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Gynecol Oncol：宫颈病变LEEP和激光锥切术复发率：5年随访研究结果

2021-09-22 王晨 张师前 张师前公众号

LEEP激光锥切术
关注

比较激光锥切术和环形电切术(LEEP)在高度宫颈上皮内瘤变(HSIL/CIN2+)患者中的复发率。方法：收集2010年至2014年接受锥切手术的HSIL/CIN2+患者的诊疗数据。采用倾向评分匹配(P

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摘要

目的：比较激光锥切术和环形电切术(LEEP)在高度宫颈上皮内瘤变(HSIL/CIN2+)患者中的复发率。方法：收集2010年至2014年接受锥切手术的HSIL/CIN2+患者的诊疗数据。采用倾向评分匹配(PSM)以减少分配偏差。Kaplan-Meir和Cox风险模型估计复发风险。结果：2966例锥切患者中，567例接受(20%)激光锥切，2399例(80%)LEEP手术。CIN3(HR:3.80(95%CI:2.01,7.21);p<0.001)和HPV持续性感染(HR:1.81 (95%C1:1.11,2.96);P < 0.001)与复发风险增加相关。选择500例接受激光锥切患者和1000名接受LEEP的患者进行（1:2）PSM匹配，发现LEEP手术切缘阳性的风险更高(11.2% vs. 4.2%)。两组患者HPV持续感染的风险相似(15.0% vs. 11.6%;p = 0.256)。LEEP术后5年复发率为8.1%，激光锥切术后5年复发率为4% (p = 0.023)。结论：HPV持续感染是激光锥切术或LEEP术后复发风险增加的最主要相关因素。

方法

    入组标准：新诊断的中/重度宫颈上皮内瘤变(HSIL/CIN2+)；鳞状细胞癌。排除标准：年龄< 18岁；有消融及冷刀锥切史；腺体病变；妊娠期；有子宫切除术史。

患者锥切术后3个月(阳性切缘)/ 6个月(阴性切缘)门诊进行阴道镜检查。后期随访时间为：前两年每6个月1次，之后每年1次，直到5年。HPV持续感染定义为在锥切术后第一次临床检查中检测到的HPV(通常在6个月)。复发性宫颈上皮内瘤变定义为患者在锥切与HSIL/CIN2+诊断之间至少有一次阴性检查。低级别宫颈病变(LSIL/CIN1)不被认为是复发性疾病。

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鉴于两组之间的回顾性比较，进行倾向评分分析（PSM），目的是减少来自不同协变量的偏倚。开发多变量logistic回归模型。年龄、病变类型(CIN2 vs. CIN3)、绝经状态、锥切前是否进行HPV检测。激光锥切术与LEEP患者的比例为1:2，P值<0.05有统计学意义。

结果

175例患者初次治疗之后的5年内复发，复发率为6%，复发中位时间18个月（5-32月）。LEEP组155例（6.4%），激光锥切组20例（3.5%）（P=0.0007），两年内复发率占5%，在3-5年内复发占1%。

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单因素分析：宫颈上皮内瘤变(HR: 1. 68 (95%CI：1. 21, 2. 33) /CIN3；p=0. 002)、术前检测的HR  HPV 类型(HR : 2.69 (95%CI: 1.25, 5.81); p= 0.011),、手术切缘阳性(HR: 2.44 (95% CI:1.68, 3. 55) ; p< 0.001)、 HPV 持续感染(HR:2. 34 (95% CI: 1. 64, 3. 33) ; p< 0. 001)和手术方式(HR: 2. 50 (95%CI: 1.99, 3.16) ; p= 0. 007)。

 

多因素分析中：CIN3 (HR: 3.80 (95%CI: 2.01, 7.21);p< 0.001)和HPV持续性感染(HR: 1.81 (95%CI: 1.11, 2.96);P<0.001)与复发风险相关。尽管手术方式虽无统计学意义，但与复发风险略有相关(HR: 1.28 (95%CI:0.78, 2.69);p = 0.071)。

