不同年龄组宫颈糜烂样改变患者发生宫颈高级别上皮内病变的差异分析

Comparison of HSIL risks of differently aged patients with pathology of cervical erosion like changes

目的探讨不同年龄组宫颈糜烂样改变患者发生宫颈高级别上皮内病变的风险。方法分别分析432例25岁~39岁年轻女性和515例40岁~65岁中老年女性阴道镜检查及病理检查资料,将阴道镜检查报告中所采集的图像,依宫颈外观分为光滑型和糜烂样改变型。对阴道镜检查有异常或阴道镜检查未见异常而TCT异常的病例行宫颈活检或宫颈搔刮,对其病理结果进行分析。结果在年轻组取病理检查的病例中,宫颈光滑患者和宫颈糜烂样改变患者存在高级别上皮内病变及以上病变的概率分别为13.47%(26/193)和12.13%(29/239),无显著统计学差异(P>0.05)。在中老年组取病理检查的病例中,宫颈光滑者和宫颈糜烂样患者存在高级别上皮内病变及以上病变的概率分别为14.13%(41/290)和22.22%(50/225),后者明显高于前者,差异有统计学意义(P<0.05)。另外,在中老年组225例糜烂样改变者中检出HSIL的比例(22.22%)高于在年轻组239例糜烂样改变者中检出HSIL的比例(11.29%),差异有显著统计学意义(P<0.01)。结论中老年妇女中宫颈有糜烂样改变的患者发生高级别宫颈上皮内病变的概率高,体检时要特别重视此类患者。

Objective The HSIL risks of differently aged patients with pathology of cervical erosion like changes were explored based on the results of colposcopy examination followed by biopsy pathology determination.Methods 432 women aged 25-39 years(young patient group)and 515 women aged 40-65 year(middle-aged and old patient group)were analyzed for the results collected in the colposcopy examination and pathology detection.The appearance of the cervix was divided into smooth type and cervical erosion like change type according to cervical pictures taken in colposcopy examination.The patients with abnormal cervical appearance under colposcopy and the cases with normal cervical appearance but with abnormal TCT examination were performed for cervical biopsy or cervical scratch followed by pathology determination.Results In the cases of young patient groups,the incidences of high-grade squamous intraepithelial lesion(HSIL)in patients with smooth type cervix and cervical erosion like change type cervix are 13.47%(26/193)and 12.13%(29/239),respectively,showing no significant statistical difference(P>0.05).In the cases of middle-aged and old patient group,the incidences of high-grade squamous intraepithelial lesion(HSIL)in patients with smooth type cervix and erosion like change type cervix are 14.13%(41/290)and 22.22%(50/225),individually,showing significant statistical difference(P<0.05).In addition,HSIL risk(22.22%)in 225 patients with cervical erosion like change of middle-aged and old patient group is significantly higher than that(11.29%)in 239 patients with smooth type cervix of young patient group.The difference is statistically significant(P<0.01).Conclusion The middle-aged and elderly patient with a cervical erosion like change has a high risk of developing HSIL,and attention should be paid to such patients during medical examination.