侵入性治疗与非侵入性处理轻度宫颈上皮内瘤变效果对比的Meta分析

目的:综合分析轻度宫颈上皮内瘤变（cervical intraepithelial neoplasia Ⅰ，CINⅠ）经侵入性治疗与非侵入性处理后的病变转归和预后情况。方法:以关键词CINⅠ+随访（follow up）进行计算机检索PubMed、CNKI、维普、万方数据库等，搜集包含CINⅠ的各种治疗及随访结果的文献。把数据分为侵入性治疗组和非侵入性处理组，应用RevMan5.3软件对数据进行Meta分析，计算OR值和95%CI。结果:符合纳入标准的文献有9篇。共2 081例，侵入性治疗组745例，非侵入性处理组1 336例，平均随访26.4月。侵入性治疗组与非侵入性处理组对比，病变逆转的OR值为2.12， 95%CI值（1.65～2.72）（P<0.01），病变稳定的OR值为0.48，95%CI值（0.37～0.63）（P<0.01），病变进展的OR值为0.61，95%CI值（0.37～1.02）（P>0.05）。结论:侵入性治疗比非侵入性处理更有效促进CINⅠ病变的逆转，但并不能更好地抑制病变进展。

Meta-analysis of efficacy comparison between invasive treatment and non-invasive treatment of mild cervical intraepithelial neoplasia

Objective:To systematically analyze whether the aggressive treatment is more effective than the non-aggressive treatment to reverse the low grade of cervical intraepithelial neoplasia (CINⅠ) and to arrest its progression.Methods:PubMed，VIP，CNKI and Wanfang databases were searched with keywords "CINⅠ"+"follow up" and without time limit.Articles about the treatments of CINⅠ with follow up were collected.The cases of CINⅠ were divided into the aggressive treatment group and non-aggressive treatment group.Using the RevMan5.3 APP，odds ratio (OR) and 95% confidence interval (CI) were calculated.Results:Nine studies were included according to the inclusion criteria.Total 2 081 patients were fitted into the Meta-analysis，among which 745 cases belonged to the aggressive treatment group and 1 336 cases belonged to the non- aggressive treatment group.The average follow-up time was 26.4 months.In the comparison of the aggressive treatment group with the non-aggressive treatment group，the OR for the reversion of CINⅠ was 2.12,95%CI (1.65～2.72)(P<0.01)，the OR for the sustaining of CINⅠ was 0.48,95%CI （0.37～0.63)(P<0.01），and the OR for the progression of CINⅠ was 0.61,95%CI （0.37～1.02)(P>0.05）.Conclusion:The aggressive treatment is more effective than the non-aggressive treatment to reverse CINⅠ.