阴道镜下LEEP联合重组人干扰素α2b治疗宫颈癌前病变的临床效果

Clinical effect of LEEP under colposcopy combined with recombinant human interferonα2b in the treatment of cervical intraepithelial neoplasia

目的分析阴道镜下子宫颈环形电切术(LEEP)联合重组人干扰素α2b治疗宫颈癌前病变(CIN)的临床效果。方法选取2018年6月至2020年10月我院收治的150例CIN患者作为研究对象,根据治疗方案不同将其分为对照组和观察组,各75例。对照组行阴道镜下LEEP治疗,观察组在对照组基础上联合重组人干扰素α2b治疗。比较两组的临床疗效[人乳头瘤病毒(HPV)转阴率、液基薄层细胞学检测(TCT)异常率、切缘阳性率、复发率]、肿瘤标志物[鳞状上皮细胞癌抗原(SCCA)、细胞角蛋白19(CK19)、糖类抗原199(CA199)]、免疫指标[白细胞分化抗原3阳性(CD3^(+))、白细胞分化抗原4阳性(CD4^(+))、CD4^(+)/白细胞分化抗原8阳性(CD8^(+))]、生活质量[Spitzer生活质量指数(SQLI)]。结果术后半年,观察组的HPV转阴率、复发率优于对照组(P<0.05);两组的TCT异常率、切缘阳性率比较,差异无统计学意义(P>0.05)。术后1个月,观察组的SCCA、CK19、CA199水平均低于对照组(P<0.05)。术后1个月,观察组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05)。术后半年,观察组的SQLI评分高于对照组(P<0.05)。结论阴道镜下LEEP联合重组人干扰素α2b治疗CIN的效果显著,有利于降低肿瘤标志物水平,提升患者免疫功能及生存质量,值得临床推广应用。

Objective To analyze the clinical effect of loop electrosurgical excision procedure(LEEP)under colposcopy combined with recombinant human interferonα2b in the treatment of cervical intraepithelial neoplasia(CIN).Methods A total of 150 patients with CIN admitted in our hospital from June 2018 to October 2020 were selected as the study subjects.According to the different treatment regimens,the patients were divided into control group and observation group,with 75 cases in each group.The control group was treated with LEEP under colposcopy,and the observation group was treated with recombinant human interferonα2b on the basis of the control group.The clinical efficacy[negative rate of human papilloma virus(HPV),abnormal rate of thinprep cytologic test(TCT),positive rate of incision margin,recurrence rate],tumor markers[squamous cell carcinoma antigen(SCCA),cytokeratin 19(CK19),carbohydrate antigen 199(CA199)],immune indexes[cluster of differentiation 3 positive(CD3^(+)),cluster of differentiation 4 positive(CD4^(+)),CD4^(+)/cluster of differentiation 8 positive(CD8^(+))],quality of life[Spitzer quality of life index(SQLI)]were compared between the two groups.Results Half an year after operation,the negative rate of HPV and recurrence rate in the observation group were better than those in the control group(P<0.05),there were no significant differences in the abnormal rate of TCT and the positive rate of incision margin between the two groups(P>0.05).One month after operation,the levels of SCCA,CK19 and CA199 in the observation group were lower than those in the control group(P<0.05).One month after operation,the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group(P<0.05).Half an year after operation,the SQLI score in the observation group was higher than that in the control group(P<0.05).Conclusion LEEP under colposcopy combined with recombinant human interferonα2b has remarkable effect in the treatment of CIN,which is conducive to reducing the levels of tumor markers,improving the immune function and quality of life of patients.It is worthy of clinical promotion.