高级别宫颈鳞状上皮内病变治疗后病灶残留、复发及妊娠

摘要：高度宫颈鳞状上皮内病变（HSIL）是宫颈癌前病变。未接受治疗的HSIL约17%的概率可进展为浸润癌。因此，准确规范地处理宫颈病变,特别是HSIL是预防宫颈癌的重要手段。ASCCP推荐冷刀锥切术（CKC）和宫颈环形电切（LEEP）为主要诊疗手段。然而部分患者接受治疗后仍存在病灶残留、复发及进展的风险。目前各研究报道HSIL治疗后发生病灶残留、复发及进展的差异较大，且术后病灶残留、复发的危险因素、术后随访方式尚无定论。本文旨在综述HSIL治疗后病灶残留及复发危险因素、处理、随访及妊娠相关问题，从而临指导临床治疗。

Residual,Recurrence and Pregnancy of Lesions after Treatment of High-Grade High-Grade Cervical Squamous Intraepithelial Lesions

High-grade cervical squamous intraepithelial lesion (HSIL) is internationally recognized as precancerous lesions of the cervix. About 17% of untreated HSIL patients are likely to develop into a invasive cancer. Therefore, accurate and standard treatment of cervical lesions, especially HSIL, is an important means to prevent cervical cancer. The American Society of Colposcopy and Cervical Pathology (ASCCP) recommends cold knife conization (CKC) and loop electrosurgical excision procedure (LEEP) as the primary methods of diagnosis and treatment. However, some patients still have the risk of residual lesions, recurrence and progression after treatment. At present, there are great differences in residual lesions, recurrence and progression after HSIL treatment, and the risk factors of residual lesions, recurrence and the mode of follow-up after HSIL treatment are still uncertain. The purpose of this article is to review the risk factors, management, follow-up and pregnancy-related issues of residual and recurrent lesions after HSIL treatment, so as to guide clinical treatment.