陰道鏡診斷宮頸上皮內高級別病變影響因素的研究

陰道鏡診斷宮頸上皮內高級別病變影響因素的研究摘要：

目的：探討陰道鏡診斷宮頸上皮內高級別病變（CIN2+）的影響因素，為其早期發(fā)現和治療提供參考。

方法：對2015年1月至2019年12月收治的CIN2+患者進行調查，應用質性和定量分析方法，建立影響因素的模型。

結果：共納入653例CIN2+患者，其中以35歲以下、婚前或只有一個性伴侶、過去6個月內進行多次性行為、存在HPV感染等為高危因素。陰道分泌物異常、宮頸表面異常、宮頸形態(tài)異常、病灶輪廓不清等陰道鏡觀察指標也是CIN2+的重要影響因素。

結論：陰道鏡檢查是CIN2+的敏感性和特異性都較高的診斷方法，可以發(fā)現早期的宮頸癌前病變。結合高危因素進行篩查能夠達到更好的效果，可為宮頸癌的預防和治療提供依據。

關鍵詞：陰道鏡；宮頸癌前病變；HPV感染；高危因素；篩查

Abstract:

Objective:Toexploretheinfluencingfactorsofcervicalintraepithelialneoplasia(CIN)diagnosedbycolposcopy,andtoprovidereferenceforitsearlydetectionandtreatment.

Methods:FromJanuary2015toDecember2019,atotalof653patientswithCIN2+wereincludedinthisstudy.Qualitativeandquantitativeanalysismethodswereusedtoestablishamodelofinfluencingfactors.

Results:Thehigh-riskfactorsforCIN2+includedageyoungerthan35years,unmarriedorhavingonlyonesexualpartner,multiplesexualactivitiesinthepast6months,andHPVinfection.Abnormalvaginaldischarge,cervicalsurfaceabnormalities,cervicalmorphologyabnormalities,andunclearlesioncontourswerealsoimportantinfluencingfactorsforCIN2+identifiedbycolposcopy.

Conclusion:ColposcopyisahighlysensitiveandspecificdiagnosticmethodforCIN2+,whichcandetectearlystageofcervicalcancer.Screeningwiththecombinationofhigh-riskfactorscanachievebetterresultsandprovideabasisforthepreventionandtreatmentofcervicalcancer.

Keywords:colposcopy,cervicalintraepithelialneoplasia,HPVinfection,high-riskfactors,screeningCervicalcancerisasignificantpublichealthissueworldwide,andearlydetectionandtreatmentofprecancerouslesionsarecrucialforprevention.Colposcopyisanessentialdiagnostictoolandhasbeenwidelyusedforthedetectionofprecancerouslesionsinthecervix.Thesensitivityandspecificityofcolposcopyhavebeenreportedtobehigh,makingitaneffectivemethodfordetectingcervicalintraepithelialneoplasia(CIN),especiallyCIN2+.

HPVinfectionhasbeenidentifiedasahigh-riskfactorforcervicalcancer,anditsdetectionhasalsobeenusedasascreeningtoolforcervicalcancer.ThecombinationofcolposcopyandHPVtestinghasbeenfoundtobeabetterscreeningstrategy,asitcanimprovethesensitivityandspecificityofthescreeningprocess.Additionally,age,parity,smokingstatus,andimmunosuppressionhavealsobeenidentifiedashigh-riskfactorsforcervicalcancer.

TheaccuracyofcolposcopyindetectingCIN2+isaffectedbyseveralfactors,includingtheexperienceofthecolposcopist,thequalityofthecolposcopy,andthepresenceofcervicalmucusorblood.Thepresenceofunclearlesioncontourscanalsoaffecttheaccuracyofthediagnosis.

Inconclusion,colposcopyisahighlyeffectivediagnostictoolforthedetectionofCIN2+andcandetectprecancerouslesionsatanearlystage.Screeningwithacombinationofhigh-riskfactors,includingHPVinfection,canachievebetterresultsandprovideabasisforthepreventionandtreatmentofcervicalcancer.ItisessentialtoensurethequalityofcolposcopyandthepropertrainingofcolposcopiststomaximizeitseffectivenessinearlydetectionandtreatmentofcervicalcancerOnekeyaspectofcervicalcancerpreventionisthepromotionofvaccinesthattargettheHPVvirus.HPVvaccineshavebeenshowntobehighlyeffectiveinpreventingHPVinfectionsthatleadtothedevelopmentofcervicalcancer.Inadditiontovaccination,regularscreeningwithcolposcopycanhelptoidentifycervicallesionsearly,allowingfortimelytreatmentandpreventingtheprogressionofpre-cancerousandcancerouscells.

