宫颈上皮内瘤变LEEP术后HPV检测的临床意义

目的:检测宫颈上皮内瘤变(CIN)患者行宫颈电环锥形切除术(LEEP)治疗前后人乳头瘤病毒(HPV)感染情况,以评价手术的有效性。方法:回顾性分析167例接受LEEP手术的CIN患者,于治疗前和治疗后12个月采取第二代杂交捕获试验(Hc2)检测高危型HPV-DNA的变化。结果:术前高危型HPV感染情况,LEEP术前行Hc2方法检测阳性率为78.44%(131/167),其中CINⅠ、CINⅡ、CINⅢ高危型HPV-DNA阳性率分别为72.92%(70/96)、80.48%(33/41)、93.33%(28/30);LEEP治疗后12个月转阴率分别为91.42%(64/70)、77.73%(24/33)、75%(21/28)。结论:宫颈上皮内瘤变行LEEP术治疗后对清除高危型HPV感染有效,HPV-DNA检测可作为一种有效的判断CIN疗效及随访观察的预后指标。

Clinical significance of HPV test after LEEP in cervical intraepithelial neoplasia

Objective ： To investigate the incidence of human papilloma virus（HPV） infection in patients with cervical intraeplthelial neoplasia （CIN） after loop electrosurgical excision procedure （LEEP） for evaluating the efficacy of this surgery. Methods ： We conducted a retrospective analysis in 167 CIN patients undergone LEEP. Those patients received hybrid capture Ⅱ（HC- Ⅱ） test for the high risk HPV-DNA 12 months before and after the surgical treatment. Results：78.44% of the patients were found preoperatively with HPV infection, in which high risk types of CIN Ⅰ , CINⅡand CINⅢ accounted for 72.92% （70/96）, 80.48% （33/ 41 ） and 93.33% （28/30） , respectively. Yet, negative results were 91. 42% （64/70, CINⅠ ）, 77.73% （24/33, CINⅡ）and 75% （21/28, CINⅢ）, respectively, 12 months after the LEEP. Conclusion ：LEEP is effective to the CIN patients with high risk types of HPV, and screening HPV through DNA test may be valuable to estimate the prognosis and efficacy of the procedure.