LCT与HR-HPV DNA在预测LEEP术治疗宫颈上皮内瘤变后复发中的作用

摘要

Objective To investigate the role of LCT with high-risk HPV-DNA in predicting cervical intraepithelial neoplasia under LEEP treatment after a follow-up.Methods Atotal of 180cases of CINⅡ-Ⅲ were taking LEEP surgery and followed up for two years.Liquid-based cytology (LCT),high-risk HPV DNA (HR-HPV DNA) and other tests with clinical data were collected.Predictive value of various methods and factors of recurrence were evaluated after treatment of LEEP surgery.Results 180 cases of patients hand a 24-month follow-up,5patients were lost and the lost rate was 2.78%.12 cases could be conifrmed that they were recurrent,the recurrence rate was 6.86%.LCT and HR-HPV DNA were used to determine the LEEP recurrence and obtained a higher sensitivity,speciifcity and Youden index,respectively.But in LCT + HR-HPV DNA,it had a predictive higher value with the sensitivity 0.866,speciifcity 0.949 and Youden index 0.815.Conclusion The combination of LCT and HR-HPV DNA in follow-up had a higher guiding values after LEEP treatment and it was worthy of promotion.%目的：探讨LCT与高危型HPV DNA在LEEP术治疗宫颈上皮内瘤变后的随访复查时的作用。方法选择行LEEP术的CIN Ⅱ～Ⅲ级患者共180例，随访2年，行液基细胞学检查（LCT）、高危HPV DNA（HR-HPV DNA）等检查，收集患者的临床资料，评价各种方法及因素在LEEP术治疗CIN后复发的预测价值。结果对180例患者进行了24个月的随访，其中5例患者失访，失访率为2.78%，发现复发的患者为12例，复发率为6.86%。LCT与HR-HPV DNA分别用于判断LEEP术后复发获得了较高的敏感度、特异性及约登指数，但采用LCT+HR-HPV DNA则预测价值更高，敏感度达0.866，特异性为0.949，约登指数为0.815。结论联合应用LCT和HR-HPV DNALEEP治疗的复发随访中具有更高的指导价值，值得临床推广。