高级别宫颈上皮内瘤变治疗后人乳头瘤病毒持续感染的相关因素分析

Analysis on related factors of HPV persistent infection of high-grade cervical intraepithelial neoplasia patients after treatment

目的探讨高级别宫颈上皮内瘤变(CINⅡ/Ⅲ)患者治疗后人乳头瘤病毒(HPV)持续感染的相关危险因素,进一步明确术后第1次随访的最佳时机。方法选取2012年1月-2014年1月在该院行宫颈锥切术治疗的CINⅡ/Ⅲ患者147例为研究对象,分别于术后3个月、6个月进行随访。每次随访均行HPV分型检测,同时记录患者年龄、HPV亚型、宫颈转化区分型、手术方式、切缘情况、术后性生活情况、术后用药情况等资料。结果术后多因素回归分析结果显示,年龄≥35岁、8种高危HPV亚型、切缘阳性为术后HPV持续感染的独立危险因素(P<0.05)。术后3个月与术后6个月HPV的转归情况比较,差异无统计学意义(P>0.05)。结论对于年龄≥35岁、8种高危HPV亚型感染、切缘阳性的CINⅡ/Ⅲ患者应密切随访,而第1次随访可于术后3个月内进行。

Objective To explore the related risk factors of human papillomavirus （HPV） persistent infection of high-grade cervical intraepithelial neoplasia （CIN ll/m） patients after treatment, further identify the optimal timing of the first visit after surgery. Methods A total of 147 CIN Ⅱ/Ⅲ patients treated by cervical conization in the hospital from January 2012 to January 2014 were selected and followed up at 3 and 6 months after surgery. HPV genotyping was conducted during follow-up, age, HPV subtypes, types of cervical transformation zone, surgical modes, margins, sexual life after surgery, medication after surgery were recorded. Results Multivariate logistic regression a- nalysis showed that over 35 years old, eight high-risk HPV subtypes, and positive margin were independent risk factors of HPV＇persistent in- fection after surgery （P〈0. 05 ） . There was no statistically significant difference in prognosis of HPV between three months and six months after surgery （ P〉0. 05） . Conclusion For the CIN Ⅱ/Ⅲ patients more than 35 years old, with eight high-risk HPV subtypes and positive margin, close follow-up should be conducted, follow-up for the first time can be carried out within three months after surgery.