Objective:To investigate the natural history of CIN I lesions. Methods:548 patients were enrolled into the cohort. They were followed up for 24-48 months without any treatment. Every 6 to 12 months,the patients were called back to have the Liquid-based Cytological Test and High-risk Human papillomavirus Test (HC-II). If the LCT was ASCIIS and HR-HPV was positive or LCT was higher than ASCIIS,then colposcopy was used to assess the disease situation and multi-point biopsies were made at the same time. The biopsy results were the gold standard to assess the outcome if it was progression,resistance or regression. Results: (1)The 36 months dropout rate was 10.22%. (2)At the end of the follow-up,16 patients had progressed to higher grade lesions,including 11 CIN II and 5 CIN III. No one had progressed to invasive cervical cancer. 29 patients whose CIN I lesions had resistant and 477 patients had regressed. Within 6 months,the CIN I progression rate,resistance rate and regression rate was separately 0.57%,67.05%,and 37.36%. Within 12 months,the CIN I progression rate,resistance rate and regression rate was separately 1.15%,48.08%,and 55.56%. Within 24 months,the CIN I progression rate,resistance rate and regression rate was separately 2.30%,20.88%,and 77.20%. Within 36 months,the CIN I progression rate,resistance rate and regression rate was separately 3.07%,5.56%,and 85.63%. (3)The 6,12,24,36 months HR-HPV cultivate clearance rate of HR-HPV positive CIN I was separately 52.76%,61.84%,82.64%,and 94.52%. Conclusions: (1) Most of the CIN I lesions (85.71%) can regress themselves during 36 months,only few part (3.07%) of them will progress to high grade lesions. The cultivate progression rate and regression rate became higher and higher along with the time during the 36 months follow-up. (2)The cultivate rate of HR-HPV clearance became higher and higher with the time during the 36 months follow-up. (3)CIN I were caused by transient HR-HPV infection,HR-HPV positive CIN I lesions had the same regression trend with HR-HPV clearance.%目的:了解宫颈上皮内瘤变Ⅰ级(CIN Ⅰ)的自然转归情况.方法:对经病理诊断为CIN Ⅰ的548例患者进行为期24～48个月的定期随访.以液基细胞学检查(LCT)联合高危型人乳头瘤病毒(HPV)检测(HC-Ⅱ)作为监测手段.当LCT诊断为意义不明的不典型鳞状细胞(ASCUS)及以上病变且高危型HPV阳性或LCT诊断为低度鳞状上皮内病变(LSIL)以上病变,进行阴道镜下多点活检,以病理结果为最终诊断,评价CIN Ⅰ在6,12,24和36个月的自然转归情况.以寿命表法计算病变转归率.结果:①随访36个月时的累积失访率为10.22％.②随访36个月,CIN Ⅰ向高级别进展的为16例,持续不变29例,病变逆转447例.CIN Ⅰ随访6个月时病变进展、持续存在和逆转为正常的百分率分别为0.57％,67.05％和37.36％；12个月时分别为1.15％,48.08％和55.56％;24个月时分别为2.30％,20.88％和77.20％；36个月时分别为3.07％,5.56％和85.63％.③高危型HPV 阳性的CIN Ⅰ患者6,12,24和36个月HPV累计自然清除率分别为52.76％,61.84％,82.64％和94.52％.结论:①CIN Ⅰ患者病变累计进展率和累计逆转率在36个月内均随时间增加而增高.②在高危型HPV阳性的CIN Ⅰ患者中,HPV的自然清除率随着时间的增加逐渐增高.③CIN Ⅰ可能由高危型HPV的一过性感染所致,高危型HPV 感染的CIN Ⅰ患者,CIN Ⅰ病变逆转趋势与高危型HPV清除趋势一致.
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