高级别宫颈上皮内瘤变患者锥切术后病变残留与复发的危险因素分析

发布时间：2018-11-15 23:33

【摘要】：目的：通过对117例高级别宫颈上皮内瘤变患者的基本资料、术后病理资料及随访资料分析,探讨高级别宫颈上皮内瘤变患者宫颈锥切术后残留与复发的高危因素,提高临床医师及高危人群的警惕性,减缓甚至阻止高度上皮内瘤变向宫颈浸润癌的进展,降低宫颈癌的发病率及死亡率。方法：回顾性分析2008～2011年在南京大学医学院附属鼓楼医院妇产科门诊就诊的锥切病理结果为CIN2或CIN3资料完整的病例117例,完成术后2年的患者随访工作,统计病变残留或复发情况,分析病变残留或复发的相关危险因素。结果：术后2年内共出现病变残留与复发病例18例,2年随访结束后无复发或残留者99例。高级别宫颈上皮内瘤变患者术后病变残留或复发与患者的分娩次数、绝经状态、术后HPV-HC2阳性结果、切缘是否阴性、是否累及腺体、病变范围及宫颈管受累情况有关,而与患者年龄、妊娠次数、术前HPV阳性结果无明显相关性。结论：分娩次数、绝经状态、术后HPV-HC2阳性结果、切缘是否阴性、是否累及腺体、病变范围及宫颈管受累情况是高级别宫颈上皮内瘤变患者术后病变残留或复发的高危因素,准确认识高级别宫颈上皮内瘤变患者术后病变残留或复发的危险因素,对预防高级别宫颈上皮内瘤变向宫颈浸润癌的发展具有重要意义。
[Abstract]:Objective: to investigate the risk factors of residual and recurrence in 117 patients with high grade cervical intraepithelial neoplasia by analyzing the postoperative pathological data and follow-up data. To increase the vigilance of clinicians and high risk groups to slow down or even prevent the progression of high intraepithelial tumors to invasive carcinoma of the cervix and to reduce the incidence and mortality of cervical cancer. Methods: from 2008 to 2011, 117 cases with complete CIN2 or CIN3 data were analyzed retrospectively. The patients were followed up for 2 years after operation, who were treated in Department of Obstetrics and Gynecology of Gulou Hospital affiliated to Medical College of Nanjing University. The risk factors of residual or recurrent lesions were analyzed. Results: there were 18 cases of residual and recurrent lesions within 2 years after operation, and 99 cases had no recurrence or residual after 2 years follow-up. The residual or recurrence of postoperative lesions in patients with high grade cervical intraepithelial neoplasia was related to the number of times of delivery, menopausal status, positive results of HPV-HC2 after operation, negative incisal margin, involvement of glands, extent of lesion and cervical canal involvement. However, there was no significant correlation with age, pregnancy frequency and HPV positive results before operation. Conclusion: the frequency of delivery, menopausal status, the positive results of HPV-HC2 after operation, whether the incisal margin is negative, whether the gland is involved, the extent of lesion and the cervical canal involvement are the high risk factors for residual or recurrence of postoperative lesions in patients with high grade cervical intraepithelial neoplasia. It is of great significance to understand the risk factors of residual or recurrent lesions in patients with high grade cervical intraepithelial neoplasia, and to prevent the development of high grade cervical intraepithelial neoplasms from developing to invasive carcinoma of the cervix.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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