宫颈高级别病变LEEP手术后2年内复发的相关因素研究

目的探究宫颈高级别病变妇女子宫颈环形电极切除(LEEP)手术后2年内复发的相关因素。方法回顾性分析458例宫颈癌前病变病人的临床资料，所有病人均顺利完成LEEP手术治疗。术后随访2年，其中31例病人复发为复发组，其余427例未复发为未复发组。对复发病人LEEP术后情况进行分析，并分析宫颈癌前病变妇女LEEP术后2年内复发的危险因素。结果458例病人中随访2年内31例复发，治愈率为93.23%，复发率为6.77%。术后半年内6例复发，术后半年至1年内8例复发，术后1~2年内17例复发。平均复发时间为(15.53±4.23)个月。2组的年龄、绝经、吸烟、累及颈管、象限累及、术前HR-HPV RLU/CO、切缘情况、术后同一型别HPV持续感染间差异有统计学意义(P < 0.05~P < 0.01)。logistic多因素分析结果显示，高龄、绝经、累及颈管、术前HR-HPV RLU/CO≥1 000、切缘阳性、术后同一型别HPV持续感染为宫颈癌前病变妇女LEEP手术后2年内复发的危险因素(P < 0.05~P < 0.01)。结论宫颈癌前病变妇女LEEP手术后2年内复发率为6.77%，高龄、绝经、累及颈管、术前HR-HPV RLU/CO≥1 000、切缘阳性、术后同一型别HPV持续感染均会增大其复发率，临床中应加强监测。

Study on the related factors of high grade cervical lesions recurrence within 2 years after LEEP surgery

ObjectiveTo explore the related factors of the recurrence within 2 years of precancerous lesions of cervical cancer after cervical loop electrosurgical excision procedure(LEEP).MethodsThe clinical data of 458 patients with precancerous lesions of cervical cancer were retrospectively analyzed.The LEEP surgery in all patients was successfully completed.After 2 years of postoperative following-up, 31 patients were set as relapsed group, and the remaining 427 patients were set as non-relapsed group.The relapse of patients was analyzed after LEEP, and the risk factors of the recurrence of cervical precancerous lesion within 2 years after LEEP were analyzed.ResultsAmong the 458 patients, 31 cases relapsed within 2 years of following-up, the cure rate and recurrence rate were 93.23% and 6.77%, respectively.Six cases, 8 cases and 17 cases recurred within 6 months, 6 months to 1 year and 1 to 2 years after operation, respeectively.The mean recurrence time was(15.53±4.23) months.The differences of the age, menopause, smoking, involvement of cervical duct, quadrant involvement, preoperative HR-HPV RLU/CO, surgical margin and postoperative persistent infection of same type HPV between two groups were statistically significant(P < 0.05 to P < 0.01).The results of logistic multivariate analysis showed that advanced age, menopause, involvement of cervical duct, preoperative HR-HPV RLU/CO ≥ 1 000, positive surgical margin and postoperative persistent infection of the same type HPV were the risk factors of recurrence within 2 years of precancerous lesions of cervical cancer after LEEP(P < 0.05 to P < 0.01).ConclusionsThe recurrence rate of precancerous lesions of cervical cancer within 2 years after LEEP surgery is 6.77%, and the advanced age, menopause, involvement of cervical duct, preoperative HR-HPV RLU/CO ≥ 1 000, positive incisal margin and postoperative persistent infection of the same type HPV can increase the recurrence rate.Therefore, the clinical monitoring should be strengthened.