| 摘要: |
| 目的:探讨宫颈高级别上皮内病变(HSIL)与微小浸润癌患者行宫颈锥切术后病变残留的危险因素。方法:选择河北医科大学第二医院2010年1月至2017年6月因宫颈HSIL或微小浸润癌行宫颈锥切术,术后再行子宫切除术患者122例为研究对象,采用单因素及多因素Logistic回归分析患者年龄、绝经状态、产次、高危型人乳头瘤病毒(HR-HPV)感染种类、锥切方式、病变级别、病变是否累及腺体、病变范围、切缘状态等因素与宫颈锥切术后病变残留的相关性。结果:122例患者中30.3%(37/122)在切除的子宫标本中发现病变残留。单因素分析显示:多重HR-HPV感染(χ~2=10.669,P=0.001)、微小浸润癌(χ~2=6.052,P=0.014)、切缘阳性(χ~2=15.006,P=0.000)与锥切术后病变残留有关。多因素分析显示:多重HR-HPV感染(OR=4.282,95%CI 1.674~10.949,P=0.002)和切缘阳性(OR=4.505,95%CI 1.823~11.138,P=0.001)是宫颈锥切术后病变残留的独立危险因素。结论:多重HR-HPV感染和切缘阳性患者宫颈锥切术后病变残留风险高,应加强管理,密切随访,以早期发现病变残留。 |
| 关键词: 宫颈病变 宫颈锥切术 病变残留 高危型人乳头瘤病毒 切缘阳性 |
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| Analysis of Risk Factors for Residual Lesions after Conization |
| ZHENG Pengtao;ZHANG Lin;YAN Lu |
| (The Second Hospital of Hebei Medical University) |
| Abstract: |
| Objective: To explore risk factors for residual lesions after conization in patients with cervical high-grade squamous intraepithelial lesions( HSIL) and microinvasive cervical cancer.Methods: 122 patients with cervical HSIL or microinvasive cervical cancer were involved,who underwent conization and follow-up hysterecto-my in the second hospital of Hebei Medical University.The relations between residual lesions and age,menopausal status,parity,high-risk human papilloma virus( HR-HPV) types,methods of conization,grade of lesions,glandular involvement,extent of lesions,margin status were assessed.Statistic data were analyzed by chi-squared test and logistic regression analysis.Results: Residual lesions were detected in uterine specimens in 30. 3%( 37/122)patients.Univariate analysis showed that multiple HR-HPV infection( χ2= 10. 669,P = 0. 001),microinvasion( χ2=6. 052,P = 0. 014),positive margins( χ2= 15. 006,P = 0. 000) were risk factors of residual lesions after conization.Multivariate analysis showed that multiple HR-HPV infection( OR = 4. 282,95% CI 1. 674-10. 949,P = 0. 002),positive margin( OR = 4. 505,95%CI 1. 823-11. 138,P = 0. 001) were independent risk factors of residual lesions after conization.Conclusions: The patients with multiple HR-HPV infection and positive margin are at high-risk of residual lesions.Enhanced management and close follow-up are necessary for detecting residual lesions early. |
| Key words: Cervicallesions Conization Residuallesions High-riskhumanpapillomavirus Positivemargin |
