宫颈冷刀锥切术联合抗HPV生物蛋白敷料治疗HSIL合并高危型HPV感染的临床效果研究

doi:10.11904/j.issn.1002-3070.2021.05.007

实用肿瘤学杂志 ›› 2021, Vol. 35 ›› Issue (5): 426-430.doi: 10.11904/j.issn.1002-3070.2021.05.007

宫颈冷刀锥切术联合抗HPV生物蛋白敷料治疗HSIL合并高危型HPV感染的临床效果研究

马莉¹, 郭思宏², 朱博熠¹, 陈杰¹

1.哈尔滨医科大学附属肿瘤医院(哈尔滨 150081);
2.黑龙江中医药大学

收稿日期:2021-03-11 修回日期:2021-05-06 出版日期:2021-10-28 发布日期:2021-10-25
通讯作者: 陈杰,E-mail:cj2365255@126.com
作者简介:马莉,女,(1993-),硕士研究生,从事妇科肿瘤的临床研究。
基金资助:
北京癌症防治学会,癌症预防与诊治科研基金(编号:IZ学研字2019-1003);哈尔滨医科大学附属肿瘤医院海燕科研基金重点项目(编号:JJZD2019-06)

Clinical effect of cervical cold knife conization combined with anti-HPV bioprotein dressing on HSIL treatment complicated with high-risk HPV infection

MA Li¹, GUO Sihong², ZHU Boyi¹, CHEN Jie¹

1. Harbin Medical University Cancer Hospital,Harbin 150081,China;
2. Heilongjiang University of Chinese Medicine

Received:2021-03-11 Revised:2021-05-06 Online:2021-10-28 Published:2021-10-25

摘要/Abstract

摘要： 目的探讨宫颈冷刀锥切术联合抗HPV生物蛋白敷料治疗宫颈高级别鳞状上皮内病变(High-grade squamous intraepithelial lesion,HSIL)合并高危型HPV感染的临床效果及应用价值。方法选择哈尔滨医科大学附属肿瘤医院2017年9月—2019年12月接收的220例确诊高危型HPV感染且病理证实为宫颈上皮内瘤变(Cervical intraepithelial neoplasia,CIN)Ⅱ~Ⅲ级的患者,随机分为观察组和对照组,对照组予以单纯宫颈冷刀锥切术(CKC)治疗,观察组予以CKC联合抗HPV生物蛋白敷料治疗,术后定期复查HPV、TCT并察看阴道分泌物,对两组疗效进行对比评价。结果观察组在术后6个月、9个月、12个月HPV转阴率为51.82%、70.00%、83.64%,治疗总有效率为62.73%、82.73%、91.82%,均高于对照组(P＜0.05);观察组术后6个月、12个月复查TCT异常率均低于对照组(P＜0.05);年龄＜50岁的观察组与对照组患者间治疗总有效率对比无统计学差异(P＞0.05),年龄≥50岁的观察组患者治疗总有效率均优于对照组(P＜0.05);观察组在术后3个月、6个月、9个月及12个月阴道分泌物正常率为48.18%、64.55%、84.55%、92.73%,均高于对照组(P＜0.05)。结论宫颈冷刀锥切术联合抗HPV生物蛋白敷料治疗HSIL合并高危型HPV感染临床效果显著,能够改善阴道环境,有效促进高危型HPV感染的消退,降低术后复发的风险,且高龄妇女更加受益。

