宫颈锥切术后病变残留的危险因素分析

Analysis on risk factors for residual lesions after cervical conization

目的分析宫颈锥切术后病变残留的相关危险因素,以降低病变残留发生率。方法选取接受宫颈锥切术治疗的100例宫颈上皮内瘤变及微小浸润癌患者为观察对象,术后随访一年,记录病变残留的发生情况,分析导致病变残留的相关危险因素。结果 100例患者均接受宫颈锥切术,其中发生术后病变残留30例,病变残留发生率为30. 00%。单因素分析发现,高危型人乳头瘤病毒种类> 1种、切缘状态为阳性、病变范围> 2个象限、病变级别为微小浸润癌、病变部位累及腺体的患者术后病变残留发生率明显增高(P <0. 05);年龄、绝经状态、产次、锥切方式与术后病变残留无明显相关性(P> 0. 05)。多因素分析结果显示,高危型人乳头瘤病毒种类、切缘状态、病变范围、病变级别、病变部位累及腺体是宫颈锥切术后病变残留的独立危险因素。结论宫颈锥切术后病变残留发生率较高,病变部位累及腺体、高危型人乳头瘤病毒种类> 1种、病变范围> 2个、病变级别为微小浸润癌、切缘状态为阳性者为术后病变残留的高危因素。

Objective To analyze the risk factors for residual lesions after cervical conization,thereby to reduce the incidence of residual lesions. Methods A total of 100 patients with cervical intraepithelial neoplasia and micro-invasive carcinoma were enrolled as objects. The 1-year follow-up was performed after operation,the incidence of residual lesions was recorded,and the related risk factors leading to residual lesions were analyzed. Results All of the 100 patients received cervical conization. Residual lesions occurred in 30 cases after operation,the incident rate of residual lesions was 30. 00%. The univariate analysis revealed that the incident rate of residual lesions increased in the patients with more than one type of high-risk human papilloma virus,positive state of incision margin,the lesion range > 2 quadrants,lesion grade of micro-invasive carcinoma,and the lesion involving the glands(P < 0. 05);no significant correlation of age,postmenopausal status,parity history and conization pattern with postoperative residual lesions were found(P > 0. 05). The multivariate analysis results showed that the type of high-risk human papillomavirus,incision margin status,lesion range,lesion grade and involvement of lesion site were the independent risk factors for postoperative residual lesions. Conclusion The incident rate of residual lesions after cervical conization is high. The lesion involving the glands,more than one type of high-risk human papilloma virus,the lesion range> 2 quadrants,lesion grade of micro-invasive carcinoma,and positive state of incision margin are the independent risk factors for residual lesions.