电邮这篇文章 子宫颈上皮内瘤变的风险因素
- 作者: Anisimova M.A.1, Shcherbakova L.N.1, Bugerenko A.E.1, Jain M.1, Kirillova K.I.1, Samokhodskaya L.M.1, Panina O.B.1
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隶属关系:
- Lomonosov Moscow State University
- 期: 卷 11, 编号 4 (2024)
- 页面: 480-489
- 栏目: Original study articles
- ##submission.dateSubmitted##: 24.06.2024
- ##submission.dateAccepted##: 25.07.2024
- ##submission.datePublished##: 22.12.2024
- URL: https://archivog.com/2313-8726/article/view/633744
- DOI: https://doi.org/10.17816/aog633744
- ID: 633744
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详细
背景。子宫颈上皮内瘤变的主要病因与人乳头瘤病毒（HPV）的持续感染密切相关。流行病学研究表明，HPV感染的发生率远高于子宫颈上皮内瘤变的发生率，因此，HPV检测在识别高等级子宫颈上皮内瘤变方面的特异性和阳性预测价值仍有限。目前，针对HPV阳性女性的筛查策略尚未明确，其关键在于识别真正处于高风险中的人群。
研究目的。评估与子宫颈上皮内瘤变风险增加相关的社会经济、行为及合并症因素。
材料与方法。研究对象包括121名于2022–2023年间前往莫斯科国立大学医学科学教育中心就诊的女性患者。根据宫颈细胞学检查结果，患者分为三组：第1组（NILM，66名）细胞学检查正常；第2组（LSIL，27名）轻度子宫颈上皮内瘤变；第3组（HSIL，28名）重度子宫颈上皮内瘤变。所有患者均接受了详细的病史调查、液基细胞学检查及HPV分型分析。统计分析使用MedCalc软件完成。
结果。数据分析显示，以下因素显著增加重度子宫颈上皮内瘤变的风险：年龄超过30岁 （风险增加5.4倍）、吸烟（3.4倍）、性行为时间超过10年（9.9倍）、性伴侣数量超过4人（6.3倍）、使用体外排精法（Postcoital Pull-out Attempt，PPA）避孕（4.1倍）、妊娠次数达到3次及以上（7.0倍）、持续HPV感染（4.7倍），尤其是HPV 16型感染（4.3倍）。在子宫颈上皮内瘤变患者中，高危型HPV感染更为常见（LSIL组88.9%，HSIL组85.7%，NILM组56.1%），且超过一半的HSIL患者感染了HPV 16型。
结论。在研究样本中，子宫颈上皮内瘤变的风险与以下因素显著相关：年龄超过30岁、吸烟、性行为超过10年、性伴侣数量超过4人、缺乏屏障避孕、多次妊娠史以及持续高危型HPV感染（尤其是HPV 16型感染）。这些因素的识别对高危人群的筛查及干预具有重要意义。
全文:
作者简介
Maria A. Anisimova
Lomonosov Moscow State University
编辑信件的主要联系方式.
Email: manecha35@mail.ru
ORCID iD: 0009-0002-6081-5597
SPIN 代码: 9561-8400
Graduate Student
俄罗斯联邦, MoscowLiya N. Shcherbakova
Lomonosov Moscow State University
Email: liya.fbm@gmail.com
ORCID iD: 0000-0003-2681-4777
SPIN 代码: 3138-4565
MD, Dr. Sci. (Medicine), Professor
俄罗斯联邦, MoscowAndrey E. Bugerenko
Lomonosov Moscow State University
Email: jeddit@yandex.ru
ORCID iD: 0000-0001-5691-7588
SPIN 代码: 5827-0440
MD, Dr. Sci. (Medicine), Assistant Professor
俄罗斯联邦, MoscowMark Jain
Lomonosov Moscow State University
Email: jain-mark@outlook.com
ORCID iD: 0000-0002-6594-8113
SPIN 代码: 3783-4441
Senior Research Associate
俄罗斯联邦, MoscowKarina I. Kirillova
Lomonosov Moscow State University
Email: dkkirillova@gmail.com
ORCID iD: 0000-0002-0873-7387
SPIN 代码: 4440-1859
Research Associate
俄罗斯联邦, MoscowLarisa M. Samokhodskaya
Lomonosov Moscow State University
Email: slm@fbm.msu.ru
ORCID iD: 0000-0001-6734-3989
SPIN 代码: 5404-6202
MD, Cand. Sci. (Medicine)
俄罗斯联邦, MoscowOlga B. Panina
Lomonosov Moscow State University
Email: olgapanina@yandex.ru
ORCID iD: 0000-0003-1397-6208
SPIN 代码: 2105-6871
MD, Dr. Sci. (Medicine), Professor
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