关键词: 人乳头瘤病毒, 宫颈高级别鳞状上皮内病变, 冷刀锥切术, 抗HPV生物蛋白敷料

Abstract: Objective The aim of this study was to investigate the clinical effect and application value of cold knife conization combined with anti-HPV bioprotein dressing in the treatment of high-grade squamous intraepithelial lesion(HSIL)complicated with high-risk HPV infection. Methods A total of 220 patients received by the Harbin Medical University Cancer Hospital from September 2017 to December 2019 diagnosed with high-risk HPV infection and pathologically confirmed to be cervical intraepithelial neoplasia(CIN)grade Ⅱ~Ⅲ were randomly divided into observation group and control group.The control group was treated with CKC alone,and the observation group was treated with CKC combined with anti-HPV bioprotein dressings.After that,HPV,TCT and vaginal secretion were reviewed regularly,and the curative effects on the two groups were compared and evaluated. Results In the observation group,the negative rate of HPV in 6 months,9 months and 12 months after surgery were 51.82%,70.00% and 83.64%,respectively,and the total effective rates of treatment were 62.73%,82.73% and 91.82%,respectively,which were higher than those in the control group(P＜0.05).The abnormal rate of TCT in the observation group at 6 months and 12 months after surgery was lower than that in the control group(P＜0.05).There was no significant difference in the total effective rate for patients younger than 50 years old between the observation group and the control group(P＞0.05).The total effective rate of treatment for patients ≥50 years old in the observation group was better than that of the control group(P＜0.05).The normal rates of vaginal secretion in the observation group at 3 months,6 months,9 months and 12 months after surgery were 48.18%,64.55%,84.55%,92.73%,respectively,which were higher than those of the control group(P＜0.05). Conclusion The cervical cold knife conization combined with anti-HPV bioprotein dressing has a significant clinical effect in the treatment of HSIL combined with high-risk HPV infection.It can improve the vaginal environment,effectively promote the regression of high-risk HPV infection,reduce the risk of postoperative recurrence,and has more benefit for elderly women.

Key words: Human papilloma virus, High-grade squamous intraepithelial lesion of the cervix, Cold knife conization, Anti-HPV biological protein dressing

中图分类号:

R737.33

马莉, 郭思宏, 朱博熠, 陈杰. 宫颈冷刀锥切术联合抗HPV生物蛋白敷料治疗HSIL合并高危型HPV感染的临床效果研究[J]. 实用肿瘤学杂志, 2021, 35(5): 426-430.

MA Li¹, GUO Sihong², ZHU Boyi¹, CHEN Jie¹. Clinical effect of cervical cold knife conization combined with anti-HPV bioprotein dressing on HSIL treatment complicated with high-risk HPV infection[J]. Journal of Practical Oncology, 2021, 35(5): 426-430.

