宫颈高级别上皮内瘤变病人宫颈锥切术后复发危险因素分析

Analysis of the risk factors for recurrence after coning in patients with high-grade cervical intraepithelial neoplasia

目的:探讨宫颈高级别上皮内瘤变(CIN)病人行宫颈锥切术后复发的高危因素。方法:选取高级别CIN病人145例作为研究对象,根据术后复发情况进行分组;比较2组病人的年龄、孕产次、绝经情况、腺体累及情况、CIN分级以及术前和术后HPV感染情况;采用单因素分析和多因素logistic回归方法分析病人锥切术后复发的危险因素。结果:145例CIN病人术后2年随访复发30例、未复发115例,单因素分析显示病人绝经情况、腺体累及情况、CIN病理分级及术后高危型人乳头瘤病毒(HPV)感染情况与术后复发相关(P<0.05~P<0.01),年龄、孕产次与术后复发无关(P>0.05)。多因素logistic回归分析显示,病人绝经情况、腺体累及情况、CIN病理分级及术后HPV感染情况是术后复发的独立危险因素(P<0.01)。结论:病人绝经情况、腺体累及情况、CIN病理分级以及术后HPV感染情况是高级别CIN病人锥切术后复发的高危因素。

Objective:To investigate the high risk factors for recurrence of high-grade cervical intraepithelial neoplasia(CIN)patients after cervical conization.Methods:The clinical data of 145 patients with high-grade CIN were retrospectively analyzed.According to the recurrence situation within 2 years after operation,the patients were divided into the recurrence group and non-recurrence group.The age,pregnancy and delivery times,menopause,gland involvement,CIN grading and preoperative and postoperative HPV infection bewteen tewo groups were compared.The univariate analysis and multivariate logistic regression were used to analyze the risk factors of recurrence after conical resection.Results:The 145 CIN patients were followed up for two years,30 cases recurrenced,and 115 cases did not recurrence.The results of univariate analysis showed that the postmenopausal status,glandular involvement,CIN pathological grade and postoperatively high-risk human papillomavirus(HPV)infection were correlated with postoperative recurrence(P<0.05 to P<0.01),while the age and pregnancy number were not correlated with postoperative recurrence(P>0.05).The results of multivariate logistic regression analysis showed that the menopause,glandular involvement,CIN pathological grade and postoperative HPV infection were the independent risk factors of postoperative recurrence(P<0.01).Conclusions:The postmenopausal status,glandular involvement,pathological grade of CIN,and postoperative HPV infection are the high risk factors for recurrence after conization in high-grade CIN patients.