School of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic of Gynecology and Obstetrics, University Clinical Centre of Serbia, Belgrade, Serbia.
J Obstet Gynaecol. 2022 Oct;42(7):3061-3066. doi: 10.1080/01443615.2022.2083486. Epub 2022 Jun 12.
We evaluated factors influencing long-term health-related quality of life (HRQoL) after excisional treatments of low- and high grade squamous intraepithelial cervical lesions (SIL) in three groups of women ( = 160): nulliparas interested in reproduction (A), parous women interested in reproduction (B) and women without pregnancy desire (C). The HRQoL was assessed using the disease-specific FACIT-CD and the generic SF36v2 questionnaires. Anxiety and depression were evaluated by Beck's inventories. After median follow-up of 5 (2-18) years, FACIT-CD total score and the score for Emotional Well-Being (EWB) were significantly lower in group A. The total, EWB and REL (Relationships) scores of FACIT-CD were the highest in group B. Women operated for HSIL demonstrated lower REL quality in comparison to those with LSIL. Neither SF36v2 nor FACIT-CD total scores differed in relation to SIL grade or type of excision. 'SF36v2 Mental Component Summary Score' and 'being parous and interested in fertility' were independent predictors of disease-specific FACIT-CD score.Impact Statement Long-term consequences of excisional treatments for cervical dysplasia on health-related quality of life (HRQoL) are not well reported. Our study provides data on HRQoL in women treated with large loop excision of the transformation zone (LLETZ) or cold knife conization (CKC) obtained during the longest (median 5 years) follow-up as reported to date. We were able to show that having children and planning further pregnancies positively influenced HRQoL in these patients. In addition, we identified nulliparas with pregnancy desire as psychologically the most vulnerable group within the studied cohort. Even several years after LLETZ or CKC, women may suffer from impaired Emotional Well-Being and reduced HRQoL. Awareness and assessment of these long-term consequences should be part of surveillance after excisional treatments for cervical dysplasia.
我们评估了三组女性（共 160 例）接受低级别和高级别宫颈上皮内瘤变（SIL）切除术治疗后对长期健康相关生活质量（HRQoL）的影响因素：有生育意愿的未产妇（A 组）、有生育意愿的经产妇（B 组）和无生育意愿的妇女（C 组）。采用疾病特异性 FACIT-CD 和通用 SF36v2 问卷评估 HRQoL。采用贝克量表评估焦虑和抑郁。中位随访 5 年（2-18 年）后，A 组 FACIT-CD 总分和情绪健康状况（EWB）评分显著降低。B 组 FACIT-CD 总分、EWB 和 REL（关系）评分最高。与低级别 SIL 相比，接受 HSIL 手术的女性 REL 质量较低。SF36v2 和 FACIT-CD 总分与 SIL 分级或切除类型无关。“SF36v2 心理成分综合评分”和“经产妇且有生育意愿”是疾病特异性 FACIT-CD 评分的独立预测因素。
切除治疗宫颈上皮内瘤变对健康相关生活质量（HRQoL）的长期影响尚未得到充分报道。本研究提供了迄今为止最长随访期（中位 5 年）接受环形电切术（LLETZ）或冷刀锥切术（CKC）治疗的女性 HRQoL 数据。我们能够证明，有孩子且计划进一步生育会对这些患者的 HRQoL 产生积极影响。此外，我们发现有生育意愿的未产妇是研究队列中心理上最脆弱的群体。即使在 LLETZ 或 CKC 治疗后数年，女性仍可能存在情绪健康受损和 HRQoL 下降。在切除治疗宫颈上皮内瘤变后的监测中，应意识到并评估这些长期后果。
