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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >Long‐term predictors of residual or recurrent cervical intraepithelial neoplasia 2–3 after treatment with a large loop excision of the transformation zone: a retrospective study
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Long‐term predictors of residual or recurrent cervical intraepithelial neoplasia 2–3 after treatment with a large loop excision of the transformation zone: a retrospective study

机译：残留或复发性宫颈上皮内瘤形成的长期预测因子2-3处理后改变区的大环路切除：回顾性研究

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Objective To assess the long‐term risk factors predicting residual/recurrent cervical intraepithelial neoplasia (CIN 2–3) and time to recurrence after large loop excision of the transformation zone (LLETZ). Design Retrospective study. Setting Colposcopy clinic. Population 242 women with CIN 2–3 treated between 1996 and 2006 and followed up until June 2016. Methods Age, margins, and high‐risk human papillomavirus (HR‐HPV) were estimated using Cox proportional hazard and unconditional logistic regression models. The cumulative probability of treatment failure was estimated by Kaplan–Meier analysis. Main outcome measure Histologically confirmed CIN 2–3, HR‐HPV, margins, age. Results CIN 2–3 was associated with HR‐HPV (HR?=?30.5, 95% confidence interval [CI]?=?3.80–246.20), age 35?years (HR?=?5.53, 95% CI?=?1.22–25.13), and margins (HR?=?7.31, 95% CI?=?1.60–33.44). HR‐HPV showed a sensitivity of 88.8% and a specificity of 80%. Ecto + /endocervical + (16.7%), uncertain (19.4%) and ecto ? /endocervical + margins (9.1%) showed a higher risk of recurrence (odds ratio [OR]?=?13.20, 95% CI?=?1.02–170.96; OR = 15.84, 95% CI?=?3.02–83.01; and OR = 6.60, 95% CI?=?0.88–49.53, respectively). Women with involved margins and/or who were HR‐HPV positive had more treatment failure than those who were HR‐HPV negative or had clear margins ( P ‐log‐rank?0.001). Conclusions HR‐HPV and margins seem essential for stratifying post‐LLETZ risk, and enable personalised management. Given that clear margins present a lower risk, a large excision may be indicated in older women to reduce the risk. Tweetable abstract After LLETZ for CIN 2–3, recurrences appear more often in women with positive HR‐HPV and involved margins and aged over 35.
机译：目的评估预测残留/复发性宫颈上皮内瘤周期（CIN 2-3）的长期危险因素及其在变换区大环切除后复发时间（Lletz）。设计回顾性研究。设置Colposcopy诊所。 1996年至2006年间有关CIN 2-3的人口242名妇女在2016年至2016年6月至2016年6月期间。方法使用Cox比例危害和无条件逻辑回归模型估计方法年龄，边距和高风险的人乳头瘤病毒（HR-HPV）。 Kaplan-Meier分析估计治疗失败的累积概率。主要结果测量组织学证实CIN 2-3，HR-HPV，边距，年龄。结果CIN 2-3与HR-HPV有关（HR？= 30.5，95％置信区间[CI]？=？3.80-246.20），年龄＆ 35？年（小时？=？5.53,95％CI？ =？1.22-25.13）和边缘（HR？=？7.31,95％CI？=？1.60-33.44）。 HR-HPV显示出88.8％的敏感性，特异性为80％。 Ecto + /内泌菌+（16.7％），不确定（19.4％）和Ecto？ /内泌菌+边缘（9.1％）显示出较高的复发风险（赔率比[或] =？13.20,95％CI; = 1.02-170.96;或= 15.84,95％CI？= 3.02-83.01;和或= 6.60,95％CI？=？0.88-49.53分别）。涉及利润率和/或HR-HPV阳性的妇女的治疗失败比HR-HPV为负面或具有清晰的边缘（P-LOG-RANK？<0.001）。结论HR-HPV和MARGINS似乎是对LLETZ后的风险分层的必要条件，并实现个性化管理。鉴于明确的利润率呈现较低的风险，可能会在老年妇女中表明大型切除，以降低风险。 Twelable Abstract在Lletz进行CIN 2-3后，患有阳性HR-HPV的女性更常见的繁殖和涉及边距和35岁以上。

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