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参考文献

1 Depuydt CE,Beert J,Bosmans E,et al.Human Papillomavirus(HPV)virion induced cancer and subfertility,two sides of the same coin[J].Facts Views Vis Obgyn,2016,8(4):211-222.
2 Durmus Y,Karalok A,Basaran D,et al.Can we predict surgical margin positivity while performing cervical excisional procedures?[J].J Obstet Gynaecol,2020,40(5):666-672.
3 陈丽梅,刘莉,陶祥,等.1 005例子宫颈HSIL患者行LEEP术后24个月内的复发及其影响因素分析[J].中华妇产科杂志,2019,54(8):534-540.
4 Chen JY,Wang ZL,Wang ZY,et al.The risk factors of residual lesions and recurrence of the high-grade cervical intraepithelial lesions(HSIL)patients with positive-margin after conization[J].Medicine(Baltimore),2018,97(41):e12792.
5 Tanaka H,Shirasawa H,Shimizu D,et al.Preventive effect of human papillomavirus vaccination on the development of uterine cervical lesions in young Japanese women[J].J Obstet Gynaecol Res,2017,43(10):1597-1601.
6 Lu L,Yang X,Li Y,et al.Chemically modified bovine beta-lactoglobulin inhibits human papillomavirus infection[J].Microbes Infect,2013,15(6-7):506-510.
7 何金华,陈君玉,伍亚玲.抗生物蛋白敷料对HPV感染宫颈CINⅠ级患者HPV转阴的改善作用及其安全性[J].中国医学创新,2018,15(21):34-37.
8 湛艳瑞.抗HPV生物蛋白敷料及重组人干扰素α-2b凝胶治疗宫颈高危型人乳头瘤病毒持续感染[J].临床研究,2019,27(8):26-27.
9 Saslow D,Solomon D,Lawson HW,et al.American cancer society,American society for colposcopy and cervical pathology,and American society for clinical pathology screening guidelines for the prevention and early detection of cervical cancer[J].J Low Genit Tract Dis,2012,16(3):175-204.
10 王艳,何丽清,蔡序子,等.派特灵治疗高危人乳头瘤病毒持续感染患者的疗效及安全性研究[J].中国全科医学,2019,22(11):1323-1327.
11 袁建晖,范燕燕,谢彤.高危型人乳头瘤病毒在2年内自然清除及持续感染与宫颈病变关系的研究[J].江西医药,2020,55(11):1566-1569.
12 Lee M,Chou C,Tang M,et al.Epithelial-mesenchymal transition in cervical cancer:correlation with tumor progression,epidermal growth factor receptor overexpression,and snail up-regulation[J].Clin Cancer Res,2008,14(15):4743-4750.
13 魏至瑶,代荫梅.宫颈锥切术后CIN残留及复发相关影响因素的研究进展[J].医学综述,2020,26(17):3416-3420,3428.
14 Katki HA,Schiffman M,Castle PE,et al.Five-year risk of recurrence after treatment of CIN 2,CIN 3,or AIS:performance of HPV and Pap cotesting in posttreatment management[J].J Low Genit Tract Dis,2013,17(5 Suppl 1):S78-84.
15 Huh WK,Ault KA,Chelmow D,et al.Use of primary high-risk human papillomavirus testing for cervical cancer screening:interim clinical guidance[J].Gynecol Oncol,2015,136(2):178-82.
16 吕江涛,周德平.人乳头瘤病毒及其相关宫颈上皮内瘤变的药物治疗进展[J].现代妇产科进展,2016,25(5):390-392.
17 何晶,张烽,朱佳尔.抗HPV生物蛋白敷料与重组人干扰素α-2b凝胶治疗高危型HPV感染的研究[J].中华医院感染学杂志,2020,30:403-408.
18 任思颖,秦明芳,陈杨,等.云南省肿瘤登记地区2011-2015年宫颈癌发病和死亡特征及时间趋势[J].实用肿瘤学杂志,2021,35(1):13-17.
19 Luca,Giannella,Cristina,et al.Age-related changes in pre-and post-conization HPV genotype distribution among women with high-grade cervical intraepithelial neoplasia[J].Int J Gynaecol Obstet,2017,137(1):72-77.
20 Hong G,Park YG,Jin HW,et al.Comparison of the clinical performance of OmniPlex-HPV and GeneFinder HPV for the detection and genotyping of human papillomaviruses in cervical specimens[J].J Med Microbiol,2018,67(9):1279-1286.
21 Tay SK,Lin LE,Goh RC.Detection rate of high-grade cervical neoplasia and cost-effectiveness of high-risk human papillomavirus genotyping with reflex liquid-based cytology in cervical cancer screening[J].Ann Acad Med Singap,2017,46(7):267-273.

[1]	雷蕾, 叶庆华, 王国增, 黄贤莉, 吴乾渝. Aurora-A在宫颈癌及癌前病变中的表达以及与HPV感染的相关性研究[J]. 实用肿瘤学杂志, 2017, 31(6): 494-499.
[2]	耿晓星, 戴智莉, 张海艳. 青黛紫草合剂治疗上皮内瘤变的临床研究[J]. 实用肿瘤学杂志, 2011, 25(4): 354-357.
[3]	李雪梅, 李联昆, 高玉华, 龙再秋. HPV病毒负荷量与宫颈病变的关系[J]. 实用肿瘤学杂志, 2009, 23(6): 538-540.
[4]	牛淑芳, 刘志强, 吴素慧, 魏学功. 人乳头瘤病毒与宫颈病变的相关性研究[J]. 实用肿瘤学杂志, 2009, 23(3): 225-227.
[5]	曹虹然;王建勋;岳秀兰;白雪峰. 胃癌组织中人乳头瘤病毒感染与胃癌关系的研究[J]. 实用肿瘤学杂志, 2005, 19(06): 422-424.

宫颈冷刀锥切术联合抗HPV生物蛋白敷料治疗HSIL合并高危型HPV感染的临床效果研究

Clinical effect of cervical cold knife conization combined with anti-HPV bioprotein dressing on HSIL treatment complicated with high-risk HPV infection

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