Analysis of the influencing factors for overtreatment in patients with high-grade squamous intraepithelial lesion on primary cervical cytology diagnosis
10.3760/cma.j.issn.1008-6315.2017.10.018
- VernacularTitle:初次细胞学诊断为鳞状上皮内高度病变过度治疗的影响因素分析
- Author:
Suyan SHEN
1
;
Hua XU
Author Information
1. 解放军第二〇二医院妇科
- Keywords:
High-grade squamous intraepithelial lesion;
overtreatment;
cervical cytology;
influencing factors
- From:
Clinical Medicine of China
2017;33(10):939-942
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the influencing factors for overtreatment in patients with high-grade squamous intraepithelial lesion(HSIL)on primary cervical cytology diagnosis.Methods Two hundred and thirty-nine patients with initially diagnosed HSIL on cervical cytology and received cervical conization from January 2012 and December 2016 were selected in this study.Overtreatment was defined as he highest level of pathologic diagnosis which was less than or equal to the low-grade squamous intraepithelial lesion(LSIL).The relevance of patients' age,menstrual status,colposcopy finding,the level of high-risk-HPV-DNA and treatment protocol to overtreatment were investigated.Results The most serious pathological diagnosis confirmed that no CIN,LSIL,HSIL,adenocarcinoma in situ(AIS)and squamous carcinoma of cervix(SCC)were detected,with 3.8%(9/239),5.6%(14/239),87.9%(210/239),0.4%(1/239),2.1%(5/239)respectively.The overall overtreatment rate was 9.6%(23/239).The level of high-risk-HPV-DNA and colposcopic findings were significantly related to overtreatment, and colposcopic finding with LSIL was the risk factor for HSIL overtreatment(OR= 8.786,95%CI= 1.671-17.311,P= 0.015),while HPV-DNA≥1000 ng/L was the protective factor(OR=0.201,95%CI=0.043-0.951,P=0.041).Conclusion The level of high-risk-HPV-DNA and the colposcopic finding are the influencing factors for overtreatment in patients with HSIL on primary cervical cytology diagnosis.
