目的 探讨宫颈锥形切除术后宫颈分泌物及宫颈组织中炎性因子的动态变化及其意义。方法 选取2013-2015年在该院就诊的行宫颈锥形切除术患者,术后定期采集宫颈创面分泌物及周围组织,定量检测肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、高迁移率族蛋白1(HMGB1)的表达,以术前作为对照组,进行统计分析。观察宫颈锥形切除术后行全子宫切除的标本中炎性细胞的浸润及表达。结果 宫颈组织及分泌物中TNF-α、IL-6、HMGB1的表达在宫颈锥形切除术后逐渐升高,术后1~2周达到高峰,与术前比较差异有统计学意义(P〈0.05),之后逐渐下降。在宫颈锥形切除术后1周行全子宫切除的标本病理显示,炎性细胞浸润及炎症反应最严重;其TNF-α、IL-6及HMGB1表达较术后4周明显升高。结论 宫颈锥形切除术后1~2周时宫颈创面炎症最为严重,应避免在此阶段行全子宫切除。
Objective To investigate the dynamic changes and its significance of inflammatory factors in cervical secretions and prior cervical tissues after cervical conical resection. Methods Women who received prior cervical conization during December 2013 and December 2015 in this hospital were selected,then the cervical tissue and secretion were collected regular interval after the conization. The expression of tumor necrosis factor-α(TNF) ,interleukin-6 (IL-6) and high mobility group protein 1 (HMGB1) were quantitative detected and analyzed. The expression and infiltration of inflammatory cell were detected by HE and immunohistochem- ical staining. Results The expression of TNF-α,IL-6 and HMGB1 in cervical tissues and secretions increased gradually after pri- orcervical conization,which reached the peak at 1 to 2 weeks after priorcervical conization,and then gradua!ly decreased, the differ- ences were statistically significant when compared with the preoperative control group (P〈0.05). The inflammatory cell infiltra- tion and the inflammatory response were most severe at 1st week after the conization. The expression of TNF-α,IL-6 and HMGB1 was at 1st week after the conization were significantly higher than that of the 4thweek group. Conclusion The Cervical inflammato- ry were most severe after the prior cervical conization about 1-2weeks,and the hysterectomy should be avoided at this stage.