Preoperative assessment indicators for high-grade cervical intraepithelial neoplasia

Wu Jin; Luo Ming; Duan Zhaoning; Jia Ying

doi:10.13406/j.cnki.cyxb.000953

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Preoperative assessment indicators for high-grade cervical intraepithelial neoplasia

更新时间：2024-01-17

- Preoperative assessment indicators for high-grade cervical intraepithelial neoplasia
- Journal of Chongqing Medical University Vol. 41, Issue 7, Pages: 698-702(2016)
- 作者机构：
  
  重庆医科大学附属第一医院妇产科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.000953
  CLC： R737.33
- Published：2016，
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[1]吴瑾,罗鸣,段赵宁,贾英.宫颈上皮内瘤变术前临床指标预测价值研究[J].重庆医科大学学报,2016,41(07):698-702.

Wu Jin, Luo Ming, Duan Zhaoning, et al. Preoperative assessment indicators for high-grade cervical intraepithelial neoplasia. [J]. Journal of Chongqing Medical University 41(7):698-702(2016)
[1]吴瑾,罗鸣,段赵宁,贾英.宫颈上皮内瘤变术前临床指标预测价值研究[J].重庆医科大学学报,2016,41(07):698-702. DOI： 10.13406/j.cnki.cyxb.000953.

Wu Jin, Luo Ming, Duan Zhaoning, et al. Preoperative assessment indicators for high-grade cervical intraepithelial neoplasia. [J]. Journal of Chongqing Medical University 41(7):698-702(2016) DOI： 10.13406/j.cnki.cyxb.000953.

摘要

目的:探讨宫颈上皮内瘤变2

级（cervical intraepithelial neoplasia

CIN）的临床指标与宫颈环状电切术（loop electrosurgical excision procedure

LEEP）治疗预后的相关性。方法:回顾性分析835例CIN2

级患者行LEEP术前的细胞学检查（Thin Prep cell test

TCT）

人乳头状瘤病毒（human papillomavirus

HPV）及病检

与术后切缘及复发的关系。结果:术后切缘阳性者105例（12.6%）

CIN3及CIN累腺组切缘阳性率高（P

0.05）;复发者19例（2.3%）

HPV16型组复发率高（P

0.05）;多因素logistic分析中

术前CIN3组（OR=1.717

95%CI=1.110

.656）和腺体受累组（OR=1.611

95%CI=1.048

.477）术后切缘阳性的风险增高;术前HPV16阳性（OR=5.840

95%CI=1.772

9.275）术后CIN复发风险增高

但切除宽度

2 cm组（OR=0.240

95%CI=0.065

.888）复发的风险降低。结论:术前CIN3及CIN累及腺体可作为LEEP切除范围的指导指标

而HPV16感染可作为预测术后复发的指标。

Abstract

Objective:To investigate clinical indicators to assess resection range

lesions residue and prognosis after loop electrosurgical excision procedure(LEEP) for cervical intraepithelial neoplasia(CIN) 2/3. Methods:The clinical data of 836 patients with CIN2/3who were treated with LEEP were retrospectively analyzed. The relationship between pre-operative results of Thin Prep cell test(TCT)

human papillomavirus(HPV)

pathological examination

resection range and post-operative excision margins and residual/recurrent was explored. Results:Positive excision margin was detected in 105/835(12.6%). The rate of positive excision margins was significantly higher in patients with CIN3 and patients with crypt involvement by CIN(P <0.05). CIN2/3 was detected in 19/835(2.3%) patients during follow-up. Post-treatment CIN2/3 was significantly higher in cases of pre-operative HPV16 infection(P<0.05). In the multivariable logistic regression analysis

the incidence of positive excision margins was significantly increased in cases of preoperative CIN3(OR=1.717

95%CI=1.110 to 2.656)and cases of preoperative crypt involvement by CIN(OR=1.611

95%CI=1.048 to 2.477)

and post-treatment CIN2/3 was significantly higher in cases of preoperative HPV16 infection(OR =5.840

95% CI =1.772

19.275) but was significantly decreased in cases with incisal marginwidth >2 cm(OR=0.240

95%CI=0.065 to 0.888). Conclusion:Preoperative CIN3 and crypt involvement by CIN should be used as indicators of clinical assessment for operative range before LEEP. HPV16 should be taken as a risk indicator for residual/recurrent CIN2/3 after LEEP.

关键词

宫颈上皮内瘤变宫颈环状电切术液基细胞学检查人乳头状瘤病毒病理学检查

Keywords

cervical intraepithelial neoplasialoop electrosurgical excision procedureThin Prep cell testhuman papillomaviruspathological examination

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Related Institution

Department of Cervical Disease,Maternal and Child Health Center of Chongqing

Department of Obstetrics and Gynecology,the Second Affiliated Hospital,Chongqing Medical University

Department of Clincal Laboratory,Chongqing Maternal and Child Health Hospital

Departmant of Obsterics and Gynecolpgy，the Second Affiliated Hospital of Chongqing Medical University

(Outpatient Department of Gynecology,Chongqing Obstetric and Gynecology Hospital，Chongqing Special Department of Cervical Disease)

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