 

图片

 

激光锥切后，HPV持续感染是影响复发的主要因素，此外，术后切缘阳性对复发也有一定的影响；LEEP术后，CIN3 (HR: 3.48 (p= 0.001)、切缘阳性(p= 0.001)和HPV持续性感染(p= 0.001)与复发有相关关系。

讨论

本研究报道宫颈上皮内瘤变(HSIL/CIN2+)患者经LEEP和激光锥切术后的复发率。本回顾性研究收集了3000例接受锥切手术的患者的数据，进行了5年随访。是调查不同手术方式对宫颈上皮内瘤变患者锥切影响的最大研究。为了减少可能的分配偏差，采用了倾向评分算法。发现：1.无论手术方式如何，HPV持续感染是增加复发风险的最主要因素；2.与LEEP相比，激光锥切术后HSIL/CIN2+的复发风险较低；3.激光锥切术后阳性切缘(特别内切缘)发生率低于LEEP，HPV持续感染不受手术方式的影响。4.阳性切缘是LEEP后复发的重要危险因素，而在激光锥切组中，未观察到阳性切缘与复发率之间的关系。

原始出处：

Bogani G, DI Donato V, Sopracordevole F, Ciavattini A, Ghelardi A, Lopez S, Simoncini T, Plotti F, Casarin J, Serati M, Pinelli C, Valenti G, Bergamini A, Gardella B, Dell'acqua A, Monti E, Vercellini P, Fischetti M, D'Ippolito G, Aguzzoli L, Mandato VD, Carunchio P, Carlinfante G, Giannella L, Scaffa C, Falcone F, Borghi C, Ditto A, Malzoni M, Giannini A, Salerno MG, Liberale V, Contino B, Donfrancesco C, Desiato M, Perrone AM, Dondi G, De Iaco P, Leone Roberti Maggiore U, Signorelli M, Chiappa V, Ferrero S, Sarpietro G, Matarazzo MG, Cianci A, Bosio S, Ruisi S, Guerrisi R, Brusadelli C, Mosca L, Tinelli R, DE Vincenzo R, Zannoni GF, Ferrandina G, Petrillo M, Dessole S, Angioli R, Greggi S, Spinillo A, Ghezzi F, Colacurci N, Muzii L, Benedetti Panici P, Scambia G, Raspagliesi F. Recurrence rate after loop electrosurgical excision procedure (LEEP) and laser Conization: A 5-year follow-up study.Gynecol Oncol. 2020 Dec;159(3):636-641. doi: 10.1016/j.ygyno.2020.08.025

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    2023-03-06 lifestar 来自上海

    #宫颈锥切技术##LEEP刀#

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    2022-04-09 ms1948154235210413

    #宫颈病变#

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style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Sun Jul 17 11:06:37 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866239, encodeId=c63e1866239f7, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Mar 09 00:06:37 CST 2022, time=2022-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716565, encodeId=2f301e165658c, content=<a href='/topic/show?id=afa5984e47a' target=_blank style='color:#2F92EE;'>#随访研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98474, encryptionId=afa5984e47a, topicName=随访研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9c1232248438, createdName=habb, createdTime=Wed Jul 06 19:06:37 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739594, encodeId=6c701e395943b, content=<a href='/topic/show?id=8041e343504' target=_blank style='color:#2F92EE;'>#研究结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73435, encryptionId=8041e343504, topicName=研究结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Apr 07 04:06:37 CST 2022, time=2022-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914426, encodeId=9454191442609, content=<a href='/topic/show?id=ecd31481c3' target=_blank style='color:#2F92EE;'>#5年随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1481, encryptionId=ecd31481c3, topicName=5年随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76fa353, createdName=tm10051981, createdTime=Wed Jul 27 06:06:37 CST 2022, time=2022-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279794, encodeId=a21612e9794d5, content=<a href='/topic/show?id=265c66e50ea' target=_blank style='color:#2F92EE;'>#激光#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66750, encryptionId=265c66e50ea, topicName=激光)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1408300, encodeId=53fa140830024, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=)]
    2022-08-16 1249842em09(暂无昵称)

