宫颈上皮内瘤变锥切术后复发因素的分析(1)
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[摘要] 目的：探讨宫颈上皮内瘤变(CIN)复发的相关危险因素。方法：回顾性分析我院2006年1月～2009年6月135例行宫颈锥切术治疗的CIN患者的相关资料，进行为期至少1年的随访，收集可能的复发危险因素，并进行单因素和多因素Logistic回归分析。结果：173例在患者随访期内共有21例复发(12.1%)，21例中术后6个月～1年时间内复发15例(72.0%)。复发时间最短6个月，最长23个月，中位时间9个月。单因素和多因素分析显示年龄(P=0.015)、吸烟情况(P=0.019)、切缘阳性情况(P=0.000)及颈管腺体累及(P=0.004)是CIN宫颈锥切术后复发的独立危险因素。结论：高龄、存在主动或被动吸烟、切缘阳性、颈管腺体累及及绝经易造成CIN术后的复发。
[关键词] 宫颈上皮内瘤变；宫颈锥切术；复发；危险因素；Logistic回归
[中图分类号] R737.33[文献标识码]A [文章编号]1673-7210(2010)10(c)-032-03
Analysis of recurrence after conization of cervical intraepithelial neoplasia
MAO Yingzi
(Department of Gynaecology and Obstetrics, the Fifth People's Hospital of Huaihua City, Huaihua 418000, China)
[Abstract] Objective: To explore the risk factors of cervical intraepithelial neoplasia (CIN) related to recurrence. Methods: The relevant data of 135 CIN patients treated by cervical conization from January 2006 to June 2009 in our hospital were retrospectively analyzed, and follow up for a period of at least 1 year, collection of possible risk factors for recurrence, used univariate and multivariate Logistic regression analysis. Results: Routine follow-up period, among 173 patients, 21 patients relapsed (12.1%), 21 cases in 6 months to 1 year after recurrence within 15 cases (72.0%). Shortest time of recurrence 6 months and a maximum of 23 months, the median time was 9 months. Univariate and multivariate analysis showed that age (P=0.015), cigarette smoking (P=0.019), positive margin situation (P=0.000) and neck control gland involved (P=0.004) was cervical conization CIN independent risk factors of recurrence. Conclusion: Elderly, active or passive smoking, positive margin, endocervical glands are involved and after menopause are easily lead to recurrence of CIN.
[Key words] Cervical intraepithelial neoplasia; Cervical conization; Relapse; Risk factors; Logistic regression
宫颈上皮内瘤变(cervical intraepithelial neoplasia，CIN)是浸润性宫颈癌的癌前病变，如不及时治疗，约66%的CIN Ⅱ/Ⅲ级进展为原位癌，2%进展为浸润癌[1]。因此，及时处理早期发现的CIN在降低宫颈癌发病率中具有重要意义。据美国阴道镜宫颈病理学会(American Society for Colposcopy and Cervical Pathology，ASCCP)制定的CIN处理指南提出，对于阴道镜满意的CIN Ⅱ/Ⅲ级患者，可采取宫颈锥切术[1]。宫颈锥切术操作简单、创伤小、出血少，切除组织可病检，可保留子宫及生育能力，是CIN治疗的最主要方法 ......
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