宫颈癌(Cervical Cancer)是我国最常见的妇科肿瘤,目前认为宫颈癌的发生发展,是因为宫颈上皮内病变继续发展,突破上皮下基底膜,浸润间质,形成了宫颈浸润癌。宫颈低级别鳞状上皮内病变大部分患者可以自然消退,在极少数个体中,长期的高危...宫颈癌(Cervical Cancer)是我国最常见的妇科肿瘤,目前认为宫颈癌的发生发展,是因为宫颈上皮内病变继续发展,突破上皮下基底膜,浸润间质,形成了宫颈浸润癌。宫颈低级别鳞状上皮内病变大部分患者可以自然消退,在极少数个体中,长期的高危型HPV感染可能促使宫颈发展至高级别鳞状上皮内病变,并有可能最终演变为宫颈癌。针对合并高危型HPV感染的宫颈低级别鳞状上皮内病变,当前的治疗方案包括药物治疗、物理疗法和手术切除等多种方法。临床可根据患者年龄、生育诉求及实际病情和经济状况,选择合适的治疗方案。本文对宫颈低级别鳞状上皮内病变合并高危型HPV感染的治疗策略进行综述,对于临床指导实践具有重要意义。Cervical cancer is the most common gynecological tumor in our country. It is currently believed that the occurrence and development of cervical cancer are a process where cervical intraepithelial neoplasia progresses, breaks through the basement membrane under the epithelium, infiltrates the stroma, and forms invasive cervical cancer. Most patients with low-grade squamous intraepithelial lesions (LSIL) of the cervix can naturally regress. In a very small number of individuals, long-term high-risk HPV infection may promote the progression of the cervix to high-grade squamous intraepithelial lesions (HSIL) and potentially evolve into cervical cancer. For low-grade squamous intraepithelial lesions of the cervix associated with high-risk HPV infection, current treatment options include drug therapy, physical therapy, and surgical excision, among various methods. Clinically, appropriate treatment plans can be selected based on the patient’s age, fertility desires, actual condition, and economic status. This article reviews the treatment strategies for low-grade squamous intraepithelial lesions of the cervix combined with high-risk HPV infection, which is of significant importance for guiding clinical practice.展开更多
目的:探讨宫颈锥切术联合三元融合蛋白(MBP-SERPINA-IFNκ,MSIK)治疗宫颈高级别鳞状上皮内病变(high-grade cervical lesions,HSIL)合并高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染的临床效果。方法:选取2019年08月...目的:探讨宫颈锥切术联合三元融合蛋白(MBP-SERPINA-IFNκ,MSIK)治疗宫颈高级别鳞状上皮内病变(high-grade cervical lesions,HSIL)合并高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染的临床效果。方法:选取2019年08月至2021年07月我院收治的186例HSIL患者,采用随机数字表法分为MSIK组(n=93)和对照组(n=93),两组均接受宫颈锥切术治疗,对照组术后非经期阴道推入干扰素α-2β凝胶,隔日一次,10次/疗程,MSIK组术后非经期阴道推入MSIK,14 d/疗程,均治疗3个疗程。比较两组患者治疗前后不同时间点TCT异常率及HR-HPV转阴率,比较两组治疗前后临床症状评分改变、治疗期间不良反应,比较两组治愈率及复发率。结果:随访期间两组HR-HPV转阴率呈升高趋势,且随访9、12个月两组HR-HPV转阴率均较随访3个月时升高(P<0.05);随访3、6、9、12个月时,MSIK组HR-HPV转阴率均高于对照组(P<0.05)。随访3、6、9、12个月,两组TCT异常率均明显低于治疗前,且MSIK组低于对照组(P<0.05)。治疗后两组临床症状评分较治疗前降低,且MSIK组更低(P<0.05)。MSIK治疗期间不良反应发生率为3.23%,低于对照组的10.75%(P<0.05)。MSIK组治愈率为97.85%,高于对照组的81.72%(P<0.05);随访12个月MSIK组无复发情况,与对照组复发率比较差异有统计学意义(P<0.05)。结论:宫颈锥切术联合MSIK治疗HSIL合并HR-HPV感染可有效提高转阴率,且治疗效果确切、复发率低,值得临床推广。展开更多
文摘宫颈癌(Cervical Cancer)是我国最常见的妇科肿瘤,目前认为宫颈癌的发生发展,是因为宫颈上皮内病变继续发展,突破上皮下基底膜,浸润间质,形成了宫颈浸润癌。宫颈低级别鳞状上皮内病变大部分患者可以自然消退,在极少数个体中,长期的高危型HPV感染可能促使宫颈发展至高级别鳞状上皮内病变,并有可能最终演变为宫颈癌。针对合并高危型HPV感染的宫颈低级别鳞状上皮内病变,当前的治疗方案包括药物治疗、物理疗法和手术切除等多种方法。临床可根据患者年龄、生育诉求及实际病情和经济状况,选择合适的治疗方案。本文对宫颈低级别鳞状上皮内病变合并高危型HPV感染的治疗策略进行综述,对于临床指导实践具有重要意义。Cervical cancer is the most common gynecological tumor in our country. It is currently believed that the occurrence and development of cervical cancer are a process where cervical intraepithelial neoplasia progresses, breaks through the basement membrane under the epithelium, infiltrates the stroma, and forms invasive cervical cancer. Most patients with low-grade squamous intraepithelial lesions (LSIL) of the cervix can naturally regress. In a very small number of individuals, long-term high-risk HPV infection may promote the progression of the cervix to high-grade squamous intraepithelial lesions (HSIL) and potentially evolve into cervical cancer. For low-grade squamous intraepithelial lesions of the cervix associated with high-risk HPV infection, current treatment options include drug therapy, physical therapy, and surgical excision, among various methods. Clinically, appropriate treatment plans can be selected based on the patient’s age, fertility desires, actual condition, and economic status. This article reviews the treatment strategies for low-grade squamous intraepithelial lesions of the cervix combined with high-risk HPV infection, which is of significant importance for guiding clinical practice.
