HIV阳性和HIV阴性女性宫颈锥切术后宫颈上皮内瘤变的复发情况。
Cervical intraepithelial neoplasia recurrence after conization in HIV-positive and HIV-negative women.
作者信息
Lima Maria Inês, Tafuri Alexandre, Araújo Angela C, de Miranda Lima Luiza, Melo Victor Hugo
机构信息
Serviço de Referência de Patologia do Colo Uterino do PAM Sagrada Família, Department of Health Services, Belo Horizonte County, Brazil.
出版信息
Int J Gynaecol Obstet. 2009 Feb;104(2):100-4. doi: 10.1016/j.ijgo.2008.10.009. Epub 2008 Dec 5.
OBJECTIVES
To evaluate the recurrence rates of cervical intraepithelial neoplasia (CIN) in a cohort of HIV-infected and noninfected women who underwent the loop electrosurgical excision procedure (LEEP).
METHODS
A prospective cohort study of 94 HIV-positive and 107 HIV-negative women, both with CIN, treated with LEEP. The diagnosis of recurrence was established after biopsy. The Kaplan-Meier method was used for survival analysis and multivariate analyses were carried out using the Cox proportional hazards regression model.
RESULTS
There was a predominance of low-grade lesions in HIV-positive compared with HIV-negative women (P<0.01). Recurrence was more frequent with compromised margins and glandular involvement (P<0.01). A multivariate analysis showed that HIV-infection, glandular involvement, and positive margins were independently associated with recurrence of lesions.
CONCLUSIONS
Recurrence rate of CIN in HIV-positive women was higher than in HIV-negative women. The factors associated with recurrence were HIV infection, glandular involvement, and positive margins.
目的
评估接受环形电切术（LEEP）的感染人类免疫缺陷病毒（HIV）和未感染HIV的女性队列中宫颈上皮内瘤变（CIN）的复发率。
方法
对94例HIV阳性和107例HIV阴性且均患有CIN的女性进行前瞻性队列研究，她们均接受了LEEP治疗。活检后确定复发诊断。采用Kaplan-Meier法进行生存分析，并使用Cox比例风险回归模型进行多变量分析。
结果
与HIV阴性女性相比，HIV阳性女性中低级别病变占主导（P<0.01）。切缘受累和腺体受累时复发更频繁（P<0.01）。多变量分析显示，HIV感染、腺体受累和切缘阳性与病变复发独立相关。
结论
HIV阳性女性中CIN的复发率高于HIV阴性女性。与复发相关的因素为HIV感染、腺体受累和切缘阳性。
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