多点CINⅢ级相关危险因素分析
|
摘要
目的探讨多点CINⅢ级发生的相关危险因素,为临床多点CINⅢ级的诊治提供理论依据。方法选取2014年9月到2017年9月经我院确诊的300例CINⅢ级患者,其中单点CINⅢ级103例作为对照组,多点CINⅢ级197例为病例组,分析多点CINⅢ级与各因素之间的相关性。结果经单因素分析及多因素Logistic回归分析,年龄、HPV感染、阴道pH值、妊娠次数及性伴侣人数是多点CINⅢ级的高危因素(OR值分别为:3.43,2.36,2.22,2.22,2.20)。结论多点CINⅢ级的发病与HPV感染密切相关,且与患者年龄、日常生活因素存在紧密的联系,广大女性应养成良好的生活习惯,降低宫颈癌的发病。
Objective To investigate the risk factors of multi-point CIN grade Ⅲ(CINⅢ) and to provide evidence for clinical diagnosis and treatment of multi-point CINⅢ. Methods 300 patients with CINⅢ diagnosed in our hospital from September 2014 to September 2017 were selected.103 cases of single-point CINⅢ were taken as control group, and 197 cases of multi-point CINⅢ were used as case group.The correlation between multi-point CINⅢ and related factors was analyzed. Results After univariate analysis and multivariate logistic regression analysis, the risk factors of multi-point CINⅢ were age, high-risk HPV infection, vaginal pH value, number of pregnancies and sexual partners(OR values:3.43,2.36,2.22,2.22,2.20). Conclusion The occurrence of multi-point CINⅢ is associated with HPV infection, patient age and daily life factors.Women should develop good living habits to reduce the incidence of cervical cancer.
Objective To investigate the risk factors of multi-point CIN grade Ⅲ(CINⅢ) and to provide evidence for clinical diagnosis and treatment of multi-point CINⅢ. Methods 300 patients with CINⅢ diagnosed in our hospital from September 2014 to September 2017 were selected.103 cases of single-point CINⅢ were taken as control group, and 197 cases of multi-point CINⅢ were used as case group.The correlation between multi-point CINⅢ and related factors was analyzed. Results After univariate analysis and multivariate logistic regression analysis, the risk factors of multi-point CINⅢ were age, high-risk HPV infection, vaginal pH value, number of pregnancies and sexual partners(OR values:3.43,2.36,2.22,2.22,2.20). Conclusion The occurrence of multi-point CINⅢ is associated with HPV infection, patient age and daily life factors.Women should develop good living habits to reduce the incidence of cervical cancer.
引文
1 Ferlay J,Soerjomataram I,Dikshit R,et al.Cancer incidence and mortality worldwide:sources,methods and major patterns in GLOBOCAN 2012.Int J Cancer,2015,136:E359-E386.
2 Xiang L,Li J,Yang W,et al.Conization using an electrosurgical knife for cervical intraepithelial neoplasia and microinvasive carcinoma.PLOS ONE,2015,10:e0131790.
3 Ghaem-Maghami S,Sagi S,Majeed G,et al.Incomplete excision of cervical intraepithelial neoplasia and risk of treatment failure:a meta-analysis.Lancet Oncol,2007,8:985-993.
4 Park JY,Lee SM,Yoo CW,et al.Risk factors predicting residual disease in subsequent hysterectomy following conization for cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer.Gynecol Oncol,2007,107:39-44.
5 Guducu N,Sidar G,Bassullu N,et al.Endocervical glandular involvement,multicentricity,and extent of the disease are features of high-grade cervical intraepithelial neoplasia.Ann Diagn Pathol,2013,17:345-346.
6 谭先杰,昊鸣,郎景和,等.子宫颈锥形切除术后全子宫切除95例临床分析.现代妇产科进展,2008,17:366-369.
7 Natee J,Therasakvichaya S,Boriboonhirunsarn D.Prevalence and risk factors for residual cervical neoplasia in subsequent hysterectomy following LEEP or conization.J Med Assoc Thai,2005,88:1344-1348.
8 Berraho M,Amarti-Riffi A,El-Mzibri M,et al.HPV and cofactors for invasive cervical cancer in Morocco:a multicentre case-control study.BMC Cancer,2017,17:435.
9 Lu Z,Chen H,Zheng X M,et al.Expression and clinical significance of high risk human papillomavirus and invasive gene in cervical carcinoma.Asian Pac J Trop M,2017,10:195-200.
10 Boulanger J C,Gondry J,Verhoest P,et al.Treatment of CIN after menopause.Eur J Obstet Gynecol Reprod Biol,2001,95:175-180.
11 Catarino R,Petignat P,Dongui G,et al.Cervical cancer screening in developing countries at a crossroad:Emerging technologies and policy choices.World J Clin Oncol,2015,6:281-290.
12 Rositch A F,Nowak R G,Gravitt P E.Increased age and race‐specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009.Cancer,2014,120:2032-2038.
13 Li J,McCormick J,Bocking A,et al.Importance of vaginal microbes in reproductive health.Reprod Sci,2012,19:235-242.
14 Banut-Sabine M,Verbruggen,Mathilde E,et al.Dysbacteriosis and squamous (pre) neoplasia of immigrants and Dutch women as established in population-based cervical screening.Diagn Cytopathol,2006,34:377-381.
