宫颈上皮内瘤变3级锥切边缘阳性与锥切后病变残留的危险因素分析

发布时间：2018-04-01 21:12

本文选题：宫颈上皮内瘤变级　切入点：宫颈锥切　出处：《医学研究生学报》2015年06期

【摘要】：目的宫颈上皮内瘤变3级(cervical intraepithelial neoplasia grade 3,CIN3)锥切边缘阳性是宫颈病变持续或进展为早期浸润癌的高危因素。文中旨在探讨CIN3锥切边缘阳性与锥切后全宫切除标本中病变残留的危险因素。方法回顾性分析广东省人民医院2001至2013年218例先行锥切后再行全宫切除术CIN3患者的临床资料,采用多因素logistic回归分析筛选锥切边缘阳性与锥切后病变残留的独立危险因素。结果患者中55例(25.2%)锥切标本边缘阳性,锥切边缘阳性的独立高危因素是阴道镜检查满意度(OR:5.18,95%CI:2.49~11.10)、锥切标本横径(OR:7.68,95%CI:2.31~28.10)以及CIN3(OR:4.38,95%CI:1.67~12.10)。患者中锥切后全宫切除标本中有病变残留47例(21.6%),病变残留的独立高危因素是锥切标本长径(OR:2.45,95%CI:1.12~5.69)、CIN3(OR:4.96,95%CI:2.17~11.70)及锥切标本边缘状态(OR:4.34,95%CI:1.95~9.78)。结论阴道镜检查满意度、锥切标本径线(横径、长径)、原位癌及锥切标本边缘状态可引起CIN3患者锥切边缘阳性或病变残留,临床工作中需高度重视。
[Abstract]:Objective to explore the positive rate of cervical intraepithelial neoplasia grade 3 intraepithelial neoplasia grade 3 (CIN3) conical margin is a high risk factor for the continuation or progression of cervical lesions to early invasive carcinoma. The purpose of this paper is to investigate the positive edge of CIN3 conical resection and the pathological changes in the specimens of total uterine resection after conical resection. Methods the clinical data of 218 patients with CIN3 after conization and then hysterectomy in Guangdong Provincial people's Hospital from 2001 to 2013 were analyzed retrospectively. Multivariate logistic regression analysis was used to screen the positive edge of conical incisors and the independent risk factors of residual lesions after conical resection. The independent high risk factors of positive conical margin were: the satisfaction degree of colposcopy was OR: 5.1895 CI: 2.491.10, the cross diameter of conical specimen was OR7.6895CI1: 2.31 28.10) and CIN3OR4.38 / 95CIW 1.671.10.The independent high risk factor of residual lesions was conical specimen from 47 cases (21. 6%). Long diameters: OR2.45 and 95: 1: 1.12 / 5.69CIN3 / OR: 4.96 / 95 / CI: 2.17 / 11.70) and the edge state of the conical specimens:: 4.34 / 95 / CI1: 1.95 / 9.78. Conclusion the colposcopy is satisfied with the examination of colposcopy. The diameter of conical specimen (transverse diameter, long diameter, in situ carcinoma and edge state of conical cut specimen) may cause positive or residual lesions in conical incision of CIN3 patients, which should be paid more attention to in clinical work.
【作者单位】：南方医科大学研究生院;广东省人民医院妇产科;
【分类号】：R737.33

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