宫颈上皮内瘤变锥切术后复发因素调查及高危型HPV检查的应用价值

Investigation of Recurrence Factors after Cervical Conization for Cervical Intraepithelial Neoplasia and Application Value of High-risk HPV Detection

目的探讨高危型人乳头瘤病毒(HPV)检查在宫颈上皮内瘤变锥切术后随访中的应用价值,并分析宫颈上皮内瘤变锥切术后复发因素。方法选择2014年1月—2017年12月我院收治的宫颈上皮内瘤变(CIN)患者138例,均进行宫颈上皮内瘤变锥切术,术后进行宫颈HPV检查,分析术后高危型HPV复发因素。结果宫颈HPV检查持续感染组CIN复发率显著高于高危HPV转阴组(P<0.05)。CIN复发组患者累及腺体比率、术前HPV≥500RIUs/CO比率、术后切缘阳性比率均显著高于CIN未复发组(P<0.05),锥切标本厚度、锥切标本宽度均小于CIN未复发组(P<0.05)。累及腺体、术前HPV≥500RIUs/CO、术后切缘阳性、锥切标本厚度≤1cm、锥切标本宽度≤2cm均是术后CIN复发独立影响因素。结论宫颈上皮内瘤变锥切术后CIN复发独立影响因素包括累及腺体、术前HPV≥500RIUs/CO、术后切缘阳性、锥切标本厚度≤1cm和锥切标本宽度≤2cm,高危型HPV检查对判断术后CIN复发具有重要作用。

Objective To investigate application value of high-risk human papilloma viruse(HPV)detection in postoperative follow-up for patients after cervical conization for cervical intraepithelial neoplasia(CIN)and to analyze recurrence factors after cervical conization for CIN.Methods A total of 138 CIN patients admitted during January 2014 and December 2017 underwent cervical conization,and then cervical HPV detections were performed after operation.High-risk HPV recurrence factors after operation were analyzed.Results Recurrence rate of CIN in HPV persistent infection group was significantly higher than that in high-risk HPV trans-negative group(P<0.05).In CIN recurrence group,values of proportion of gland involvement,preoperative HPV equal or more than 500 RIUs/CO and postoperative positive proportion of margin were significantly higher(P<0.05),while thickness and width of conization specimens were smaller than those in CIN non-recurrence group(P<0.05).Gland involvement,preoperative HPV equal or more than 500 RIUs/CO,postoperative positive margin,thickness of conization specimens less than or equal to 1 cm and width of conization specimens less than or equal to 2 cm were all independent factors for postoperative CIN recurrence.Conclusion Gland involvement,preoperative HPV equal or more than 500 RIUs/CO,postoperative positive margin,thickness of conization specimens less than or equal to 1 cm and width of conization specimens less than or equal to 2 cm are independent factors affecting CIN recurrence after cervical conization for cervical intraepithelial neoplasia,and high-risk HPV detection has an important role in judgment of postoperative CIN recurrence.