    #NEC#

    0

  4. 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topicId=null, topicList=[TopicDto(id=46305, encryptionId=80774630525, topicName=宫颈病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bc28864114, createdName=ms1948154235210413, createdTime=Sat Apr 09 20:06:37 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044203, encodeId=039b2044203da, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Tue Aug 16 16:06:37 CST 2022, time=2022-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922443, encodeId=3e9219224430e, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Sun Jul 17 11:06:37 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866239, encodeId=c63e1866239f7, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Mar 09 00:06:37 CST 2022, time=2022-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716565, encodeId=2f301e165658c, content=<a href='/topic/show?id=afa5984e47a' target=_blank style='color:#2F92EE;'>#随访研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98474, encryptionId=afa5984e47a, topicName=随访研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9c1232248438, createdName=habb, createdTime=Wed Jul 06 19:06:37 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739594, encodeId=6c701e395943b, content=<a href='/topic/show?id=8041e343504' target=_blank style='color:#2F92EE;'>#研究结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73435, encryptionId=8041e343504, topicName=研究结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Apr 07 04:06:37 CST 2022, time=2022-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914426, encodeId=9454191442609, content=<a href='/topic/show?id=ecd31481c3' target=_blank style='color:#2F92EE;'>#5年随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1481, encryptionId=ecd31481c3, topicName=5年随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76fa353, createdName=tm10051981, createdTime=Wed Jul 27 06:06:37 CST 2022, time=2022-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279794, encodeId=a21612e9794d5, content=<a href='/topic/show?id=265c66e50ea' target=_blank style='color:#2F92EE;'>#激光#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66750, encryptionId=265c66e50ea, topicName=激光)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1408300, encodeId=53fa140830024, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=)]
    2022-07-17 spoonycyy

    #复发率#

    0

  5. 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topicId=null, topicList=[TopicDto(id=46305, encryptionId=80774630525, topicName=宫颈病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bc28864114, createdName=ms1948154235210413, createdTime=Sat Apr 09 20:06:37 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044203, encodeId=039b2044203da, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Tue Aug 16 16:06:37 CST 2022, time=2022-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922443, encodeId=3e9219224430e, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Sun Jul 17 11:06:37 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866239, encodeId=c63e1866239f7, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Mar 09 00:06:37 CST 2022, time=2022-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716565, encodeId=2f301e165658c, content=<a href='/topic/show?id=afa5984e47a' target=_blank style='color:#2F92EE;'>#随访研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98474, encryptionId=afa5984e47a, topicName=随访研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9c1232248438, createdName=habb, createdTime=Wed Jul 06 19:06:37 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739594, encodeId=6c701e395943b, content=<a href='/topic/show?id=8041e343504' target=_blank style='color:#2F92EE;'>#研究结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73435, encryptionId=8041e343504, topicName=研究结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Apr 07 04:06:37 CST 2022, time=2022-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914426, encodeId=9454191442609, content=<a href='/topic/show?id=ecd31481c3' target=_blank style='color:#2F92EE;'>#5年随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1481, encryptionId=ecd31481c3, topicName=5年随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76fa353, createdName=tm10051981, createdTime=Wed Jul 27 06:06:37 CST 2022, time=2022-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279794, encodeId=a21612e9794d5, content=<a href='/topic/show?id=265c66e50ea' target=_blank style='color:#2F92EE;'>#激光#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66750, encryptionId=265c66e50ea, topicName=激光)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1408300, encodeId=53fa140830024, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=)]
    2022-03-09 minlingfeng

