宫颈上皮内瘤变锥切术切缘阳性的相关因素分析
发布时间：2018-07-13 08:38
【摘要】：目的宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)是与宫颈浸润癌密切相关的一组癌前期病变。宫颈锥切术已成为CIN患者首选的治疗方法,手术病理切缘阳性是宫颈锥切术后病变复发的危险因素。本研究通过对接受宫颈冷刀锥切术(cold knifecone,CKC)或环形电切除术(loop electrosurgical excision procedure,LEEP)的CIN患者进行回顾性分析,探讨造成宫颈锥切术切缘阳性的原因,旨在降低切缘阳性率。方法回顾性分析沈阳市妇婴医院2013-01-01-2014-12-31经阴道镜宫颈活检诊断为CIN并接受宫颈锥切术471例患者,对患者年龄、是否绝经、HPV感染、病变范围、手术方式、病变级别和术后病理提示宫颈上皮腺体受累等7种因素与宫颈锥切术后切缘阳性率做相关性分析。结果 471例宫颈锥切术患者中63例术后病理提示切缘阳性,阳性率为13.38%。单因素分析结果显示,宫颈锥切术后切缘阳性与HPV感染(χ~2=8.470,P0.05)、手术方式(χ~2=8.851,P0.01)、病变级别(χ~2=9.842,P0.05)及宫颈上皮腺体受累(χ~2=3.560,P0.05)有关,与患者年龄(t=1.293,P0.05)、是否绝经(χ~2=0.204,P0.05)及病变范围(χ~2=0.498,P0.05)无关。多因素Logistic回归分析显示,HPV感染、LEEP和宫颈高级别病变是CIN锥切术后切缘阳性的危险因素。其中HPV感染因素,与HPV阴性组比较,HPV低危和高危组OR值分别为2.611(95%CI为1.214~5.615)和2.338(95%CI为1.100~4.968);病变级别因素,与CINⅠ比较,CINⅡ、CINⅢ和早期宫颈癌组OR值分别为7.903(95%CI为1.046~29.725)、27.852(95%CI为4.131~86.835)和21.548(95%CI为1.373~124.877)。结论 HPV感染、LEEP及CIN高级别病变是造成宫颈锥切术切缘阳性的高危因素,在CIN制定宫颈锥切手术方式时应予以重视。
[Abstract]:Objective: cervical intraepithelial neoplasia (cervical intraepithelial neoplasia cin) is a group of precancerous lesions closely related to invasive cervical carcinoma. Cervical conization has become the first choice in the treatment of cin patients. The positive margin of operation and pathology is the risk factor for recurrence of cervical conization. The purpose of this study was to investigate the causes of positive margin of cervical conization by retrospective analysis of cin patients undergoing cold knifecone conization or (loop electrosurgical excision procedure LEEP. The purpose of this study was to reduce the positive rate of incisal margin. Methods retrospective analysis was made on 471 patients with cin diagnosed by colposcopy cervical biopsy in Shenyang Gynecological and infantile Hospital 2013-01-01-2014-12-31. The age of the patients, whether or not they were infected by HPV, the extent of the lesion, and the operation methods were analyzed. The grade of lesion and postoperative pathology showed that there were 7 factors related to cervical epithelial gland involvement and the positive rate of incisal margin after conization of cervix. Results among 471 cases of cervical conization, 63 cases showed positive margin after operation, and the positive rate was 13.38%. Univariate analysis showed that the positive margin of cervical conization was associated with HPV infection (蠂 ~ 2 / 2 / 8.470 / P 0.05), surgical method (蠂 ~ (2 / 2) = 8.851 / P ~ (0.01), grade of lesion (蠂 ~ (29) / 842 / P ~ (0.05) and cervical epithelial gland involvement (蠂 ~ (2 +) = 3.560), but had no relationship with age (t = 1.293), menopause (蠂 ~ (2) = 0.204 / 0) and lesion range (蠂 ~ (22) 0.498P ~ (0.05), and was not associated with age (t = 1.293), menopause (蠂 ~ (2) = 0.204) and lesion range (蠂 ~ (20.498) P 0.05). Multivariate logistic regression analysis showed that the infection of HPV and high grade lesions of cervix were the risk factors of positive margin after cin conization. The OR values of low risk and high risk groups were 2.611 (95 CI = 1.2145.615) and 2.338 (95 CI = 1.100 卤4.968), and the OR values of cin 鈪，
本文编号：2118800
[Abstract]:Objective: cervical intraepithelial neoplasia (cervical intraepithelial neoplasia cin) is a group of precancerous lesions closely related to invasive cervical carcinoma. Cervical conization has become the first choice in the treatment of cin patients. The positive margin of operation and pathology is the risk factor for recurrence of cervical conization. The purpose of this study was to investigate the causes of positive margin of cervical conization by retrospective analysis of cin patients undergoing cold knifecone conization or (loop electrosurgical excision procedure LEEP. The purpose of this study was to reduce the positive rate of incisal margin. Methods retrospective analysis was made on 471 patients with cin diagnosed by colposcopy cervical biopsy in Shenyang Gynecological and infantile Hospital 2013-01-01-2014-12-31. The age of the patients, whether or not they were infected by HPV, the extent of the lesion, and the operation methods were analyzed. The grade of lesion and postoperative pathology showed that there were 7 factors related to cervical epithelial gland involvement and the positive rate of incisal margin after conization of cervix. Results among 471 cases of cervical conization, 63 cases showed positive margin after operation, and the positive rate was 13.38%. Univariate analysis showed that the positive margin of cervical conization was associated with HPV infection (蠂 ~ 2 / 2 / 8.470 / P 0.05), surgical method (蠂 ~ (2 / 2) = 8.851 / P ~ (0.01), grade of lesion (蠂 ~ (29) / 842 / P ~ (0.05) and cervical epithelial gland involvement (蠂 ~ (2 +) = 3.560), but had no relationship with age (t = 1.293), menopause (蠂 ~ (2) = 0.204 / 0) and lesion range (蠂 ~ (22) 0.498P ~ (0.05), and was not associated with age (t = 1.293), menopause (蠂 ~ (2) = 0.204) and lesion range (蠂 ~ (20.498) P 0.05). Multivariate logistic regression analysis showed that the infection of HPV and high grade lesions of cervix were the risk factors of positive margin after cin conization. The OR values of low risk and high risk groups were 2.611 (95 CI = 1.2145.615) and 2.338 (95 CI = 1.100 卤4.968), and the OR values of cin 鈪，
本文编号：2118800
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