宫颈环形电切术联合围术期干扰素治疗宫颈上皮内瘤变的疗效及其对T细胞亚群的影响

Efficacy of LEEP combined with perioperative interferon in the treatment of cervical intraepithelial neoplasia and its effect on T cell subsets

目的:分析宫颈环形电切术(LEEP)联合围术期干扰素α2b凝胶治疗宫颈上皮内瘤变(CIN)的疗效及其对T细胞亚群的影响。方法:将100例CIN合并高危型人乳头瘤病毒(HR-HPV)感染患者分为A组和B组,每组各50例。A组采用LEEP术联合术前术后重组人干扰素α2b凝胶治疗,B组采用单纯LEEP手术治疗。比较两组CIN患者手术出血量、手术时间、手术疗效、术后并发症发生率、HR-HPV转阴率、CIN复发率、外周血CD4^(+)、CD8^(+)表达率及CD4^(+)/CD8^(+)比值。结果:两组患者术中出血量、手术时间、总有效率比较,差异均无统计学意义(P>0.05);A组患者疗效及术后3个月内HR-HPV转阴率高于B组,差异有统计学意义(P<0.05);A组患者并发症总发生率及术后12个月CIN复发率低于B组,差异有统计学意义(P<0.05);A组术后CD8^(+)水平低于B组,CD4^(+)、CD4^(+)/CD8^(+)水平高于B组,差异有统计学意义(P<0.05)。结论:LEEP术前术后联合干扰素α2b治疗有助于提高疗效、HR-HPV转阴率及外周血CD4^(+)/CD8^(+)水平,降低术后并发症发生率及CIN复发率,值得临床推广。

Objective:To analyze the effect of loop electrosurgical excision procedure(LEEP)combined with perioperative interferonα2b gel on CIN and its effect on T cell subpopulation.Methods:A total of 100 CIN patients with HR-HPV infection were randomly divided into group A and Group B,with 50 cases each.Patients in group A were treated with LEEP combined with preoperative and postoperative recombinant human interferonα2b gel,while patients in group B were treated with LEEP alone.The operative blood loss,operative time,operative efficacy,postoperative complication rate,HR-HPV negative conversion rate,CIN recurrence rate,and peripheral blood CD4^(+)and CD8^(+)expression rates and CD4^(+)/CD8^(+)ratio were compared between the two groups of CIN patients.Results:There were no statistically significant differences in intraoperative blood loss,operative time,and total effective rate between the two groups(P>0.05).The curative effect and HR-HPV negative conversion rate within 3 months after operation in group A were significantly higher than that in group B,with statistically significant difference(P<0.05).The total incidence of complications and CIN recurrence 12 months after surgery in group A were significantly lower than those in group B(P<0.05).The postoperative CD8^(+)level of group A was significantly lower than that of group B,and the levels of CD4^(+)and CD4^(+)/CD8^(+)were significantly higher than that of group B(P<0.05).Conclusion:LEEP combined with preoperative and postoperative interferonα2b therapy can improve the efficacy,HR-HPV negative conversion rate and the level of CD4^(+)/CD8^(+)in peripheral blood,reduce the incidence of postoperative complications and CIN recurrence,and is worthy of further clinical promotion.