高危型HPV检测对宫颈上皮内瘤变锥切后残存病变或复发的预测价值

Predictive value of high risk HPV detection for residual lesions or recurrence after conization of cervical intraepithelial neoplasia

目的:探讨高危型HPV检测对宫颈上皮内瘤变锥切后残存病变或复发的预测价值。方法:选取我院2010年12月至2016年12月间收治的因宫颈上皮内瘤变行二次手术治疗的患者700例作为研究对象,收集患者临床资料进行回顾性研究,所有患者在首次手术前6个月均行高危型HPV检查。结果:再次手术后有482例患者观察到残存病变或复发情况;218例无病变,占31.14%;247例与锥切病理结果相符,占35.29%;188例降级,占26.86%;47例升级,占6.71%;患者年龄、胎次、锥切方法、腺体是否累及、病变程度等与患者残存病变发生无关(P>0.05),而RUL/PC≥500是宫颈锥切术后残存病变或复发的危险因素(P<0.05)。结论:使用高危型HPV检测是有效地预测宫颈锥切术后残存病变发生或复发的方法,对子宫颈疾病的诊疗具有重要的意义。

Objective：To investigate the predictive value of high risk HPV detection for residual lesions or recurrence after conization of cervical intraepithelial neoplasia.Methods：Seven hundreds patients with cervical intraepithelial neoplasia treated by surgery in our hospital from December 2010 to December 2016 were selected as the subjects,clinical data were collected and analyzed retrospectively.All patients underwent high risk HPV testing 6 months before the first operation.Results：After surgery,there were 482 patients with residual disease or recurrence,218 cases without lesions,accounting for 31.14%,247 cases were consistent with the results of conization,accounting for 35.29%,188 cases were degraded,accounting for 26.86%,and the number of cases was upgraded in 47 cases,accounting for 6.71%.Age,parity,conization method,gland involvement,lesions were unrelated to the occurrence of residual disease（P〈0.05）,RUL/PC≥500 is risk factors of residual disease or recurrence after cervical conization（P〈0.05）.Conclusion：The use of high-risk HPV detection is an effective method to predict the occurrence or recurrence of residual lesions after cervical conization,which is of great significance to the diagnosis and treatment of cervical diseases.