    #Oncol#

    0

  6. 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topicId=null, topicList=[TopicDto(id=46305, encryptionId=80774630525, topicName=宫颈病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bc28864114, createdName=ms1948154235210413, createdTime=Sat Apr 09 20:06:37 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044203, encodeId=039b2044203da, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Tue Aug 16 16:06:37 CST 2022, time=2022-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922443, encodeId=3e9219224430e, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Sun Jul 17 11:06:37 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866239, encodeId=c63e1866239f7, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Mar 09 00:06:37 CST 2022, time=2022-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716565, encodeId=2f301e165658c, content=<a href='/topic/show?id=afa5984e47a' target=_blank style='color:#2F92EE;'>#随访研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98474, encryptionId=afa5984e47a, topicName=随访研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9c1232248438, createdName=habb, createdTime=Wed Jul 06 19:06:37 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739594, encodeId=6c701e395943b, content=<a href='/topic/show?id=8041e343504' target=_blank style='color:#2F92EE;'>#研究结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73435, encryptionId=8041e343504, topicName=研究结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Apr 07 04:06:37 CST 2022, time=2022-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914426, encodeId=9454191442609, content=<a href='/topic/show?id=ecd31481c3' target=_blank style='color:#2F92EE;'>#5年随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1481, encryptionId=ecd31481c3, topicName=5年随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76fa353, createdName=tm10051981, createdTime=Wed Jul 27 06:06:37 CST 2022, time=2022-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279794, encodeId=a21612e9794d5, content=<a href='/topic/show?id=265c66e50ea' target=_blank style='color:#2F92EE;'>#激光#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66750, encryptionId=265c66e50ea, topicName=激光)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1408300, encodeId=53fa140830024, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=)]
    2022-07-06 habb

    #随访研究#

    0

  7. 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topicId=null, topicList=[TopicDto(id=46305, encryptionId=80774630525, topicName=宫颈病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bc28864114, createdName=ms1948154235210413, createdTime=Sat Apr 09 20:06:37 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044203, encodeId=039b2044203da, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Tue Aug 16 16:06:37 CST 2022, time=2022-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922443, encodeId=3e9219224430e, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Sun Jul 17 11:06:37 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866239, encodeId=c63e1866239f7, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Mar 09 00:06:37 CST 2022, time=2022-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716565, encodeId=2f301e165658c, content=<a href='/topic/show?id=afa5984e47a' target=_blank style='color:#2F92EE;'>#随访研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98474, encryptionId=afa5984e47a, topicName=随访研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9c1232248438, createdName=habb, createdTime=Wed Jul 06 19:06:37 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739594, encodeId=6c701e395943b, content=<a href='/topic/show?id=8041e343504' target=_blank style='color:#2F92EE;'>#研究结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73435, encryptionId=8041e343504, topicName=研究结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Apr 07 04:06:37 CST 2022, time=2022-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914426, encodeId=9454191442609, content=<a href='/topic/show?id=ecd31481c3' target=_blank style='color:#2F92EE;'>#5年随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1481, encryptionId=ecd31481c3, topicName=5年随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76fa353, createdName=tm10051981, createdTime=Wed Jul 27 06:06:37 CST 2022, time=2022-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279794, encodeId=a21612e9794d5, content=<a href='/topic/show?id=265c66e50ea' target=_blank style='color:#2F92EE;'>#激光#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66750, encryptionId=265c66e50ea, topicName=激光)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1408300, encodeId=53fa140830024, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=)]
    2022-04-07 智智灵药

