宫颈上皮内瘤变锥切术后复发因素分析.docVIP

宫颈上皮内瘤变锥切术后复发因素分析[摘要] 目的：探讨宫颈上皮内瘤变（CIN）复发的相关危险因素。方法：回顾性分析我院2006年1月～2009年6月135例行宫颈锥切术治疗的CIN患者的相关资料，进行为期至少1年的随访，收集可能的复发危险因素，并进行单因素和多因素Logistic回归分析。结果：173例在患者随访期内共有21例复发（12.1%），21例中术后6个月～1年时间内复发15例（72.0%）。复发时间最短6个月，最长23个月，中位时间9个月。单因素和多因素分析显示年龄（P=0.015）、吸烟情况（P=0.019）、切缘阳性情况（P=0.000）及颈管腺体累及（P=0.004）是CIN宫颈锥切术后复发的独立危险因素。结论：高龄、存在主动或被动吸烟、切缘阳性、颈管腺体累及及绝经易造成CIN术后的复发。 [关键词] 宫颈上皮内瘤变；宫颈锥切术；复发；危险因素；Logistic回归 [中图分类号] R737.33[文献标识码]Ａ [文章编号]1673-7210（2010）10（c）-032-03 Analysis of recurrence after conization of cervical intraepithelial neoplasia MAO Yingzi (Department of Gynaecology and Obstetrics, the Fifth People’s Hospital of Huaihua City, Huaihua 418000, China) [Abstract] Objective: To explore the risk factors of cervical intraepithelial neoplasia (CIN) related to recurrence. Methods: The relevant data of 135 CIN patients treated by cervical conization from January 2006 to June 2009 in our hospital were retrospectively analyzed, and follow up for a period of at least 1 year, collection of possible risk factors for recurrence, used univariate and multivariate Logistic regression analysis. Results: Routine follow-up period, among 173 patients, 21 patients relapsed (12.1%), 21 cases in 6 months to 1 year after recurrence within 15 cases (72.0%). Shortest time of recurrence 6 months and a maximum of 23 months, the median time was 9 months. Univariate and multivariate analysis showed that age (P=0.015), cigarette smoking (P=0.019), positive margin situation (P=0.000) and neck control gland involved (P=0.004) was cervical conization CIN independent risk factors of recurrence. Conclusion: Elderly, active or passive smoking, positive margin, endocervical glands are involved and after menopause are easily lead to recurrence of CIN. [Key words] Cervical intraepithelial neoplasia; Cervical conization; Relapse; Risk factors; Logistic regression 宫颈上皮内瘤变（cervical intraepithelial neoplasia，CIN）是浸润性宫颈癌的癌前病变，如不及时治疗，约66%的CIN Ⅱ/Ⅲ级进展为原位癌，2%进展为浸润癌[1]。因此，及时处理早期发现的CIN在降低宫颈癌发病率中具有