results Thirty patients were not detected residue and recidivation of C1N diagnosed by colposcopy and site-specific biopsies to doubtful focus of infection. In the group, 6 women were abnormal detected by TCT, 24 women were negative detected by HC2, the negative rate was 80%, when LEEP ended six months; the cure rate was 100% when LEEP ended twelve months. Conclusion It is double interrupted effect by combining LEEP and 1NF to treat CIN in elderly women. It can raise the one cure rate of the patients with CIN.