膦甲酸钠联合LEEP治疗高级别宫颈上皮肉瘤变合并高危HPV亚型感染患者的临床疗效

Clinical effect of sodium phosphonate combined with LEEP in the treatment of high-grade cervical epithelial sarcoma complicated with high-risk HPV subtype infection

目的探讨膦甲酸钠联合高频电波刀宫颈电圈切除术(LEEP)治疗高级别宫颈上皮肉瘤变合并高危人乳头瘤病毒(HPV)亚型感染患者的临床疗效。方法选取2018年1月至2019年7月本院收治的100例高级别宫颈上皮肉瘤变合并高危HPV亚型感染患者作为研究对象,按照随机数字表法分为两组,每组50例。对照组予以LEEP治疗,研究组予以膦甲酸钠联合LEEP治疗,比较两组阴道流血时间、阴道流液时间、HPV转阴情况、HPV再感染情况、宫颈薄层液基细胞学检查(TCT)异常情况及免白细胞介素-4(IL-4)、白细胞介素-12(IL-12),和干扰素(IFN-γ)水平。结果研究组阴道流血时间、阴道流液时间比较差异无统计学意义。治疗前,两组IFN-γ、IL-4、IL-12水平比较差异无统计学意义;治疗后,两组IL-4水平均低于治疗前,IFN-γ、IL-12水平均高于治疗前,且研究组IL-4水平低于对照组,IFN-γ、IL-12水平均高于对照组,差异有统计学意义(P<0.05)。术后3、6、12个月研究组TCT异常、HPV再感染率均低于对照组,HPV转阴率高于对照组,差异有统计学意义(P<0.05)。结论膦甲酸钠联合LEEP治疗高级别宫颈上皮肉瘤变合并高危HPV亚型感染效果显著,可促进患者术后恢复,有效降低HPV再感染风险。

Objective To investigate the clinical effect of sodium phosphonate combined with loop electrosurgical excision procedure(LEEP)in the treatment of high-grade cervical epithelial sarcoma complicated with high-risk human papillomavirus(HPV)subtype infection.Methods 100 patients with high-grade cervical epithelial sarcoma complicated with high-risk HPV subtype infection treated in our hospital from January 2018 to July 2019 were selected as the research subjects,and they were divided into two groups according to random number table method,with 50 cases in each group.The control group was treated with LEEP,and the study group was treated with sodium phosphonate combined with LEEP,the vaginal bleeding time,vaginal fluid flow time,HPV negative conversion,HPV reinfection,cervical thin-layer liquid-based cytology(TCT)abnormalities and the levels of interleukin-4(IL-4),interleukin-12(IL-12),interferon-γ(IFN-γ)were compared between the two groups.Results There was no significant difference in vaginal bleeding time and vaginal fluid flow time in the study group.Before treatment,there was no significant difference in the levels of IL-4,IL-12 and IFN-γbetween the two groups;after the treatment,the level of IL-4 in the two groups was lower than that before the treatment,and the level of IFN-γ,IL-12 was higher than those before treatment,and the level of IL-4 in the study group was lower than that in the control group,while the levels of IFN-γand IL-12 in the study group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).At 3,6,and 12 months after operation,the abnormal TCT and HPV reinfection rate in the study group were lower than those in the control group,and the HPV negative conversion rate was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Foscarnet combined with LEEP is effective in the treatment of high-grade cervical epithelial sarcoma with high-risk HPV subtype infection,which can promote postoperative recovery and effectively reduce the risk of HPV reinfection.