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目的:经治疗后人乳头瘤病毒是否持续存在的指标评价用宫颈电环切除术(LEEP)治疗宫颈上皮内瘤变的有效性。方法:在312名TCT异常,做阴道镜检查的妇女中,268名妇女随访均超过1年。共有200名妇女接受了LEEP治疗,68名妇女仅接受随访。治疗前和随访1年后分别取宫颈标本,用PCR技术检测人乳头瘤病毒脱氧核糖核酸。结果:在LEEP治疗的妇女中,139人(77.5%)治疗前的人乳头瘤病毒核糖核酸阳性。4名(2%)患者随访时仍阳性,但4人随访时的乳头瘤病毒型别均与治疗前不同。161名妇女治疗前存在Ⅰ-Ⅲ级的宫颈上皮内瘤样变(CIN),随访时仅有3例鳞状细胞不典型细胞。结论:治疗后的人乳头瘤病毒基因组被彻底清除,没有不典型增生复发。该结果提示人乳头瘤病毒检测对监测治疗的有效性非常有意义;宫颈上皮内瘤变经LEEP这种治疗可以清除人乳头瘤病毒,值得临床推广。
OBJECTIVE: To evaluate the effectiveness of cervical loop excision (LEEP) in the treatment of cervical intraepithelial neoplasia after the treatment of human papillomavirus (HPV). METHODS: Of 312 women with abnormal TCT who underwent colposcopy, 268 women were followed up for more than 1 year. A total of 200 women received LEEP treatment and 68 women were followed up. Cervical specimens were collected before treatment and one year after follow-up, respectively. PCR was used to detect human papillomavirus DNA. RESULTS: Of the LEEP-treated women, 139 (77.5%) were positive for human papillomavirus RNA before treatment. Four (2%) patients were still positive at follow-up, but the types of papillomavirus at four follow-up were different from those before treatment. There were 161 women with grade Ⅰ-Ⅲ cervical intraepithelial neoplasia (CIN) before treatment, only 3 cases of squamous cell atypical cells were followed up. Conclusion: The HPV genome was completely eradicated and there was no recurrence of atypical hyperplasia. The results suggest that the detection of human papillomavirus (HPV) is of great significance for monitoring the effectiveness of treatment; cervical intraepithelial neoplasia by LEEP treatment can clear the human papillomavirus, worthy of clinical promotion.