【摘要】 目的探讨宫颈上皮内瘤变1(CIN1)患者的非治疗与治疗后的转归。方法收集在天津市大港医院宫颈癌筛查,并经病理证实为CIN1的116例患者,其中63例未治疗仅随访(非治疗组),53例患者接受治疗(治疗组),全部病例随访2年。结果第24个月非治疗组与治疗组CIN1自然消退率61.82%,持续存在率34.55%,进展率为5.45%(均为CIN2,未发现宫颈浸润癌)。非治疗组HPV第24个月高危型HPV阳性率14.55%(8/55),HR-HPV持续阳性6例,3例进展病例均为HR-HPV阳性。治疗组中物理治疗组1年以后复发率4.88%,采用宫颈锥切或宫颈环形电切(LEEP)者均未发现复发,目前所有患者仍在继续随访。结论多数CIN1病变会自然消退,HPV也自然清除,但对于高危型HPV持续阳性的患者应警惕其进展为高度CIN。对怀疑高度病变的患者宜采用宫颈锥切或环切治疗,以免漏诊;物理治疗复发率高,不宜采用。更多还原

【Abstract】 Objective To compare the different treatment and prognosis of cervical intraepithelial neoplasia 1(CIN1) . Methods 116 patients who underwent cervical cancer screening and were confirmed of CIN1 from March 2008 to August 2008 recriuted in this study. They were divided into follow-up group (63 cases) and treatment group (53 cases). In treamtment group, 41 patients underwent physical therapy, 7 cases received cervical conization and, 5 cases underwent LEEP. All patients were followed up for 2 years. Results At 24 months, the rate of regress, sustained and cumulative progress in all the 116 patients were 61.82%, 34.55% and 5.45% ( all were CIN2) . In follow-up group, the rate of high-risk HPV (HR-HPV) positive was 14.55%(8/55) and 6 cases were persistent positive of HR-HPV at 24 months. 3 progressive cases were all HR-HPV positive. The recurrence rate in physical therapy patients were 4.88% and none patients relapsed in cervical cone biopsy or LEEP treatment group. Conclusions Most CIN1 could regress and HPV could naturally be cleared, but those with persistent positive HR-HPV may at high risk of progressive lesions. Cervical cone biopsy or LEEP should be performed in those suspected High grade level. Physical therapy is not recommended for the high recurrence rate.更多还原