Risk Factors Of Residual Or Recurrence After LEEP In High Grade Cervical Intraepithelial Neoplasia And Its Correlation With TCM Syndrome

Purpose:The study takes the high grade suicidal intraepithelial lesion(HSIL)patients as the research object,whom have conducted after a loop electrosurgical excision procedure(LEEP)and followed up for 2 years.By researching the high risk factors of Cervical Cancer and the Traditional Chinese Medicine(TCM)syndrome to determine residual or recurrence.,and then this paper discuss the risk factors of residual/recurrence after HSIL LEEP and its relationship with TCM syndrome.Method:1.Cases collected from the Gynaecology Clinic or Inpatient Department of the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine during the period from Jan.2014 to Jan.2016.Patients who have identified HISL by pathological examination and conducted LEEP.The follow-up period was 2 years.The follow-up period was 2 years:3 months after operated,execute Liquid-based cytology test(TCT);6 months,12 months and 24 months after operated,execute TCT combined high-risk human papillomavirus(high risk human papillomavirus virus,HR-HPV)DNA.residual or recurrent patients were study group,no Residual/recurrent patients were controls group.2.Using the epidemiological survey of risk factors of cervical cancer to conduct epidemiological investigations on the subjects,simultaneously evaluate postoperative pathology(positive margin,gland involvement),and record postoperative HR-HPV DNA test results(6 months,12 months).Determine the risk factors associated with HSIL residual/recurrence after HSIL LEEP.3.Apply the CIN syndrome survey form,collect the information of the four diagnosis of TCM for the su'bjects,and refer to Zhu Wenfeng's?Syndrome of Syndrome Differentiation?for TCM syndrome differentiation.To study the distribution characteristics of TCM syndrome of residual/recurrence after HSIL LEEP.4.To investigate the risk factors of residual/recurrence after HSIL LEEP and its correlation with TCM syndrome.Result:1.A total of 165 cases were collected in this study.Residues/recurrence occurred in 12 cases.The residual/recurrence rate a:fter HSIL LEEP was 7.3%.There was no statistical difference between the study group and the control group in terms of occupation(P=0.730)and education(P=0.442).The significance was statistically significant(P<0.05)in terms of age(P=0.000)and Body Mass Index(BMI)(P=0.000).2.Risk factors of residual/recurrence after HSIL LEEP:?The related risk factors included age?50 years(P=0.000),menopause(P=0.019),positive margin(P=0.043),after continuous HR-HPV infection after surgery(p=0.001).?The independent risk factors included positive margin(P=0.034),persistent HPV infection after surgery(P=0.009).Distribution characteristics of residual/recurrent TCM syndrome after HSIL LEEP:?Study Group:Disease location syndrome factor distribution:liver most,9 cases,followed by kidney,uterus,spleen;Disease essence syndrome factor distribution:wet most,10 cases,followed by heat,yin deficiency;TCM syndrome types distribution:Uterine palace damp heat syndrome,liver and kidney yin deficiency syndrome and liver dampness heat syndrome up to 4 cases.?control group:Disease location syndrome factor distribution:uterus most,72 cases,followed by the liver,spleen,kidney,heart;Disease essence syndrome factor distribution:wet most,81cases,followed by heat,qi deficiency,stagnation,yin deficiency,blood stasis;TCM syndrome types distributionr:Uterine palace damp heat syndrome most,37 cases,followed spleen damp syndrome.liver qi stagnation syndrome,liver and kidney yin deficiency syndrome,stasis obstructive uterine syndrome,liver dampness heat syndrome.?Postoperative liver disease(P=0.026)and kidney(P=0.049)were statistically significant with residual/recurrence after HSLI LEEP;Disease nature wetness(P=0.042)and heat(P=0.045)were statistically significant with residual/recurrence after HSLI LEEP;Liver dampness-heat syndrome(P=0.035)was statistically significant with residual/recurrence after HSIL LEEP.4.The relationship between the risk factors of residual/recurrence after HSIL LEEP and TCM syndrome:positive margin of conization specimen and after persistent HR-HPV infection were no correlation with liver dampness heat syndrome(P>0.05).In Conclusion:1.positive margin of conization specimen,persistent HR-HPV infection is the independent risk factors of residual/recurrence after HSIL LEEP.During the follow-up,patients who combine the above factors need to be followed up frequently after the operation.2.In the study group,the syndrome elements of disease location was mainly liver,but also the kidney,uterus;and spleen;the control group was mainly composed of uterine trophy,but also liver,spleen,kidney,and heart;The residual/recurrence after HSIL LEEP is related to liver and kidney.In the study group,syndrome elements of disease nature was mainly wet,accompanied heat and yin deficiency as the contributing factors to the disease.In the control group,the disease nature was mainly wet,accompanied the heat,qi deficiency,qi stagnation,yin deficiency,and blood stasis as the contributing factors to the disease.The disease nature of HISL was mainly wet.Residual/recurrence after HSIL LEEP is related to wetness and heat.3.liver dampness heat syndrome,liver and kidney yin deficiency and liver heat syndrome is the most common syndrome in residual/recurrence after HSIL LEEP.Residual/recurrence after HSIL LEEP is related to dampness-heat syndrome.