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目的探讨应用高危型人乳头瘤病毒(human papillomavirus,HPV)负荷量指导宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅰ的治疗。方法回顾2007～2011年在海珠区妇幼保健院诊断CINⅠ合并HPV持续感染半年以上的30～49岁患者,将90例经病理诊断为CINⅠ、资料齐全的患者按治疗方法分为3组,观察组给予观察,微波组应用微波破坏治疗,切除组应用转化区大环状切除术(large loop excision of the transformation zone,LLETZ)切除宫颈移行带,于治疗后6个月、12个月复查,将HPV负荷量≥100.00设为高负荷组,HPV负荷量10.00～99.99设为中负荷组,HPV负荷量1.00～9.99设为低负荷组。结果治疗后1年,切除组清除HPV感染率达到100.0%,HPV高负荷组的患者应用微波破坏治疗和观察的方法清除HPV感染率分别为55.6%、0%,HPV中负荷组的患者应用微波破坏治疗和观察的方法清除HPV感染率分别为70.0%、22.2%,HPV低负荷量的患者应用微波破坏治疗和观察的方法清除HPV感染率分别为90.9%、30.8%。结论对于病理诊断为CINⅠ的患者,HPV负荷量≥100.00、持续HPV感染、已生育,出血症状明显者可考虑行微波治疗或LLETZ治疗。
Objective To investigate the treatment of cervical intraepithelial neoplasia (CIN) Ⅰ using high-risk human papillomavirus (HPV) load. Methods From 2007 to 2011, 90 patients aged 30-49 who were diagnosed as CINⅠ with HPV infection more than six months in Haizhu District Maternal and Child Health Hospital were divided into three groups according to the method of treatment. The observation group Observed in the microwave group, microwave destructive treatment was applied. In the resection group, the cervical transition band was excised with the LLETZ, and was examined at 6 months and 12 months after treatment. HPV Load ≥100.00 set as high load group, HPV load 10.00 ~ 99.99 as the load group, HPV load 1.00 ~ 9.99 as the low load group. Results One year after the treatment, the HPV infection rate in the resection group was 100.0%. The HPV infection rate was 55.6% and 0% in the HPV high-load group, and the patients in the HPV load group were treated with microwave The rate of HPV infection was 90.9% and 30.8%, respectively. The rate of HPV infection was 70.0% and 22.2% respectively. Conclusion For pathological diagnosis of CIN Ⅰ patients, HPV load ≥ 100.00, persistent HPV infection, have children, bleeding obvious symptoms may consider microwave treatment or LLETZ treatment.