15 Zozaya-Hindhliffe M,Lillis R,Martin DH,et al.Quantitative PCR assessments of bacterial species in women with and without bacterial vaginosis.J Clin Microbiol,2010,48:1812-1819.
16 Goodman M T,Shvetsov Y B,McDuffie K,et al.Prevalence,acquisition,and clearance of cervical human papillomavirus infection among women with normal cytology:Hawaii human papillomavirus cohort study.Cancer Res,2008,68:8813-8824.
17 Ye J,Cheng X,Chen X,et al.Short-term type specific HPV persistence and its predictors in an asymptomatic general female population in Zhejiang,China.Int J Gynaecol Obstet,2010,110:217-222.
18 Maucort-Boulch D,Plummer M,Castle P E,et al.Predictors of human papillomavirus persistence among women with equivocal or mildly abnormal cytology.Int J Cancer,2010,126:684-691.
19 Kim JW,Song SH,Jin CH,et al.Factors affecting the clearance of high-risk human papillomavirus infection and the progression of cervical intraepithelial neoplasia.J Int Med Res,2012,40:486-496.
20 Murthy NS,Mathew A.Risk factors for pre-cancerous lesions of the cervix.Eur J Cancer Prev,2000,9:5-14.
21 Bekker RL,Keyser KG,Bulten J,et al.The value of loop electrosurgical conization in the treament of stage IA1 microinvasive carcinoma of the uterine cervix.Int J Gynecol Cancer,2002,12:485-489.
2 Xiang L,Li J,Yang W,et al.Conization using an electrosurgical knife for cervical intraepithelial neoplasia and microinvasive carcinoma.PLOS ONE,2015,10:e0131790.
3 Ghaem-Maghami S,Sagi S,Majeed G,et al.Incomplete excision of cervical intraepithelial neoplasia and risk of treatment failure:a meta-analysis.Lancet Oncol,2007,8:985-993.
4 Park JY,Lee SM,Yoo CW,et al.Risk factors predicting residual disease in subsequent hysterectomy following conization for cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer.Gynecol Oncol,2007,107:39-44.
5 Guducu N,Sidar G,Bassullu N,et al.Endocervical glandular involvement,multicentricity,and extent of the disease are features of high-grade cervical intraepithelial neoplasia.Ann Diagn Pathol,2013,17:345-346.
6 谭先杰,昊鸣,郎景和,等.子宫颈锥形切除术后全子宫切除95例临床分析.现代妇产科进展,2008,17:366-369.
7 Natee J,Therasakvichaya S,Boriboonhirunsarn D.Prevalence and risk factors for residual cervical neoplasia in subsequent hysterectomy following LEEP or conization.J Med Assoc Thai,2005,88:1344-1348.
8 Berraho M,Amarti-Riffi A,El-Mzibri M,et al.HPV and cofactors for invasive cervical cancer in Morocco:a multicentre case-control study.BMC Cancer,2017,17:435.
9 Lu Z,Chen H,Zheng X M,et al.Expression and clinical significance of high risk human papillomavirus and invasive gene in cervical carcinoma.Asian Pac J Trop M,2017,10:195-200.
10 Boulanger J C,Gondry J,Verhoest P,et al.Treatment of CIN after menopause.Eur J Obstet Gynecol Reprod Biol,2001,95:175-180.
11 Catarino R,Petignat P,Dongui G,et al.Cervical cancer screening in developing countries at a crossroad:Emerging technologies and policy choices.World J Clin Oncol,2015,6:281-290.
12 Rositch A F,Nowak R G,Gravitt P E.Increased age and race‐specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009.Cancer,2014,120:2032-2038.
13 Li J,McCormick J,Bocking A,et al.Importance of vaginal microbes in reproductive health.Reprod Sci,2012,19:235-242.
14 Banut-Sabine M,Verbruggen,Mathilde E,et al.Dysbacteriosis and squamous (pre) neoplasia of immigrants and Dutch women as established in population-based cervical screening.Diagn Cytopathol,2006,34:377-381.
15 Zozaya-Hindhliffe M,Lillis R,Martin DH,et al.Quantitative PCR assessments of bacterial species in women with and without bacterial vaginosis.J Clin Microbiol,2010,48:1812-1819.
16 Goodman M T,Shvetsov Y B,McDuffie K,et al.Prevalence,acquisition,and clearance of cervical human papillomavirus infection among women with normal cytology:Hawaii human papillomavirus cohort study.Cancer Res,2008,68:8813-8824.
17 Ye J,Cheng X,Chen X,et al.Short-term type specific HPV persistence and its predictors in an asymptomatic general female population in Zhejiang,China.Int J Gynaecol Obstet,2010,110:217-222.
18 Maucort-Boulch D,Plummer M,Castle P E,et al.Predictors of human papillomavirus persistence among women with equivocal or mildly abnormal cytology.Int J Cancer,2010,126:684-691.
19 Kim JW,Song SH,Jin CH,et al.Factors affecting the clearance of high-risk human papillomavirus infection and the progression of cervical intraepithelial neoplasia.J Int Med Res,2012,40:486-496.
20 Murthy NS,Mathew A.Risk factors for pre-cancerous lesions of the cervix.Eur J Cancer Prev,2000,9:5-14.
21 Bekker RL,Keyser KG,Bulten J,et al.The value of loop electrosurgical conization in the treament of stage IA1 microinvasive carcinoma of the uterine cervix.Int J Gynecol Cancer,2002,12:485-489.