310例宫颈上皮内瘤变(CIN)术后随访的临床分析

摘要

Objective:To analyse the data of cervical intraepithelial neoplasia(CIN) after loop electrosurgical excision procedure (LEEP).Methods:To compare the positive rate of thinprep cytologic test(TCT) and human papillomavirus(HPV) before and after LEEP 3 months,6 months,12 months and analyse the correlation between the grade of CIN and the positive rate of TCT and HPV.Results:The positive rates of TCT before LEEP and after LEEP 3 months,6 months,12 months were 89.68％ in age 21-30,30.00％ in age 31-40,6.77％ 41-50,1.61％ 51-60.The positive rates of HPV before LEEP and after LEEP 3 months,6 months,12 months were 93.55％ in age 21-30,56.77％ in age 31-40,14.19％ in age 41-50,5.48％ in age 51-60.With the age increased.There was a trend of gradually increased positive rate of TCT and HPV in the age group of 21-30,31-40,41-50,51-60 after LEEP 3 months,6 months with age increased(P ＜ 0.05).The significant difference in positive rate of TCT and HPV was found between the age of 51-60 and 21-30,31-40,41-50 after LEEP 12 months(P ＜ 0.05).There were no significant differences in positive rate of TCT and HPV among age 21-30,31-40,41-50 (P ＞ 0.05).Positive rate of TCT and HPV gradually increased after LEEP 3 months,6 months,12 months with the grade of CIN increasing.The difference was significant between CIN2 and CIN3 in same followup period (P ＜ 0.05).Conclusion:LEEP can significantly decrease the positive rate of TCT and HPV.The positive rate of HPV obviously decrease after LEEP 6 months.%目的:分析310例CIN术后随访资料.方法:比较手术前后3月、6月、12月液基细胞术(TCT)阳性率、HPV感染率的改变.分析其与不同年龄,不同病变程度间的关系.结果:310例标本中,术后3月TCT阳性率由术前89.68％降至30.00％,术后6月、12月TCT的阳性率分别为6.77％、1.61％；术后3月HPV的感染率由术前93.55％降至56.77％,术后6月、12月分别为14.19％、5.48％.随年龄增加,术后3月、6月,不同年龄组TCT阳性率及HPV感染率分别逐渐增加,且各组间的差异分别具有显著性(P＜0.05).术后12月,51-60岁年龄组TCT阳性率及HPV感染率均显著高于其余各组,差异具有显著性(P＜0.05),而其它各组间差异无显著性(P＞0.05)；随CIN级别增加,术后3月、6月、12月TCT的阳性率及HPV的感染率分别增加,在同一随访时限内不同级别间TCT阳性率及HPV感染率差异分别具有显著性(P＜0.05).结论:宫颈环形电切术(LEEP)能显著减低TCT、HPV的阳性率.术后3月复查HPV阳性率下降不明显,术后6月HPV阳性率明显降低.对于年龄较大、病变程度高的CIN术后患者,应加强随访.