LEEP治疗CIN伴高危型HPV感染的临床观察

目的探讨高频电波刀电圈切除术（LEEP）治疗宫颈上皮内瘤变（CIN）伴高危型人乳头瘤病毒（HPV）感染的临床疗效。方法对116例CINⅠ～Ⅲ伴高危型HPV阳性患者进行LEEP治疗，术后3个月再次检测其宫颈HPV—DNA的负荷量，同时行阴道镜检查及宫颈活检。结果术后3个月，80％以上的CINⅠ-Ⅲ病例转为慢性炎症；宫颈HPV负荷量由术前162．81下降为1．05，转阴率47．41％，低HPV负荷组与高HPV负荷组两组之间CIN转归存在显著差异（P=0．000）。结论LEEP可以有效治疗宫颈上皮内瘤变，同时可以明显降低宫颈HPV负荷量。LEEP治疗后，宫颈病变的转归与术后高危型HPV的负荷量的高低密切相关，提示高危型HPV负荷量的检测作为CIN治疗后随访项目之一有其必要性。

Clinical observation of cervical intra-epithelial neoplasia with high risk HPV infection after LEEP treatment

Objective To explore the curative effect of loop electrosurgical excision procedure （LEEP） on cervical intra- epithelial neoplasia （CIN） infected with high risk human papillomavirus （HR- HPV）. Methods A total of 116 women with high risk human papillomavirus （HR- HPV） infection and CIN Ⅰ/Ⅱ/Ⅲ confirmed by histology were treated by LEEP. Three months later, HR- HPV load was measured by Hybird Capture 2 （HC2） system again, And in the meanwhile, the colposcopy and cervical biopsy were performed. Results According to pathology, 84.13% of the women with CIN Ⅰ , 85.71% of CIN Ⅱ and 83.33% of CIN m turned to chronic cervicitis three moths later. The preoperative HPV - DNA loading showed no significant difference among women with CINⅠ , CINⅡand CIN m （P=0.705）. HPV loading turned to be negative postoperatively in 47.41% （55/116） of the women. After LEEP treatment, in the low viral loading group, 91 cases turned to chronic cervictis and 10 remained CIN; in the high viral loading group, 7 cases turned to chronic cervictis; 8 cases remained CIN. There difference between the two groups was significant （P=0.000）. Conclusions LEEP is the effective treatment of cervical lesion and can significantly decrease the HPV - DNA loading at cervix. After LEEP therapy, the prognosis of CIN is related to viral loading of HR - HPV. HC2 examination is a useful method in the follow - up of HPV infection of patients with CIN.