CIN治疗后评估手段及随访时间的临床研究

发布时间：2018-04-01 03:12

本文选题：宫颈鳞状上皮内瘤变　切入点：HPV检测　出处：《现代妇产科进展》2015年10期

【摘要】：目的:研究宫颈上皮内瘤变(CIN)治疗后随访的手段和方法,包括随访时间、间隔时间和评估手段。方法:2011~2012年在我院进行CIN手术治疗并规律随访的患者685例,随访18~42个月,采用间隔4~6个月进行HPV检测、宫颈液基细胞学检查和阴道镜检查等评估手段,将其结果与设定的3个临床结局[痊愈、HPV持续感染、CIN残留(复发)]比较,分析其相关性并进行统计学分析。结果:术后6月,HPV检测的阴性预测值为97.9%,阳性预测值为42.6%;HPV(-)+TCT(-)的阴性预测值为98.2%,阳性预测值为73.1%;HPV(-)+Colp.(-)的阴性预测值为98.4%,阳性预测值为54.5%。3者检测结果的阴性预测值比较,差异无统计学意义(P0.05);阳性预测值以HPV+TCT方法更准确。术后12月复诊患者中,HPV、HPV+TCT和HPV+Colp.检测的阳性预测值分别为69.7%,77.8%,77.8%,均高于术后6个月;而阴性预测值者低于术后6个月。结论:HPV检测是CIN手术治疗后随访和评估较好的手段;6个月内HPV检测阴性对CIN临床预后的阴性预测更准确;HPV阳性预测值与临床结局的关系,HPV与TCT联合检查最准确;12个月的随访阳性结果比术后6个月的结果对残留/复发病例的预测更准确。
[Abstract]:Objective: to study the methods of follow-up after treatment of cervical intraepithelial neoplasia (cin), including follow-up time, interval and evaluation methods. Methods: 685 patients underwent CIN operation in our hospital from 2011 to 2012 and were followed up regularly for 18 ~ 42 months. HPV, cervical liquid-based cytology and colposcopy were evaluated at intervals of 4 to 6 months. The results were compared with the three clinical outcomes. Results: the negative predictive value of HPV test was 97.9, the positive predictive value was 42.6 HPV-TCT-TCT-negative predictive value was 98.2 and the positive predictive value was 73.1% HPV-Colp.HPV-Colp.-), the positive predictive value was 98.4 and the positive predictive value was 98.4, respectively, and the positive predictive value was 98.4 and the positive predictive value was 98.2 and the positive predictive value was 98.4 and the positive predictive value was 98.4 and the positive predictive value was 98.4 and the positive predictive value was 98.4 and the positive predictive value was 98.4, respectively. The negative predictive value of the test results was 54.5.3, The positive predictive value of HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-HPV-H@@. The negative predictive value of HPV was lower than that of 6 months after operation. Conclusion: the detection of HPV is a better method for the follow-up and evaluation of CIN after operation, and the negative predictive value of HPV is more accurate in predicting the clinical prognosis of CIN within 6 months. The results of 12 months follow-up were more accurate than those of 6 months after operation for the prediction of residual / recurrent cases.
【作者单位】：深圳市妇幼保健院妇科子宫颈疾病诊治中心;
【分类号】：R737.33

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