【摘要】：目的：通過對117例高級別宮頸上皮內(nèi)瘤變患者的基本資料、術(shù)后病理資料及隨訪資料分析,探討高級別宮頸上皮內(nèi)瘤變患者宮頸錐切術(shù)后殘留與復(fù)發(fā)的高危因素,提高臨床醫(yī)師及高危人群的警惕性,減緩甚至阻止高度上皮內(nèi)瘤變向?qū)m頸浸潤癌的進(jìn)展,降低宮頸癌的發(fā)病率及死亡率。 方法：回顧性分析2008～2011年在南京大學(xué)醫(yī)學(xué)院附屬鼓樓醫(yī)院婦產(chǎn)科門診就診的錐切病理結(jié)果為CIN2或CIN3資料完整的病例117例,完成術(shù)后2年的患者隨訪工作,統(tǒng)計病變殘留或復(fù)發(fā)情況,分析病變殘留或復(fù)發(fā)的相關(guān)危險因素。 結(jié)果：術(shù)后2年內(nèi)共出現(xiàn)病變殘留與復(fù)發(fā)病例18例,2年隨訪結(jié)束后無復(fù)發(fā)或殘留者99例。高級別宮頸上皮內(nèi)瘤變患者術(shù)后病變殘留或復(fù)發(fā)與患者的分娩次數(shù)、絕經(jīng)狀態(tài)、術(shù)后HPV-HC2陽性結(jié)果、切緣是否陰性、是否累及腺體、病變范圍及宮頸管受累情況有關(guān),而與患者年齡、妊娠次數(shù)、術(shù)前HPV陽性結(jié)果無明顯相關(guān)性。 結(jié)論：分娩次數(shù)、絕經(jīng)狀態(tài)、術(shù)后HPV-HC2陽性結(jié)果、切緣是否陰性、是否累及腺體、病變范圍及宮頸管受累情況是高級別宮頸上皮內(nèi)瘤變患者術(shù)后病變殘留或復(fù)發(fā)的高危因素,準(zhǔn)確認(rèn)識高級別宮頸上皮內(nèi)瘤變患者術(shù)后病變殘留或復(fù)發(fā)的危險因素,對預(yù)防高級別宮頸上皮內(nèi)瘤變向?qū)m頸浸潤癌的發(fā)展具有重要意義。
[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.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.33

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