宫内皮质瘤2级的临床过程:基于人口的队列研究
Kathrine D Lycke1, Johnny Kahlert2, Rikke K Damgaard1
1Department of Gynecology and Obstetrics, Gødstrup Hospital, Herning, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
American journal of obstetrics and gynecology
|August 18, 2023
概括
对2级子宫内皮质瘤的积极监测显示出高回归率,支持从手术切除转变. 细胞质正常的女性是这种方法的理想候选人.
科学领域:
- 妇科 妇科医生 妇科
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 宫内皮质瘤2级 (CIN2) 历史上需要手术切除.
- 高回归率表明,积极监测可能是一个可行的替代方案.
- 目前的回归率估计缺乏可靠的数据,原因是小规模的研究和各种定义.
研究的目的:
- 在积极监测下确定CIN2的回归和进展率.
- 利用全国医疗保健注册数据进行综合分析.
- 为CIN2.2的临床管理策略提供信息.
主要方法:
- 基于人口的队列研究在丹麦 (1998-2020).
- 包括年龄在18-40岁的女性,CIN2处于主动监测下.
- 排除了之前的CIN2+或外科切除;分析了累积发病率和修改的Poisson回归.
主要成果:
- 研究了超过11000名女性;在24个月后,回归率为62.9%,进展率为33.3%.
- 大多数事件 (回归/进展) 发生在12个月内.
- 高度细胞学增加了进展风险 (aRR 1.58);年龄没有显著影响.
结论:
- 高CIN2回归率支持积极监测,特别是在细胞质低度或正常的女性中.
- 这支持临床管理从外科切除转向警等待的转变.
- 全国数据为CIN2回归和进展提供了可靠的估计.
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