精细化环形电极宫颈锥切术对宫颈上皮内瘤变患者人乳头瘤病毒16/18感染及宫颈机能的影响
|
摘要
目的探讨精细化环形电极宫颈锥切术(LEEP)对宫颈上皮内瘤变(CIN)患者人乳头瘤病毒(HPV) 16/18感染及宫颈机能的影响。方法将80例CIN患者分成观察组及对照组,每组40例。对照组采用冷刀宫颈锥切术治疗,观察组采用精细化LEEP术治疗。观察两组患者术后HPV16/18表达阳性率、宫颈机能及并发症发生情况。结果观察组患者术后3个月宫颈狭窄程度及宫颈修复情况均优于对照组,术后1年并发症发生率低于对照组,术后第6个月、第12个月HPV16/18表达阳性率均低于对照组(均P <0. 05)。结论采用精细化LEEP术治疗CIN患者疗效确切,术后并发症少,利于宫颈机能恢复,有效抑制HPV16/18感染。
Objective To investigate the effect of refined loop electrosurgical excision procedure(LEEP) on human papillomavirus(HPV) 16/18 infection and cervical function in the patients with cervical intraepithelial neoplasia(CIN). Methods Eighty patients with CIN were divided into observation group and control group,with 40 cases in each group. The control group was treated with cold-knife cervical conization,while the observation group was treated with refined LEEP. The positive expression rate of HPV16/18,cervical function and complications were observed after operation in the patients of both groups.Results Compared to the control group,the degree of cervical stenosis and cervical repairment at 3 months after operation were superior,the incident rate of complications at 1 year after operation was lower,and the positive expression rates of HPV16/18 at the 6 th and 12 th months after operation were lower in the observation group(all P < 0. 05). Conclusion Application of refined LEEP to CIN patients can obtain a definite efficacy,fewer postoperative complications,is beneficial to the cervical function recovery and effectively inhibits HPV16/18 infection.
Objective To investigate the effect of refined loop electrosurgical excision procedure(LEEP) on human papillomavirus(HPV) 16/18 infection and cervical function in the patients with cervical intraepithelial neoplasia(CIN). Methods Eighty patients with CIN were divided into observation group and control group,with 40 cases in each group. The control group was treated with cold-knife cervical conization,while the observation group was treated with refined LEEP. The positive expression rate of HPV16/18,cervical function and complications were observed after operation in the patients of both groups.Results Compared to the control group,the degree of cervical stenosis and cervical repairment at 3 months after operation were superior,the incident rate of complications at 1 year after operation was lower,and the positive expression rates of HPV16/18 at the 6 th and 12 th months after operation were lower in the observation group(all P < 0. 05). Conclusion Application of refined LEEP to CIN patients can obtain a definite efficacy,fewer postoperative complications,is beneficial to the cervical function recovery and effectively inhibits HPV16/18 infection.
引文
[1] Guo M,Hu L,Baliga M,et al. The predictive value of p16(INK4a)and hybrid capture 2 human papillomavirus testing for high-grade cervical intraepithelial neoplasia[J]. Am J Clin Pathol,2004,122(6):894-901.
[2] Xi LF,Schiffman M,Ke Y,et al. Type-dependent association between risk of cervical intraepithelial neoplasia and viral load of oncogenic human papillomavirus types other than types 16 and 18[J]. Int J Cancer,2017,140(8):1747-1756.
[3] Hariri S,Bennett NM,Niccolai LM,et al. Reduction in HPV 16/18-associated high grade cervical lesions following HPV vaccine introduction in the United States-2008-2012[J]. Vaccine,2015,33(13):1608-1613.
[4] Garland SM,Paavonen J,Jaisamrarn U,et al. Prior human papillomavirus-16/18 AS04-adjuvanted vaccination prevents recurrent high grade cervical intraepithelial neoplasia after definitive surgical therapy:Post-hocanalysis from a randomized controlled trial:[J]. Int J Cancer,2016,139(12):2812-2826.
[5]孙玉敏. LEEP术治疗宫颈上皮内瘤变的效果研究[J].中国卫生标准管理,2015,6(5):108-109.
[6]李宁,佐晶,黄婴,等. HPV分型检测在子宫颈高级别鳞状上皮内病变治疗后随访中的临床意义[J].中华妇产科杂志,2015,50(4):258-262.
[7] Socolov D,Anton G,Anton AC,et al. Electrosurgical loop excision/conisation for cervical intraepithelial neoplasia in an algorithm that excludes Punch biopsy-a study of 210 cases[J]. Chirurgia(Bucur),2009,104(3):295-301.
[8] Witt BL,Factor RE,Jarboe EA. Negative loop electrosurgical cone biopsy finding following a biopsy diagnosis of HighGrade squamous intraepithelial lesion frequency and clinical significance[J]. Arch Pathol Lab Med,2012,136(10):1259-1261.
