宫颈上皮内瘤变发生的相关危险因素分析

Risk Factors Related to the Occurrence of Cervical Intraepithelial Neoplasia

目的探讨宫颈鳞状上皮内瘤变(CIN)的危险致病因素,为临床诊疗提供支持。方法选择CIN病人97例为研究对象,对其实施阴道镜下活检和高危型HPV检测,同时给予高频电波刀宫颈环状电圈切除术(LEEP)治疗。结果本组97例病人中CINⅠ、Ⅱ、Ⅲ期病人例数分别为53例、27例、17例,经由LEEP术治疗后94例患者临床治愈,治愈率为96.9%,余3例有病灶残留;7例复发,占7.2%;本组高危型HPV阳性患者为59例,占60.8%;与CINⅠ期相比,CINⅡ、Ⅲ期病感染率更高,差异显著(P<0.05);经Logistic回归分析发现,CIN独立危险因素主要包括性伴多、年龄、无性生活防护以及性传播疾病(STD)感染。结论 CIN的发生与患者下生殖道感染以及性行为等因素存在密切关联;CIN治疗手段中LEEP术效果确切。重度CIN与高危型HPV感染存在关联性;对于CIN患者预后而言,高危型HPV检测可有效指导临床预测复发或病灶残留。

Objective To investigate the aangerous pamogemc provide support for clinical diagnosis and treatment. Methods 97 cases of CIN patients were selected as research object. All the cases received the high-risk HPV test and biopsy under colposcopy, and were treated with cervical loop electrosurgical excision procedure （LEEP）. Results The number of patients with was 53, 17 and 17 respectively. 94 cases were cured after LEEP surgery, with the cure rate of 96.9%; the other 3 cases had lesions residues. 7 cases （7.2%） had recurrence. 59 cases （60.8%） were high-risk HPV-positive. Compared with CIN I period, patients at CIN stage had higher prevalence of disease （P 〈0.05）. The Logistic regression analysis showed that CIN independent risk factors included multiple sexual partners, age, asexual life protection, and sexually transmitted disease （STD） infections. Conclusions There is a close correlation between the occurrence of CIN and factors such as lower genital tract infections and sexual behaviour. LEEP surgery has exact effect in the treatment of C1N. Severe CIN is associated with high-risk HPV infection. The high-risk HPV testing can effectively guide the clinical predictors of recurrence or residual lesions.