HPV感染及相应治疗对CINⅠ转归的影响

Impact of HPV Infection and the Corresponding Treatment on CIN Ⅰ Turnover

【目的】探讨人乳头瘤病毒（HPV）感染以及相应治疗对宫颈上皮内瘤变轻度（CIN Ⅰ）患者预后的影响。【方法】选取2010年6月至2011年6月在本院妇科门诊，经阴道镜下宫颈活检组织病理学检查诊断为CIN Ⅰ的患者220例，按照 HPV检测结果分为HPV低危型组（ n ＝115）和高危型组（ n ＝105）。并按照患者个人要求，其中低危组中78例采用药物治疗，37例采用LEEP刀手术治疗；高危组中35例采用药物治疗，70例采用LEEP刀手术治疗，定期随访，行薄层液基细胞学（TCT ）、HPV以及阴道镜检查，分析其转归情况。【结果】经过6个月，12个月，24个月随访发现，HPV低危型LEEP刀手术治疗组无疾病进展病例，药物治疗组以及 HPV高危型LEEP治疗组均有1例疾病进展病例，但组间比较无统计学差异（ P ＞0．05），HPV高危型药物治疗组有3例疾病进展病例，与 HPV高危型LEEP刀手术治疗组比较，疾病转归差异有统计学意义（ P ＜0．05）。 H PV 低危型和 H PV 高危型组比较，两组疾病转归差异有统计学意义（ P ＜0．05）。【结论】HPV高危型持续性感染，是CIN Ⅰ进展的高危因素，LEEP刀手术治疗对改善高危型 HPV感染的转归较单纯药物治疗效果显著。

[Objective] To explore the effect of human papilloma virus （HPV ） infection and the corre‐sponding treatment on the prognosis of patients with mild cervical intraepithelial neoplasia （CIN Ⅰ ） .[Meth‐ods] Totally 220 CIN I patients diagnosed by colposcopic cervical biopsy pathology in gynecological department of our hospital from June 2010 to June 2011 were selected .According to HPV test results ,all patients were divided into low‐risk HPV group（ n =115） and high‐risk HPV group（ n =105） .In accordance with the re‐quirements of individual patients ,78 cases in low‐risk group received drug therapy and 37 patients underwent loop electrosurgical excision procedure （LEEP） ,and 35 patients in high‐risk group received drug therapy and 70 patients underwent LEEP .All patients were followed up regularly .Thin layer of liquid based cytology （TCT） ,HPV and colposcope examination were performed .The outcome was analyzed .[Results]After 6 ,12 and 24 months of follow up ,there was no disease progression case in low‐risk HPV group treated with LEEP and 1 disease progression case in drug therapy group and high‐risk HPV group treated with LEEP respective‐ly ,but there was no significant difference among groups（ P 〉0 .05） .There was also significant difference in the outcome between low‐risk HPV group and high‐risk HPV group（ P〈0 .05） .[Conclusion] The persistent high‐risk HPV infection is a high risk factor for CIN Ⅰ progression .The efficacy of LEEP in improving the outcome of high‐risk HPV infection is more significant than that of simple drug therapy .