在初级HPV宫癌查计划中对CIN2进行保守的管理:一个队列研究
Francesca Leoni1, Paolo Giorgi Rossi1, Corrado Morana2
1Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
大约40%患有2级子宫内皮质瘤 (CIN2) 的妇女通过选择保守的治疗来避免治疗. 之前的HPV阴性查结果与CIN2.2的保守管理中更好的结果有关.
科学领域:
- 妇科 妇科 妇科 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) 管理包括治疗或保守的方法.
- 保守的管理决策受到患者因素和临床评估的影响.
- 了解保守管理的结果对于优化患者护理至关重要.
研究的目的:
- 量化成为HPV阴性或需要在24个月内延迟治疗的概率,以保守地管理CIN2.
- 确定影响选择保守管理的决定因素,随访损失和患者的结果.
主要方法:
- 一项前性队列研究,对生检确认CIN2.2的妇女进行.
- 为45岁及以下的妇女提供保守的治疗,被评估为低风险,没有腺体病变.
- 随访包括在6个月,12个月和24个月后进行HPV检测,细胞学和大肠镜检查.
- 竞争风险和日志双项模型被用来分析决定因素.
主要成果:
- 在352名女性中,有180名女性选择了保守的管理.
- 在24个月内,40.6%成为HPV阴性,43.9%接受延迟治疗,15.5%保持HPV阳性.
- 年龄较小,立即进行镜检查,低级细胞学和I级镜检查有利于保守的管理.
- 之前的HPV阴性查与成为HPV阴性和更好的随访坚持有关.
结论:
- 保守的管理允许大约40%的CIN2妇女在24个月内避免立即治疗.
- 在第二轮HPV查中诊断出女性是保守管理的更好候选人.
- 在接受治疗的组中检测到两例侵袭性癌症.
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