Clinical efficacy of thermocoagulation in women with biopsy-confirmed cervical low-grade squamous intraepithelial lesions (LSILs) or less after colposcopy referral.
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引用次数: 0
Abstract
Objectives: To evaluate the clinical efficacy of thermocoagulation in women with biopsy-confirmed cervical low-grade squamous intraepithelial lesions (LSIL) or less after colposcopy referral.
Material and methods: A longitudinal study was performed. Women who were diagnosed with cervical LSIL or chronic cervicitis underwent scheduled follow-up examinations with cytology and human papilloma virus (HPV) genotyping for two years after the initial management with thermocoagulation or observation without treatment. All women underwent scheduled follow-up with combined cytology and HPV test at 6th months, 12th months, and 24th months after the initial management. Both HPV clearance and cytological regression were included in the analysis, with clinical cure defined as normal cytology and negative HPV results.
Results: A total of 221 women were included. The histopathological results identified 136 (61.54%) patients with LSIL and 85 (38.46%) with chronic cervicitis. Of these, 113 (51.13%) received thermocoagulation therapy, and 108 (48.87%) chose observation. The 2-year follow-up rate was 91.40%. Women who received thermocoagulation presented a significantly higher probability of cure for two years than those who chose observation (62.86% vs 39.18%, p < 0.001). This preponderance was not observed in the subgroup analysis regarding women with cervical cervicitis (54.17% vs 41.38%, p = 0.277) but was observed in women with LSILs (70.18% vs 38.24%, p < 0.001).
Conclusions: Thermocoagulation may be indicated for patients with cervical LSILs as an effective outpatient procedure in clinical practice.
目的:评价热凝治疗阴道镜转诊后活检证实宫颈低级别鳞状上皮内病变(LSIL)或以下的妇女的临床疗效。材料和方法:进行纵向研究。诊断为宫颈LSIL或慢性宫颈炎的妇女在最初采用热凝治疗或不治疗观察后,接受为期两年的细胞学和人乳头瘤病毒(HPV)基因分型随访检查。所有女性在初始治疗后的第6个月、第12个月和第24个月接受了联合细胞学和HPV检测的预定随访。HPV清除率和细胞学回归均被纳入分析,临床治愈定义为细胞学正常和HPV阴性结果。结果:共纳入221名妇女。组织病理学结果确定136例(61.54%)LSIL患者和85例(38.46%)慢性宫颈炎患者。其中热凝治疗113例(51.13%),观察108例(48.87%)。2年随访率为91.40%。接受热凝治疗的妇女2年的治愈率明显高于选择观察的妇女(62.86% vs 39.18%, p < 0.001)。在宫颈炎妇女的亚组分析中未观察到这种优势(54.17%对41.38%,p = 0.277),但在LSILs妇女中观察到这种优势(70.18%对38.24%,p < 0.001)。结论:在临床实践中,热凝可以作为一种有效的门诊手术治疗宫颈LSILs患者。
期刊介绍:
Ginekologia Polska’ is a monthly medical journal published in Polish and English language.
‘Ginekologia Polska’ will accept submissions relating to any aspect of gynaecology, obstetrics and areas directly related. ‘Ginekologia Polska’ publishes original contributions, comparative works, case studies, letters to the editor and many other categories of articles.