| 王之信,何玉,周萍,杨芳,杨晨.宫颈高级别病变术后病理升级相关因素分析[J].中国临床保健杂志,2023,26(3):403-406. |
| 宫颈高级别病变术后病理升级相关因素分析 |
| Analysis of factors related to pathological upgrading after cervical conization |
| 投稿时间：2023-04-08 |
| DOI：10.3969/J.issn.1672-6790.2023.03.026 |
| 中文关键词: 宫颈鳞状上皮内病变 病理过程 宫颈肿瘤 子宫颈切除术 影响因素分析 |
| 英文关键词: Squamous intraepithelial lesions of the cervix Pathologic processes Uterine cervical neoplasms Trachelectomy Root cause analysis 〖FL |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨宫颈高级别鳞状上皮内病变(HSIL)锥切术后病理升级为宫颈浸润癌的危险因素,并构建预测模型,用于临床评估阴道镜下宫颈活检HSIL的患者发生宫颈浸润癌的风险。方法 选取2019年1月至2021年11月在安徽理工大学第一附属医院妇产科就诊,阴道镜下宫颈活检诊断为HSIL,并行宫颈冷刀锥切术(CKC)的患者327例,分析术后病理提示为宫颈浸润癌患者情况,通过单因素、多因素分析得出术后病理升级的独立影响因素,利用ROC曲线计算曲线下面积,R语言绘制列线图。结果 单因素分析表明年龄、转化区类型、液基薄层细胞检测(TCT)、累腺情况、接触性出血、绝经情况、初次生育年龄、切缘情况、累及病灶点数在HSIL术后病理是否升级中差异有统计学意义(P<0.05),多因素分析表明年龄、接触性出血、切缘情况、TCT是HSIL术后病理升级的独立影响因素(P<0.05),ROC曲线显示年龄、接触性出血、切缘情况、TCT四项指标联合预测病理升级的曲线下面积(AUC)为85.9%,绘制列线图,一致性指数(c-index)为0.858。结论 年龄、接触性出血、切缘情况、TCT联合构建的风险预测模型对HSIL术后病理升级为宫颈浸润癌有较好的预测价值。 |
| 英文摘要: |
| Objective To investigate the risk factors for pathological upgrading to invasive cervical cancer after conization of cervical high-grade squamous intraepithelial lesions (HSIL),and construct a predictive model for clinical assessment of the risk of invasive cervical cancer in patients with colposcopic biopsy for HSIL.Methods Three hundred and twenty seven patients who were diagnosed as HSIL by cervical biopsy under colposcopy and underwent cold knife conization (CKC),were selected from January 2019 to November 2021 in the department of gynecology and obstetrics of the First Affiliated Hospital of Anhui University of Science and Technology.The postoperative pathological findings of cervical invasive cancer were analyzed.The independent influencing factors of postoperative pathological upgrading were analyzed by univariate analysis and multivariate analysis.The area under the curve was calculated by ROC curve,and the nomogram was drawn by R language.Results Univariate analysis showed that factors like age,type of transformation area,TCT,involveminal gland condition,cervical contact bleeding,menopause state,first child-bearing age,cervical conization margin and number of lesions involved have statistically significant value difference in pathological upgrading after HSIL(P<0.05),Multivariate analysis showed that age,cervical contact bleeding,cervical conization margin and TCT were independent influencing factors of postoperative pathological upgrading for HSIL(P<0.05),ROC curve showed that the area under the curve (AUC) of combining age,cervical contact bleeding,cervical conization margin,TCT was 85.9%.Drawn the nomogram,and the c-index was 0.858.Conclusions The risk prediction model constructed by age,cervical contact bleeding,cervical conization margin and TCT have good predictive value for pathological upgrading to invasive cervical cancer after HSIL operation. |
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