    #研究结果#

    0

  8. 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topicId=null, topicList=[TopicDto(id=46305, encryptionId=80774630525, topicName=宫颈病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bc28864114, createdName=ms1948154235210413, createdTime=Sat Apr 09 20:06:37 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044203, encodeId=039b2044203da, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Tue Aug 16 16:06:37 CST 2022, time=2022-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922443, encodeId=3e9219224430e, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Sun Jul 17 11:06:37 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866239, encodeId=c63e1866239f7, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Mar 09 00:06:37 CST 2022, time=2022-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716565, encodeId=2f301e165658c, content=<a href='/topic/show?id=afa5984e47a' target=_blank style='color:#2F92EE;'>#随访研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98474, encryptionId=afa5984e47a, topicName=随访研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9c1232248438, createdName=habb, createdTime=Wed Jul 06 19:06:37 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739594, encodeId=6c701e395943b, content=<a href='/topic/show?id=8041e343504' target=_blank style='color:#2F92EE;'>#研究结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73435, encryptionId=8041e343504, topicName=研究结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Apr 07 04:06:37 CST 2022, time=2022-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914426, encodeId=9454191442609, content=<a href='/topic/show?id=ecd31481c3' target=_blank style='color:#2F92EE;'>#5年随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1481, encryptionId=ecd31481c3, topicName=5年随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76fa353, createdName=tm10051981, createdTime=Wed Jul 27 06:06:37 CST 2022, time=2022-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279794, encodeId=a21612e9794d5, content=<a href='/topic/show?id=265c66e50ea' target=_blank style='color:#2F92EE;'>#激光#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66750, encryptionId=265c66e50ea, topicName=激光)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1408300, encodeId=53fa140830024, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=)]
    2022-07-27 tm10051981

    #5年随访#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2117892, encodeId=e66c211e892e6, content=<a href='/topic/show?id=e3e510546518' target=_blank style='color:#2F92EE;'>#宫颈锥切技术#</a><a href='/topic/show?id=11a510546ea0' target=_blank style='color:#2F92EE;'>#LEEP刀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=105465, encryptionId=e3e510546518, topicName=宫颈锥切技术), TopicDto(id=105467, encryptionId=11a510546ea0, topicName=LEEP刀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Mar 06 10:57:19 CST 2023, time=2023-03-06, status=1, ipAttribution=上海), GetPortalCommentsPageByObjectIdResponse(id=1689769, encodeId=30b01689e6980, content=<a href='/topic/show?id=80774630525' target=_blank style='color:#2F92EE;'>#宫颈病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46305, encryptionId=80774630525, topicName=宫颈病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bc28864114, createdName=ms1948154235210413, createdTime=Sat Apr 09 20:06:37 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044203, encodeId=039b2044203da, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Tue Aug 16 16:06:37 CST 2022, time=2022-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922443, encodeId=3e9219224430e, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Sun Jul 17 11:06:37 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866239, encodeId=c63e1866239f7, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Mar 09 00:06:37 CST 2022, time=2022-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716565, encodeId=2f301e165658c, content=<a href='/topic/show?id=afa5984e47a' target=_blank style='color:#2F92EE;'>#随访研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98474, encryptionId=afa5984e47a, topicName=随访研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9c1232248438, createdName=habb, createdTime=Wed Jul 06 19:06:37 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739594, encodeId=6c701e395943b, content=<a href='/topic/show?id=8041e343504' target=_blank style='color:#2F92EE;'>#研究结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73435, encryptionId=8041e343504, topicName=研究结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Apr 07 04:06:37 CST 2022, time=2022-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914426, encodeId=9454191442609, content=<a href='/topic/show?id=ecd31481c3' target=_blank style='color:#2F92EE;'>#5年随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1481, encryptionId=ecd31481c3, topicName=5年随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76fa353, createdName=tm10051981, createdTime=Wed Jul 27 06:06:37 CST 2022, time=2022-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279794, encodeId=a21612e9794d5, content=<a href='/topic/show?id=265c66e50ea' target=_blank style='color:#2F92EE;'>#激光#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66750, encryptionId=265c66e50ea, topicName=激光)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1408300, encodeId=53fa140830024, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=)]
    2021-09-24 oliver169

    #激光#

    0

  10. 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topicName=激光)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1408300, encodeId=53fa140830024, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Fri Sep 24 05:06:37 CST 2021, time=2021-09-24, status=1, ipAttribution=)]
    2021-09-24 一闲

    #宫颈#

    0

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