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宫颈癌无 HIV 感染妇女的肛门上皮内病变的横断面研究。

Cross-sectional study of anal intraepithelial lesions in women with cervical neoplasia without HIV.

机构信息

Department of Pathology of the Lower Genital Tract, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil.

Department of Fetal Medicine and Ultrasonography, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil.

出版信息

Int J Gynaecol Obstet. 2018 Feb;140(2):233-240. doi: 10.1002/ijgo.12367. Epub 2017 Nov 22.

Abstract

OBJECTIVE

To evaluate the prevalence of anal intraepithelial lesions and associated risk factors in women with cervical neoplasia.

METHODS

The present cross-sectional study enrolled patients with intraepithelial or invasive cervical neoplasia who had been referred to the lower genital tract pathology outpatient department of the Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil, between December 1, 2008, and December 31, 2009; patients with HIV infections were excluded. All participants underwent anal cytology and high-resolution anoscopy; sociodemographic and clinical risk factors were identified using multivariate analysis.

RESULTS

There were 324 patients included and 37 (11.4%) had anal intraepithelial neoplasia. Factors associated with anal intraepithelial neoplasia in the multivariate analysis were being older than 35 years of age (P=0.002), having completed no more than 4 years of education (P=0.012), anomalous anal cytology (P=0.003), and anomalous high-resolution anoscopy findings (P<0.001); subclinical HPV lesions on vulvoscopy (P=0.057) were not associated with anal intraepithelial neoplasia.

CONCLUSION

The prevalence of anal intraepithelial neoplasia was high among patients with cervical neoplasia who did not have HIV, particularly patients older than 35 years.

摘要

目的

评估宫颈病变女性中肛门上皮内病变的流行情况及其相关危险因素。

方法

本横断面研究纳入了 2008 年 12 月 1 日至 2009 年 12 月 31 日期间因宫颈上皮内或浸润性肿瘤而被转诊至巴西累西腓费尔南多·菲格雷多综合医学研究所下生殖道病理学门诊的患者;排除了 HIV 感染者。所有参与者均接受肛门细胞学和高分辨率肛门镜检查;采用多变量分析确定社会人口学和临床危险因素。

结果

共纳入 324 例患者,其中 37 例(11.4%)患有肛门上皮内瘤变。多变量分析中与肛门上皮内瘤变相关的因素为年龄大于 35 岁(P=0.002)、受教育程度不超过 4 年(P=0.012)、异常肛门细胞学(P=0.003)和异常高分辨率肛门镜检查结果(P<0.001);外阴镜下亚临床 HPV 病变(P=0.057)与肛门上皮内瘤变无关。

结论

在未感染 HIV 的宫颈病变患者中,肛门上皮内瘤变的流行率较高,尤其是年龄大于 35 岁的患者。

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