Tian QiaoXian, Ma JiaYao, Wu YaHua, Wang LingYun, Yang WenJiao
Department of Obstetrics and Gynecology, Fengcheng Hospital, Shanghai, 201411, China.
Department of Obstetrics and Gynecology, Fengcheng Hospital, No.9983 Chuannanfeng Road, Fengxian District, Shanghai, 201411, China.
Open Med (Wars). 2025 Mar 6;20(1):20241101. doi: 10.1515/med-2024-1101. eCollection 2025.
This study analyzed the prognosis of patients with high-grade squamous intraepithelial lesion (HSIL) after loop electrosurgical excision procedure (LEEP) and elucidated the predictive value of neutrophil-to-lymphocyte ratio (NLR) and margin condition in relation to prognostic recurrence.
A total of 209 patients were included, with 46 cases in the recurrence/residual group, 156 cases in the no recurrence/residual group, and 7 cases lost to follow-up. General information, past history and comorbid underlying diseases, laboratory tests, and other relevant clinical information were compared between the two groups. The ROC curves were plotted to assess the diagnostic values of NLR, platelet-to-lymphocyte ratio (PLR), and lymphocytes. Log-rank test was conducted to plot the Kaplan Meier curves to assess the occurrence of recurrence/residual. Risk factors for the occurrence of recurrence/residual in patients during follow-up were analyzed.
Patients with high-risk human papillomavirus (HR-HPV) infection, positive margins, and higher PLR and NLR had a higher risk of recurrence/residual at follow-up. HR-HPV infection, positive margins, and higher levels of PLR and NLR showed significant hazard ratios. High NLR, positive margins, and HR-HPV infection resulted in poor prognosis and the occurrence of recurrence or residual.
NLR levels and positive margins may be markers for predicting HSIL recurrence/residual lesions after LEEP.
本研究分析了高级别鳞状上皮内病变(HSIL)患者行环形电切术(LEEP)后的预后情况,并阐明了中性粒细胞与淋巴细胞比值(NLR)及切缘情况对预后复发的预测价值。
共纳入209例患者,其中复发/残留组46例,无复发/残留组156例,失访7例。比较两组患者的一般资料、既往史及合并基础疾病、实验室检查及其他相关临床信息。绘制ROC曲线评估NLR、血小板与淋巴细胞比值(PLR)及淋巴细胞的诊断价值。进行对数秩检验绘制Kaplan Meier曲线评估复发/残留的发生情况。分析随访期间患者复发/残留发生的危险因素。
高危型人乳头瘤病毒(HR-HPV)感染、切缘阳性以及PLR和NLR较高的患者随访时复发/残留风险更高。HR-HPV感染、切缘阳性以及PLR和NLR水平较高显示出显著的风险比。高NLR、切缘阳性及HR-HPV感染导致预后不良及复发或残留的发生。
NLR水平及切缘阳性可能是预测LEEP术后HSIL复发/残留病变的标志物。