[9]吴翠霞,张艳红,葛小花,等.高危型HPV感染与宫颈癌前病变与宫颈癌的相关性研究[J].中华医院感染学杂志,2016,26(11):2568-2570.
[10]蔡为民,阚延静,耿建祥,等.子宫颈尖锐湿疣组织中HPV感染基因型别分布[J].临床与实验病理学杂志,2015,31(4):395-399.
[11]严毅,王晓辉,王玉,等.甘肃武都农村妇女HPV感染、CIN病变与P16~(INK4A)表达相关性分析[J].中华疾病控制杂志,2015,19(11):1171-1173.
[12]栗永梅,汪萍,谢拥军. LEEP刀联合保妇康栓治疗高危型HPV感染CIN的临床观察[J].现代肿瘤医学,2014,22(3):628-630.
[13]王海瑞,廖光东,江宇,等. p16/mcm2双染在宫颈上皮内瘤变的诊断价值及其与高危型HPV感染的关系[J].中华流行病学杂志,2017,38(9):1241-1245.
[14]李亚军,杨明珠,秦文芝.不同级别宫颈病变中HPV感染状态的临床分析[J].中国实验诊断学,2015,19(1):71-74.
[15]杨志玲,刘华,吕瑜玫,等. 120例宫颈上皮内瘤变患者不同型别HPV感染状况分析[J].重庆医学,2016,45(4):475-477.
[16]陈永峰,陈妍,薛荣.高危型HPV-DNA检测在宫颈上皮内瘤变手术治疗后的意义[J].新疆医学,2014,44(2):41-42.
[2] Xi LF,Schiffman M,Ke Y,et al. Type-dependent association between risk of cervical intraepithelial neoplasia and viral load of oncogenic human papillomavirus types other than types 16 and 18[J]. Int J Cancer,2017,140(8):1747-1756.
[3] Hariri S,Bennett NM,Niccolai LM,et al. Reduction in HPV 16/18-associated high grade cervical lesions following HPV vaccine introduction in the United States-2008-2012[J]. Vaccine,2015,33(13):1608-1613.
[4] Garland SM,Paavonen J,Jaisamrarn U,et al. Prior human papillomavirus-16/18 AS04-adjuvanted vaccination prevents recurrent high grade cervical intraepithelial neoplasia after definitive surgical therapy:Post-hocanalysis from a randomized controlled trial:[J]. Int J Cancer,2016,139(12):2812-2826.
[5]孙玉敏. LEEP术治疗宫颈上皮内瘤变的效果研究[J].中国卫生标准管理,2015,6(5):108-109.
[6]李宁,佐晶,黄婴,等. HPV分型检测在子宫颈高级别鳞状上皮内病变治疗后随访中的临床意义[J].中华妇产科杂志,2015,50(4):258-262.
[7] Socolov D,Anton G,Anton AC,et al. Electrosurgical loop excision/conisation for cervical intraepithelial neoplasia in an algorithm that excludes Punch biopsy-a study of 210 cases[J]. Chirurgia(Bucur),2009,104(3):295-301.
[8] Witt BL,Factor RE,Jarboe EA. Negative loop electrosurgical cone biopsy finding following a biopsy diagnosis of HighGrade squamous intraepithelial lesion frequency and clinical significance[J]. Arch Pathol Lab Med,2012,136(10):1259-1261.
[9]吴翠霞,张艳红,葛小花,等.高危型HPV感染与宫颈癌前病变与宫颈癌的相关性研究[J].中华医院感染学杂志,2016,26(11):2568-2570.
[10]蔡为民,阚延静,耿建祥,等.子宫颈尖锐湿疣组织中HPV感染基因型别分布[J].临床与实验病理学杂志,2015,31(4):395-399.
[11]严毅,王晓辉,王玉,等.甘肃武都农村妇女HPV感染、CIN病变与P16~(INK4A)表达相关性分析[J].中华疾病控制杂志,2015,19(11):1171-1173.
[12]栗永梅,汪萍,谢拥军. LEEP刀联合保妇康栓治疗高危型HPV感染CIN的临床观察[J].现代肿瘤医学,2014,22(3):628-630.
[13]王海瑞,廖光东,江宇,等. p16/mcm2双染在宫颈上皮内瘤变的诊断价值及其与高危型HPV感染的关系[J].中华流行病学杂志,2017,38(9):1241-1245.
[14]李亚军,杨明珠,秦文芝.不同级别宫颈病变中HPV感染状态的临床分析[J].中国实验诊断学,2015,19(1):71-74.
[15]杨志玲,刘华,吕瑜玫,等. 120例宫颈上皮内瘤变患者不同型别HPV感染状况分析[J].重庆医学,2016,45(4):475-477.
[16]陈永峰,陈妍,薛荣.高危型HPV-DNA检测在宫颈上皮内瘤变手术治疗后的意义[J].新疆医学,2014,44(2):41-42.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |