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目的:探讨CINⅢ患者病理升级为浸润癌的相关危险因素,建立风险评估模型,从而为CINⅢ患者制定有效治疗方案。方法:收集2011年1月至2015年12月于郑州大学第一附属医院就诊的宫颈活检为CINⅢ的患者2200例,根据锥切术后病理是否升级分为病理升级组和未升级组,并对各预测因素进行单因素和多因素logistic回归分析。结果:单因素分析发现,阴道镜印象、口服避孕药、MRI检查结果、病变累犯点位数、年龄是病理升级的危险因素(P<0.05)。多因素logistic回归分析结果发现,阴道镜印象、MRI检查结果、病变累犯点位数、年龄是患者术后病理升级的独立危险因素(P<0.05)。结论:阴道镜印象、MRI检查结果、病变累犯点位数、年龄是患者术后病理升级的独立危险因素,临床医生需综合考虑进行风险评估,合理选择手术方式。
Objective: To investigate the risk factors associated with pathological progression to invasive carcinoma in CIN Ⅲ patients and to establish a risk assessment model to develop an effective treatment regimen for CIN Ⅲ patients. Methods: Totally 2200 cervical biopsies from January 2011 to December 2015 at the First Affiliated Hospital of Zhengzhou University were collected and divided into pathological and non-escalation groups according to the pathological changes after conization The predictors of single factor and multivariate logistic regression analysis. Results: Univariate analysis showed that the colposcopy impressions, oral contraceptives, MRI findings, the number of recurrent lesions and age were the risk factors of pathological changes (P <0.05). Multivariate logistic regression analysis showed that the results of colposcopy, MRI findings, the number of recidivism sites and age were independent risk factors for postoperative pathological improvement (P <0.05). CONCLUSION: Colposcopy impressions, MRI findings, the number of recurrent lesion sites and age are independent risk factors for postoperative pathological improvement. Clinicians need to consider the risk assessment and choose the appropriate surgical approach.