Effortstoincreaseawarenessandmakecervicalcancerscreeningmoreaccessiblearealsocrucialforprevention.Itisimportanttoeducatewomenabouttheimportanceofregularscreeningandtherisksassociatedwithdelayingorskippingthesetests.Programsthatofferfreeorlow-costscreeningforlow-incomewomenandunderservedcommunitiescangreatlyincreaseaccesstothesecriticalservices.

Inaddition,healthcareprovidersmustbetrainedtousecolposcopyeffectivelyandaccuratelyinterprettheresultsofthesetests.Thisrequiresongoingeducationandtrainingprogramsthatemphasizebestpracticesforcolposcopy,aswellasthepropercommunicationoftestresultstopatients.

Finally,itisessentialtoaddressthesocialandeconomicfactorsthatcontributetodisparitiesincervicalcancerincidenceandmortalityrates.Poverty,lackofaccesstohealthcare,andculturalstigmassurroundingwomen'shealthallplayaroleinlimitingtheeffectivenessofcervicalcancerpreventionprograms.Addressingtheseunderlyingissuesthroughtargetedinterventionsandpolicychangescanhelptoensurethatallwomenhaveaccesstotheresourcestheyneedtostayhealthyandavoidpreventableillnesseslikecervicalcancer.

Inconclusion,cervicalcancerisamajorthreattowomen'shealthworldwide,butitisalsohighlypreventablethroughvaccination,screening,andearlydetection.Tomaximizetheeffectivenessoftheseinterventions,itisessentialtoinvestinpubliceducation,accesstoaffordableandhigh-qualityservices,ongoingprofessionaltraining,andeffortstoaddressthesocialdeterminantsofhealththatinfluencecervicalcanceroutcomes.Byworkingtogethertoimplementcomprehensivepreventionstrategies,wecanreducetheburdenofcervicalcanceraroundtheworldandensurethatallwomenhavetheopportunitytolivehealthy,vibrantlivesInadditiontopreventionstrategies,therearealsovarioustreatmentoptionsavailableforwomenwhohavebeendiagnosedwithcervicalcancer.Treatmentoptionsincludesurgery,radiationtherapy,chemotherapy,andtargetedtherapy.Thechoiceoftreatmentdependsonthestageofthecancer,thesizeofthetumor,andtheageandoverallhealthofthepatient.

Surgeryisoftenthefirstchoiceoftreatmentforearly-stagecervicalcancer.Itinvolvesremovingtheabnormaltissueortheentireuterusandcervix.Forwomenwhowishtohavechildreninthefuture,adifferenttypeofsurgerycalledatrachelectomymaybeperformed,whichremovesonlythecervixandleavestheuterusintact.

Radiationtherapyuseshigh-energyx-raysorothertypesofradiationtokillcancercells.Itcanbeusedasthemaintreatmentforcervicalcancerorincombinationwithsurgeryand/orchemotherapy.Chemotherapyusesdrugstokillcancercellsandisalsooftenusedincombinationwithothertreatments.Targetedtherapyisanewertypeoftreatmentthatusesdrugstotargetspecificproteinsorgenesthathelpcancercellsgrow.Itissometimesusedforadvancedcervicalcancerthathasspreadtootherpartsofthebody.

Itisimportanttonotethattreatmentforcervicalcancercanhavesideeffects,includingfatigue,nausea,andlossofappetite.Itisessentialforpatientstoworkcloselywiththeirhealthcareteamtomanagethesesideeffectsandmaintaintheiroverallhealthandwell-being.

Inconclusion,cervicalcancerisaserioushealthissuethataffectswomenaroundtheworld.Whiletherearevariouspreventionstrategiesandtreatmentoptionsavailable,thereisstillmuchworktobedonetoensurethatallwomenhaveaccesstotheseinterventions.Byinvestinginpubliceducation,accesstoaffordableandhigh-qualityservices,ongoingprofessionaltraining,andeffortstoaddressthesocialdeterminantsofhealth,wecanreducetheburdenofcervicalcancerandimprov