Eliminating HPV DNA Positive Result with Large Loop Excision of the Transformation Zone (LLETZ)/Loop Electrosurgical Excision Procedure (LEEP) in Precancerous Cervical Lesions

Q4 Medicine

Indonesian Journal of Obstetrics and Gynecology Pub Date : 2024-05-20 DOI:10.32771/inajog.v12i2.1897

R. Sanif, Patiyus Agustiansyah, Raissa Nurwany, Irawan Sastradinata, Theodorus, Wisman Agustian

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Abstract

Abstract Objective: To determine the use of LLETZ/LEEP to eliminate HPV DNA positive result in patients with cervical precancerous lesions at General Hospital dr. Mohammad. Hoesin, Palembang. Methods: A case series with cervical precancerous lesions was undertaken at the Oncology Polyclinic of dr.Mohammad Hoesin Hospital Palembang from January to October 2022. There were 24 samples with positive HPV DNA before LLETZ/LEEP. Samples then checked for HPV DNA after LLETZ/LEEP. The effectiveness of LLETZ/LEEP therapy was analyzed using the Mc Nemar test. Comparison of HPV DNA outcomes (positive or negative) based on procedure, HPV DNA type and histopathological type was analyzed using Fisher Exact and Pearson Chi Square tests. All data were analyzed using SPPS version 22.0. Results: In this study, it was found that the average age of patients with cervical precancerous lesions was 40.25 ± 7.67 years (28 - 57 years). Based on the diagnosis, 8 samples were found with High-grade Squamous Intraepithelial Lesion (HGSIL) and 16 samples with Low-grade Squamous Intraepithelial Lesion (LGSIL). All samples in this study were housewives and the majority were multiparas (75.0%). History of abortion in the patients in this study was only found in 5 samples (20.8%). The results showed that there were significant differences in the HPV DNA before and after LLETZ/LEEP therapy (p = 0.000). In addition, the results showed that there was no difference in the outcome of HPV DNA based on the procedure (p = 1.000) and the type of HPV DNA (p = 0.643). After LLETZ/LEEP therapy was carried out, it was found that only 1 subject has positive HPV DNA result and the HPV DNA virus found was type 52 and (high risk) and 42 (low risk). Conclusion: It can be concluded that LLETZ/LEEP therapy is effective in eliminating HPV DNA positive results in cervical precancerous lesions Keywords: cervical cancer, HPV DNA, LLETZ/LEEP, precancerous lesions, RCT

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宫颈癌前病变的大环切除术（LLETZ）/环形电切术（LEEP）可消除 HPV DNA 阳性结果

摘要目的确定使用 LLETZ/LEEP 消除综合医院宫颈癌前病变患者的 HPV DNA 阳性结果。Mohammad.Hoesin, Palembang.方法：2022 年 1 月至 10 月期间，巴伦邦 Mohammad Hoesin 医院肿瘤综合门诊对宫颈癌前病变进行了病例系列研究。在 LLETZ/LEEP 之前，有 24 份样本的 HPV DNA 呈阳性。然后在LLETZ/LEEP后对样本进行HPV DNA检查。LLETZ/LEEP 疗法的有效性通过麦克尼玛测试进行分析。使用费舍尔精确检验和皮尔逊奇异方差检验分析了基于手术、HPV DNA 类型和组织病理学类型的 HPV DNA 结果（阳性或阴性）比较。所有数据均使用 SPPS 22.0 版进行分析。结果研究发现，宫颈癌前病变患者的平均年龄为（40.25 ± 7.67）岁（28 - 57 岁）。根据诊断结果，8 个样本为高级别鳞状上皮内病变（HGSIL），16 个样本为低级别鳞状上皮内病变（LGSIL）。本研究中的所有样本均为家庭主妇，大多数为多胎妊娠（75.0%）。本研究中只有 5 个样本（20.8%）的患者有过流产史。结果显示，LLETZ/LEEP 治疗前后的 HPV DNA 存在显著差异（p = 0.000）。此外，结果显示，HPV DNA 的结果与治疗过程（p = 1.000）和 HPV DNA 的类型（p = 0.643）没有差异。在进行 LLETZ/LEEP 治疗后，发现只有 1 名受试者的 HPV DNA 结果呈阳性，发现的 HPV DNA 病毒类型为 52 型（高危）和 42 型（低危）。结论关键词：宫颈癌、HPV DNA、LLETZ/LEEP、癌前病变、RCT

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