宫内皮质瘤1级和进展的长期风险和治疗
Ingrid Baasland1,2, Tone Bjørge1,3, Birgit Engesæter1
1Section for Cervical Cancer Screening, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway.
PloS one
|April 23, 2025
概括
对1级子宫内皮质瘤 (CIN1) 的积极监测可能需要调整后续检查. 长期数据显示,CIN2+和CIN3+的进展风险显著,特别是高风险HPV类型,为管理策略提供了信息.
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1级 (CIN1) 由于感知进展风险较低,通常通过积极监测进行管理.
- 然而,关于CIN1进展和治疗发生的长期数据有限.
- 本研究旨在通过评估长期结果,提供对CIN1管理的见解.
研究的目的:
- 估计患有高度子宫病变 (CIN2+) 的进展风险和在被诊断为CIN1.1的妇女中治疗的发生率.
- 为制定基于证据的CIN1.1管理和后续指导方针提供信息.
- 分析基于初始细胞学和HPV状态的进展风险.
主要方法:
- 利用来自挪威宫癌查计划 (2002-2019) 的全国性注册表数据.
- 包括26,130名第一次经过组织学确认的CIN1诊断的妇女.
- 随着时间的推移,对参与者进行了CIN2+ (CIN2,CIN3,AIS或宫癌) 的检测和治疗.
主要成果:
- 在五年内,CIN2+的累积发病率达到19.0%.
- 具有高度细胞学或HPV16/18阳性状态的女性显示了更高的5年累积发病率 (分别为26.0%和25.0%).
- 5年后,CIN3+的累积发病率为12.7%,治疗5年的发病率为15.2%.
结论:
- 对CIN1的进展和治疗风险很大,特别是在具有特定细胞学和HPV配置文件的女性中.
- 目前的积极监控策略可能需要改进.
- 建议对CIN1管理进行差异化的后续指南,考虑索引细胞学和HPV16/18状态.
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