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在初级HPV查人口中,转化区 (LLETZ) 负大环切除的预测因素

Victoria L Parker¹, Emma Long², Kay Ellis³

¹Division of Clinical Medicine, School of Clinical Medicine and Population Health, The University of Sheffield, Level 4 The Jessop Wing, Tree Root Walk, Sheffield S10 2SF, United Kingdom.

Journal of gynecology obstetrics and human reproduction

|January 19, 2025

概括

高龄和HPV测试预测了转化区 (LLETZ) 结果的负大循环切除结果. 建议对具有挑战性的患者群体进行进一步的研究,以改善宫癌查结果.

科学领域:

妇科瘤学妇科瘤学
宫病理学宫病理学
科尔波斯科比 (Colposcopy) 是一种对人体的检查.

背景情况:

宫癌查依赖于细胞学和人类乳头瘤病毒 (HPV) 测试.
转化区的大环切除术 (LLETZ) 是宫内皮质瘤的常见治疗方法.
了解与负的LLETZ组织学相关的因素对于优化患者管理至关重要.

研究的目的:

为了确定组织学上负的LLETZ手术的比率.
在英国大肠镜检查室中确定负的LLETZ组织学预测因子.

主要方法:

对2969名接受LLETZ.治疗的患者进行了回顾性队列研究.
对镜数据库记录的分析.
单变量和多变量逻辑回归以确定重要的预测因素.

主要成果:

10%的LLETZ手术产生了负组织学结果.
阴性LLETZ的显著预测因素包括年龄较大,阳性高风险HPV与阴性细胞学,不令人满意的结肠镜检查,重复LLETZ,以及活检和治疗程序.
接受"选择和治疗"程序的患者不太可能呈阴性LLETZ.

结论:

阴性LLETZ更有可能与阳性活检由于HPV测试的敏感性.
潜在的原因包括小体积疾病去除,自发回归或免疫反应.
需要在老年患者和不令人满意的结肠镜检查患者中进行进一步的研究,这些患者被确定为具有挑战性的转诊人群.

关键词:

没有CIN的存在.宫内皮质瘤是宫内皮质瘤.科尔波斯科比 (Colposcopy) 是一种对人体的检查.这是一个HPVHPVHPV.大循环切除的转换区域程序的切除.负的LLETZ 没有.过度治疗过度治疗

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