The Study Of Multi-monitor Methods On The Natural Prognosis And Intervention Treatment Of Cervical Intraepithelial NeoplasiaⅠ

Objective According the study of natural prognosis and intervention treatment of CINⅠ,we observe the changes of High Risk- Human Papillomavirus (HR-HPV),Thin-Prep Cytology Test (TCT) and histopathology between natural prognosis and intervention treatment and analyse the factors between them. It may provide the basement for the clinical management of CINⅠ.Methods To choose a series of 74 patients as the non intervention group, which were diagnosed CINI by histopathology examination in START from 2499 women aged 30 to 49 in daqiao rustic xiushui country Jiangxi province in October,2004.The primary follow-up was on the twelfth month after screening including HR-HPV and TCT ;The second follow-up was on the twenty-fourth month after screening including HR-HPV,TCT,colposcopy and histopath- ology examination.Which was diagnosed CINI by histopathology examination at the twenty-fourth month should be observed continuely; which was diagnosed CINⅡor above by histopathology examination at the twenty-fourth month should be treated referring to the criterion. In addition to choose a series of 65 patients aged 25 to 50 randomly as the intervention group, which were diagnosed CINI by histopathology examination in the JIANGXI Province Women&Children Health Hospital during October,2004 to October,2005. 65 patients all subject to Loop Electrodurgical Excision Procedure (LEEP) treatment.They all do HR-HPV and TCT preoperatively and the specimen was send to do histopathology examination postoperatively. 63 patients that were diagnosed CINI by histopathology examination after operation were brought into the intervention group, to recheck HR-HPV,TCT at the twelfth month after operation,which one of them was masculine should do colposcopy and histopathology examination.There were two patients was diagnosed CINⅡor above by histopathology examination after LEEP should be treated referring to the criterion and be rejected from the intervention group.Results 1 In the non intervention group and intervention group,the rate of HR-HPV infection is 85.1% and 66.7% ,respectively. 2 After twenty–four months follow-up, the rate of regression is 56.76%,the rate of persistence is 33.78% and the rate of progression is 9.46% including five CINⅡand two CINⅢduring 74 CINI of the non intervention group.3 The HR-HPV infection clearance rate of non intervention after 12 months and 24 months were 38.10 % (24/63), 46.03%(29/63). The difference was not statistically significant ( P﹥0.05). After 12 months the HR-HPV infection clearance rate in non intervention and intervention were 38.10%(24/63), 90.5%(38/42), respectively.The difference was statistically significant ( P<0.05). 4 The rate of regression HR-HPV persistence masculine, HR-HPV persistence negative and HR-HPV transfer negative were 30.00% ( 9 / 30 ) ,71.42% ( 5 / 7 ) and 79.31% ( 23 /29),respectively.Those in HR-HPV persistence masculine was significantly lower in compared with the others ,the difference was statistically significan(tP<0.01).5 The treatment effective power in LEEP cure is 100%, at the same time, the HR-HPV infection clearance rate was 90.5%(38/42).6 The rate of regression during the patients aged 30-39 and aged 40-49 is 52.78%(19/36),60.53%(23/38), respectively. The difference was not statistically significant(P﹥0.05).7Three TCT examination masculine rate in non intervention group were 25.68%(19/74),6.76%(5/74)and 8.11%(6/74), respectively. In front and back the TCT examination masculine rate in intervention group is 8.11% (6/74),1.35%.(1/74).Conclusions 1 Most CINⅠmerged HR-HPV infection.2 This study indicated that the advancement of CINⅠis a step by step process .3 The difference of the HR-HPV clearance rate in intervention group and non intervention group was statistically significant.4 The HR- HPV persistence infection is the dominating risk factor in the advancement of CINⅠ. The HR- HPV persistence masculine CINⅠshould be given the intervention treatment.5 The HR- HPV persistence negative and transfer negative CINⅠcan be observed.6 The LEEP is a kind of effectively and viable method for the treatment of CINⅠ.7 The study indicated that no relativity existed between age and the prognosis of CINⅠ.8 Whether testing TCT can be a single monitor method to the prognosis of CINⅠneeded further research .