宫颈环形电切术联合阴道镜治疗宫颈癌前病变患者的临床效果

Clinical Effect of Cervical Circular Electrotomy Combined with Colposcopy in the Treatment of Cervical Precancerous Lesions

目的 评估宫颈癌前病变(precancerous lesions of cervical cancer,CCP)患者接受宫颈环形电切术(circular electrotomy of cervix,LEEP)+阴道镜治疗的临床效果。方法 目的抽样法选取2019年6月—2022年6月武汉仁爱医院收治的230例CCP患者为研究对象。根据治疗方法不同分为观察组和对照组,各115例。观察组给予LEEP+阴道镜治疗、对照组给予宫颈激光烧灼术治疗。对比两组手术相关指标、肿瘤标志物、高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)转阴率、复发率。结果 观察组各项手术相关指标优于对照组,差异有统计学意义(P均<0.05)。术后,观察组细胞角蛋白19(cytokeratin 19,CK19)、鳞状上皮细胞癌抗原(squamous cell carcinoma antigen,SCC-Ag)、癌胚抗原(carcinoembryonic antigen,CEA)低于对照组,差异有统计学意义(P均<0.05)。随访1年,观察组HR-HPV转阴率为98.26%(113/115),高于对照组的90.43%(104/115),复发率为0.88%(1/113),低于对照组的6.73%(7/104),差异有统计学意义(χ^(2)=6.604、5.212,P均<0.05)。结论 在CCP治疗中采用LEEP+阴道镜,可以改善手术相关指标,提高HR-HPV转阴率,降低CK19、SCC-Ag、CEA表达及复发率。

Objective To evaluate the clinical effect of circular electrotomy of cervix (LEEP) plus colposcopy on precancerous lesions of cervical cancer (CCP).Methods 230 CCP patients admitted to Wuhan Renai Hospital from June2019 to June 2022 were selected as the research objects by target sampling method.According to different treatment methods,they were divided into an observation group and a control group,with 115 cases in each group.The observation group received LEEP+colposcopy treatment,while the control group received cervical laser cauterization treatment.Compare two groups of surgical related indicators,tumor markers,high risk human papillomavirus (HR-HPV)seroconversion rate,and recurrence rate.Results The observation group had better surgical related indicators than the control group,and the differences were statistically significant (all P<0.05).After surgery,the levels of cytokeratin 19(CK19),squamous cell carcinoma antigen (SCC-Ag),and carcinoembryonic antigen (CEA) in the observation group were lower than those in the control group,and the differences were statistically significant (both P<0.05).After a oneyear follow-up,the HR-HPV conversion rate in the observation group was 98.26%(113/115),which was higher than the control group's 90.43%(104/115),and the recurrence rate was 0.88%(1/113),which was lower than the control group's 6.73%(7/104),the differences were statistically significant (χ^(2)=6.604,5.212,both P<0.05)。Conclusion The use of LEEP+colposcopy in CCP treatment can improve surgical related indicators,increase HR-HPV negative conversion rate,reduce CK19,SCC-Ag,CEA expression and recurrence rate.