绝经期与非绝经期高级别宫颈上皮内瘤变及宫颈癌患者临床特点分析

发布时间：2018-03-06 00:21

本文选题：绝经　切入点：宫颈上皮内瘤变　出处：《中国妇产科临床杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨绝经期高级别CIN乃至宫颈癌患者的不同特点。方法回顾性分析2014年1月至2015年9月宫颈冷刀锥切术手术病理确诊为CIN2级及以上的139例患者(绝经组35例,未绝经组104例)临床特点。结果 (1)绝经组患者仅8.57%出现接触性出血,明显低于未绝经组患者(23.08%),同时,绝经组患者65.71%(23/35)宫颈外观光滑,明显高于未绝经组患者(34.62%,36/104),χ~2=10.3673,P=0.0013;(2)绝经组和未绝经组患者中均以HPV16感染为最多见。未绝经组单独HPV16感染占比46.2%(48/104),HPV16合并其他高危型别感染占比17.3(18/104);而绝经组则分别为51.4%(18/35)和14.3%(5/35)。两组比较,差异无统计学意义(P0.05);(3)绝经组患者高危HPV阳性率91.4%(32/35),未绝经组患者为96.2%(100/104)(χ~2=1.223,P=0.368);绝经组患者HPV16阳性率为65.7%(23/35),未绝经组患者为68.3%(71/104)(χ~2=1.223,P=0.368);绝经组和未绝经组患者TCT检查提示HSIL阳性率均偏低,分别为28.6%(10/35)和25%(26/104)。结论绝经期患者宫颈鳞柱交界内移,接触性出血较少,宫颈外观常光滑,临床症状体征不明显,因此严格规律的宫颈筛查尤为重要。
[Abstract]:Objective to investigate the different characteristics of high grade CIN and cervical cancer in menopausal period. Methods from January 2014 to September 2015, 139 patients with CIN2 grade and above were analyzed retrospectively. Results only 8.57% patients in the menopausal group had contact bleeding, which was significantly lower than that in the unmenopausal group. Meanwhile, the appearance of cervix was smooth in the menopausal group (65.71 / 35). It was significantly higher than that in the unmenopausal group (34.622% 36 / 104, 蠂 2 10.3673 P0. 0013%). The HPV16 infection was the most common in the menopausal group and the unmenopausal group. The proportion of HPV16 infection alone in the unmenopausal group was 46.2% 104HPV16 / 104HPV16 with other high-risk types of infection, and in the menopausal group it was 51.4% 1835%) and 14.3335% in the menopausal group, respectively. There was no significant difference in the positive rate of high risk HPV between menopausal group and unmenopausal group. The positive rate of high risk HPV in the menopausal group was 91.4 / 32 / 35, and in the unmenopausal group was 96.2o / 100 / 104g (蠂 ~ 21.2223 / P 0.368). The positive rate of HPV16 was 65.723 / 3535 in menopause group and 68.31104m in premenopausal group (蠂 ~ 21.2233P = 0.368). TCT examination in menopausal group and unmenopausal group showed that the positive rate of HSIL was lower than that in postmenopausal and unmenopausal group. Conclusions Cervical screening is very important in menopausal patients with cervical squamous column movement, less contact bleeding, smooth cervical appearance, and lack of clinical symptoms and signs.
【作者单位】：首都医科大学附属北京友谊医院;
【分类号】：R737.33

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