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目的研究宫颈环形电切术(LEEP)标本与术前宫颈活检的病理结果的符合率,以及LEEP锥切术对人乳头状瘤病毒(HPV)感染的影响。方法通过对397例宫颈上皮病变的LEEP标本进行病理学观察,并与术前宫颈活检的病理结果进行比较,研究两次病理结果的符合率;比较LEEP术前与术后高危型HPV检查结果,探讨LEEP锥切术对HPV感染的影响。结果宫颈LEEP标本与术前多点活检的诊断符合率为49.87%(198/397),降级39.29%(156/397),升级10.83%(43/397)。术后高危型HPV检查的阳性率为23.67%(58/245),较术前86.00%(315/368)显著降低(χ2=302.94,P=0.0000)。术后高危型HPV持续阳性的患者CIN的复发率为70.69%(41/58),显著高于HPV阴性者的21.57%(11/51),差异有统计学意义(χ2=26.45,Ρ=0.0001)。结论 LEEP锥切标本与术前宫颈活检的病理诊断有较高符合率;LEEP术后高危型HPV阳性率较术前显著降低;术后HPV持续感染有较高复发的危险性。
Objective To study the coincidence rate of cervical ring electrosurgical excision (LEEP) and pathological findings of preoperative cervical biopsy and the effect of LEEP conization on human papillomavirus (HPV) infection. Methods The pathological findings of LEEP specimens from 397 cases of cervical epithelial lesions were compared with the pathological findings of preoperative cervical biopsy to study the coincidence rate of two pathological results. Comparing the results of LEEP preoperative and postoperative high-risk HPV test, To investigate the effect of LEEP conization on HPV infection. Results The coincidence rate of cervical LEEP specimens and preoperative multipoint biopsy was 49.87% (198/397), 39.29% (156/397) and 10.83% (43/397) respectively. The positive rate of postoperative high risk HPV test was 23.67% (58/245), which was significantly lower than 86.00% (315/368) preoperatively (χ2 = 302.94, P = 0.0000). The recurrence rate of CIN was 70.69% (41/58) in patients with persistent high-risk HPV and 21.57% (11/51) in HPV-negative patients, the difference was statistically significant (χ2 = 26.45, P = 0.0001 ). Conclusions There is a high coincidence rate between LEEP conization specimens and pathological diagnosis of preoperative cervical biopsy. The positive rate of high-risk HPV after LEEP is significantly lower than that before operation. Persistent HPV infection is associated with a high risk of recurrence.