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[1]林 蘭 吳冬梅 鄧 勇 林善英 黃 燁.高級別宮頸上皮內(nèi)瘤變LEEP術(shù)后HPV持續(xù)感染的危險(xiǎn)因素及預(yù)測模型構(gòu)建[J].福建醫(yī)藥雜志,2019,41(06):1-4.
　LIN Lan,WU Dongmei,DENG Yong,et al.Risk factor of HPV persistent infection of high-grade cervical intraepithelial neoplasia after treatment and build of a nomogram prediction model[J].FUJIAN MEDICAL JOURNAL,2019,41(06):1-4.
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高級別宮頸上皮內(nèi)瘤變LEEP術(shù)后HPV持續(xù)感染的危險(xiǎn)因素及預(yù)測模型構(gòu)建()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
41
期數(shù):
2019年06期
頁碼:
1-4
欄目:
臨床研究
出版日期:
2019-12-25

文章信息/Info

Title:
Risk factor of HPV persistent infection of high-grade cervical intraepithelial neoplasia after treatment and build of a nomogram prediction model
文章編號:
1002-2600(2019)06-0001-05
作者:
林 蘭 吳冬梅 鄧 勇 林善英 黃 燁
福建中醫(yī)藥大學(xué)附屬第二人民醫(yī)院婦產(chǎn)科(福州 350013)
Author(s):
LIN Lan; WU Dongmei; DENG Yong; LIN Shanying; HUANG Ye.
Department of Obstetrics & Gynecology, the Affiliated Second People Hospital, Fujian College of Traditional Chinese Medicine; Fuzhou,Fujian 350013, China
關(guān)鍵詞:
高級別宮頸上皮內(nèi)瘤變;  人乳頭瘤病毒;  持續(xù)感染;  相關(guān)因素;  列線圖
Keywords:
high-grade cervical intraepithelial neoplasia;  human papillomavirus;  persistent infection;  related factor;  nomogram
分類號:
R737.33
文獻(xiàn)標(biāo)志碼:
A
摘要:
目的 探討高級別宮頸上皮內(nèi)瘤變(CINⅡ/Ⅲ)患者經(jīng)宮頸電環(huán)切術(shù)(LEEP)治療后高危型人乳頭瘤病毒(HR-HPV)持續(xù)感染的相關(guān)危險(xiǎn)因素,建立列線圖模型預(yù)測高危人群,降低術(shù)后殘留率或復(fù)發(fā)率。方法 選取2016年1月-2017年12月在我院行LEEP術(shù)治療的CINⅡ/CINⅢ患者139例為研究對象,術(shù)前及術(shù)后6個(gè)月行第二代雜交捕獲試驗(yàn)、HPV分型及陰道微生態(tài)檢查,同時(shí)記錄患者初次性生活年齡、分娩方式、切緣情況、術(shù)后性生活保護(hù)情況等資料。運(yùn)用logistic回歸分析確定高危因素,建立預(yù)測HPV持續(xù)感染風(fēng)險(xiǎn)的列線圖模型,分別用一致性系數(shù)和校準(zhǔn)曲線評估模型的預(yù)測性能和符合度。結(jié)果 術(shù)后6個(gè)月時(shí)HR-HPV持續(xù)陽性37例,陽性率17.3%,局限于7種高危亞型。多因素分析顯示初次性生活年齡<16歲、術(shù)前HR-HPV DNA≥100 RLU/CO、切緣陽性、性生活無保護(hù)為術(shù)后HPV持續(xù)感染的獨(dú)立危險(xiǎn)因素(P<0.05),其OR值分別為0.239、4.876、14.135、0.359。用于預(yù)測HPV持續(xù)感染的列線圖的準(zhǔn)確度為0.821。結(jié)論 基于初次性生活年齡<16歲、術(shù)前HR-HPV DNA≥100 RLU/CO、切緣陽性、性生活無保護(hù)構(gòu)建的列線圖,可用于指導(dǎo)臨床發(fā)現(xiàn)高危人群,進(jìn)行嚴(yán)密隨訪。
Abstract:
Objective To explore the risk factor of human papillomavirus(HPV)persistent infection of high-grade cervical intraepithelial neoplasia(CINⅡ/Ⅲ)patients after loop electrosurgical excision procedure(LEEP), establish a nomogram model to predict the high-risk population, and reduce the incidence rates of postoperative recurrence and residual.Methods A total of 139 CINⅡ/Ⅲ patients treated by cervical conization in the hospital from January 2016 to December 2017 were selected and followed up at six months after surgery.High-risk HPV and vaginal microflora were performed before treatment and during follow-up,age at onset of sexual life,delivery modes,incisal margin,condom use after surgery were recorded.A nomogram model for predicting the risk of HPV persistent infection was established,and the predictive performance and compliance of the model were evaluated using the consistency index(C-index)and the calibration curve.Results At six months after operation,37 patients with HPV persistent infection had the positive rates of 17.3%,limited to seven high-risk HPV subtypes.Multivariate logistic regression analysis showed that <16 years old when first sex, preoperative HR-HPV DNA≥100 RLU/CO, positive incisal margin and condom useless after operation were independent risk factors of HPV persistent infection; OR values were 0.239(95%CI 0.081-0.702),4.876(95%CI 1.801-13.149),14.135(95%CI 4.215-47.398),0.359(95%CI 0.130-0.994).The accuracy of nomogram used to predict the risk of HPV persistent infection was 0.821.Conclusion A nomogram, constructed based on <16 years old when first sex,the amount of HR-HPV DNA≥100 RLU/CO before treatment, positive incisal margin and condom useless after operation,can be used to find the high-risk population who need close follow-up.

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更新日期/Last Update: 2019-12-25