La Vecchia C, Franceschi S, Decarli A, Fasoli M, Gentile A, Gritti P
Obstet Gynecol. 1985 Nov;66(5):703-7.
The relationship between electrocoagulation diathermy and the risk of cervical neoplasia was evaluated in a case-control study of 145 women with cervical intraepithelial neoplasia compared with 145 age-matched outpatient control subjects, and 191 cases of invasive cervical cancer compared with 191 control subjects in the hospital for acute conditions unrelated to any of the identified or suspected risk factors for cervical cancer. History of electrocoagulation was associated with an apparently reduced risk of cervical intraepithelial neoplasia (relative risk = 0.50, with 95% confidence interval = 0.29-0.87), and of invasive cancer (relative risk = 0.42, 95% confidence interval = 0.22-0.82). However, this apparent protection could be largely explained in terms of a different frequency of previous Papanicolaou smears in patients and control subjects. When adjustment was made for that variable, the risk estimates of CIN and invasive cancer among women who had undergone electrocoagulation increased to 0.62 and 0.83 and became statistically nonsignificant. Further allowance for other identified potential confounding factors by means of multiple logistic regression raised these estimates to 0.73 and 0.94, respectively. Thus, these data provide evidence against the hypothesis that electrocoagulation may have an important and independent role in the prevention of cervical neoplasia.
在一项病例对照研究中，对145例宫颈上皮内瘤变女性与145例年龄匹配的门诊对照对象进行了评估，以探讨电凝透热疗法与宫颈肿瘤发生风险之间的关系；此外，还对191例浸润性宫颈癌患者与191例对照对象进行了研究，这些对照对象来自一家收治与任何已确定或疑似宫颈癌风险因素均无关的急性病患者的医院。电凝治疗史与宫颈上皮内瘤变风险的显著降低相关（相对风险=0.50，95%置信区间=0.29 - 0.87），与浸润性癌风险的显著降低也相关（相对风险=0.42，95%置信区间=0.22 - 0.82）。然而，这种明显的保护作用在很大程度上可以用患者和对照对象之前巴氏涂片检查频率的差异来解释。当对该变量进行调整后，接受电凝治疗的女性中，宫颈上皮内瘤变和浸润性癌的风险估计值分别增至0.62和0.83，且在统计学上无显著意义。通过多因素逻辑回归进一步考虑其他已确定的潜在混杂因素后，这些估计值分别升至0.73和0.94。因此，这些数据提供了证据，反驳了电凝疗法可能在预防宫颈肿瘤方面具有重要且独立作用这一假设。
