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目的:探讨联合LCT和高危型HPV检测对CIN宫颈治疗后的随访意义。方法:对200例LCT异常,高危型HPV阳性,阴道镜活检证实为CIN1～3的患者行LEEP治疗或宫颈冷刀锥切,治疗后进行严格随访,包括LCT和高危型HPV检测,阳性病例行组织学检查。结果:(1)所有病例经治疗后均无病变残留,其治愈率为100%。(2)从治疗后3个月起,CIN1组高危型HPV转阴率为100%。在随访的第3个月和6个月,CIN2～3组高危型HPV转阴率分别为73.17%和90.85%,显著低于CIN1组,差异有统计学意义(P<0.05)。(3)从随访12个月起,一直有2例病例持续HPV阳性,均为CIN3患者,但LCT和阴道镜检查未发现细胞学异常,继续随访。结论:CIN治疗后高危型HPV的转阴时间及转阴率与CIN的级别有关;高危型HPV持续阳性,但LCT和阴道镜检查无异常者可继续严格随访;LCT联合高危型HPV检测是CIN治疗后临床追踪随访的有效手段。
Objective: To investigate the significance of combined LCT and high-risk HPV testing in the follow-up of cervical CIN after cervical cancer treatment. Methods: 200 cases of LCT abnormalities, high-risk HPV positive, colposcopy biopsy confirmed CIN1 ~ 3 patients undergoing LEEP treatment or cervical cold knife conization, followed up strictly followed, including LCT and high-risk HPV testing, positive cases Histological examination. Results: (1) All the cases had no residual disease after treatment, and the cure rate was 100%. (2) From 3 months after treatment, the high-risk HPV negative rate in CIN1 group was 100%. At 3 months and 6 months of follow-up, the negative conversion rates of high-risk HPV in CIN2 ~ 3 group were 73.17% and 90.85%, respectively, which were significantly lower than those in CIN1 group (P <0.05). (3) From the 12-month follow-up, there were 2 consecutive cases of HPV positive, all of whom were CIN3 patients. However, cytologic abnormalities were not found by LCT and colposcopy and follow-up was continued. CONCLUSIONS: The negative conversion rate and negative conversion rate of high-risk HPV after CIN are related to the grade of CIN. High-risk HPV persists positive, but LCT and colposcopy can be followed up strictly. LCT combined with high-risk HPV test is CIN Clinical follow-up after treatment effective means.