宫颈上皮内瘤变相关危险因素102例分析_临床医学论文.docVIP

宫颈上皮内瘤变相关危险因素102例分析_临床医学论文 宫颈上皮内瘤变相关危险因素102例分析_临床医学论文 【摘要】 　　［目的］ 研究宫颈鳞状上皮内瘤变（CIN）的发病相关危险因素及诊疗方法。 ［方法］ 102例CIN患者行阴道镜下活检和高频电波刀宫颈环状电圈切除术（LEEP），并同时行高危型HPV检测（HCⅡ）。［结果］ 102例患者中CINⅠ54例，CINⅡ29例，CINⅢ19例。LEEP术后治愈率为96.1%（98/102），发现病灶残留4例，复发8例（7.8%）。63例高危型HPV阳性，总感染率为61.76%。CINⅡ、Ⅲ组较CINⅠ感染率显著升高(0.05)。术后HPV持续感染率25%。多因素非条件Logistic回归分析显示，年龄、近5年性传播疾病（STD）感染、无性生活防护和性伴的多性是CIN的独立危险因素。［结论］ CIN与性行为和下生殖道感染等因素相关。LEEP是CIN诊断和治疗的有效方法。高危型HPV与重度CIN的发生有关，术后高危型HPV 检测对预测残留或复发有指导意义。 【关键词】 宫颈上皮内瘤变　危险因素　宫颈电圈切除术　人乳头瘤病毒 　　An Analysis of Risk Factors in 102 Cases with Cervical Intraepithelial Neoplasia QU Wang-lei, JIN Fei, CHEN Wen-bing (The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325007, China) Abstract: ［Purpose］ To study the risk factors，diagnosis and management of cervical intraepithelial neoplasia (CIN). ［Methods］ One hundred and two cases with CIN underwent cervical biopsy by colposcopy and loop electrosurgical excision procedure (LEEP) and hybrid captureⅡ(HCⅡ) test for CIN. ［Results］ Of 102 cases who underwent LEEP, 54 cases were CINⅠ，29 cases were CIN Ⅱand 19 cases were CIN Ⅲ. The cure rate was 96.1%（98/102）by LEEP. There were residual lesions in 4 cases and 8 cases recurred (7.8 %) .The overall positive rate of HR-HPV testing was 61.76% (63 cases). The positive rate in CIN Ⅱand CIN Ⅲ was significantly higher than that in CIN Ⅰ(0.05). The positive rate of HR-HPV persistent infection after LEEP was 25%. The nonconditional multifactors logistic analysis showed that the independent risk factors of CIN were age, history of sexually transmitted diseases(STD) in the latest 5 years, lack of defence in sexual life, and the variety of sexual partners. ［Conclusions］ CIN correlates to sexuality and reproductive tractinfection. LEEP is a kind of effective method for the diagnosis and treatment in CIN. HR-HPV may play an important role in the occurrence of high-grade CIN, and the detection after LEEP helps for prediction of residuals or recurrence. Key words: cervical intraepithe