Analysis of natural regression and influencing factors of HSIL in the cervix of childbearing age patients / 中华妇产科杂志
Chinese Journal of Obstetrics and Gynecology
; (12): 516-525, 2023.
Article
en Zh
| WPRIM
| ID: wpr-985672
Biblioteca responsable:
WPRO
ABSTRACT
Objective:
To investigate the natural regression and related factors of high-grade squamous intraepithelial lesion (HSIL) in the cervix of childbearing age women, and to evaluate the applicability of conservative management for future fertility needs.Methods:
This study included 275 patients of reproductive age with fertility needs, who were diagnosed as HSIL by biopsy from April 30, 2015 to April 30, 2022, including 229 cases (83.3%) cervical intraepithelial neoplasia (CIN) Ⅱ and 46 cases (16.7%) CIN Ⅱ-Ⅲ. They were followed-up without immediate surgery in the First Affiliated Hospital of Nanjing Medical University. The median follow-up time was 12 months (range 3-66 months). The regression, persistence and progression of lesions in patients with HSIL were analyzed during the follow-up period, the influencing factors related to regression and the time of regression were analyzed.Results:
(1) Of the 275 HSIL patients, 213 cases (77.5%, 213/275) experienced regression of the lesion during the follow-up period. In 229 CIN Ⅱ patients, 180 cases (78.6%) regressed, 21 cases (9.2%) persisted, and 28 cases (12.2%) progressed. In 46 CIN Ⅱ-Ⅲ patients, 33 cases (71.7%) regressed, 12 cases (26.1%) persisted, and 1 case (2.2%) progressed to invasive squamous cell carcinoma stage Ⅰ a1. There was no significant difference in the regression rate between the two groups (χ2=1.03, P=0.309). (2) The average age at diagnosis, age <25 years old at diagnosis were independent influencing factor of HSIL regression in univariate analysis (all P<0.05). There was no significant difference between HSIL regression and pathological grading, the severity of screening results, human papillomavirus (HPV) genotype, colposcopy image characteristics, number of biopsies during follow-up and pregnancy experience (all P>0.05). (3) The median regression times for patients aged ≥25 years and <25 years at diagnosis were 15 and 12 months, respectively. Kaplan-Meier analysis showed that age ≥25 years at diagnosis significantly increased the median regression time compared to <25 years (χ2=6.02, P=0.014).Conclusions:
For HSIL patients of childbearing age, conservative management without immediate surgical intervention is preferred if CINⅡ is fully evaluated through colposcopy examination. Age ≥25 years at diagnosis is a risk factor affecting the prognosis of HSIL patients.
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Papillomaviridae
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Biopsia
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Carcinoma in Situ
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Displasia del Cuello del Útero
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Neoplasias del Cuello Uterino
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Cuello del Útero
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Colposcopía
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Infecciones por Papillomavirus
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Lesiones Intraepiteliales Escamosas de Cuello Uterino
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Lesiones Intraepiteliales Escamosas
Límite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
Zh
Revista:
Chinese Journal of Obstetrics and Gynecology
Año:
2023
Tipo del documento:
Article