HPV感染监测在宫颈病变治疗后的应用

Application of HPV infection monitoring after treatment of cervical lesions

目的探究人乳头瘤病毒(HPV)感染监测在宫颈病变治疗后妇女中的应用,为预防和减少宫颈癌的发生提供参考。方法选取2014年5月-2016年5月医院收治的196例宫颈病变患者为研究对象,对患者进行研究及随访,其中包括宫颈上皮内瘤变患者159例及宫颈癌Ⅰ期患者37例。观察宫颈病变患者的HPV感染率、转阴率、术后HR-HPV负荷量的变化情况以及宫颈病变残留及复发率。结果宫颈上皮内瘤变Ⅰ感染率为88.71%,宫颈上皮内瘤变Ⅱ为70.37%,宫颈上皮内瘤变Ⅲ为83.72%,宫颈癌Ⅰ期为86.49%,宫颈上皮内瘤变Ⅰ、Ⅱ比较,宫颈上皮内瘤变Ⅱ、Ⅲ比较,两组差异有统计学意义(χ2=7.474,P=0.058);治疗后6个月与12个月宫颈上皮内瘤变Ⅰ、宫颈上皮内瘤变Ⅱ、宫颈上皮内瘤变Ⅲ及宫颈癌Ⅰ期的HR-HPV负荷量较治疗前均有所降低(P<0.05);宫颈病变治疗后HR-HPV总转阴140例,总转阴率为71.43%,其中宫颈上皮内瘤变Ⅰ42例,占30.00%,宫颈上皮内瘤变Ⅱ34例,占24.29%,宫颈上皮内瘤变Ⅲ34例,占24.29%,宫颈癌Ⅰ期30例,占21.43%,但各级别的HR-HPV转阴率比较,差异无统计学意义(P=0.814)。结论 HPV感染在行宫颈病变治疗患者随访中是一项重要指标,能有效预防和减少患者发生宫颈癌,值得在临床上推广使用。

OBJECTIVE To explore the application of HPV infection monitoring in women after cervical lesions,so as to provide references for the prevention and reduction of cervical cancer.METHODS A total of 196 cases of patients with cervical lesions in our hospital were selected from May 2014 to May 2016 to study and follow up,including 159 cases of patients with cervical intraepithelial neoplasia and 37 cases of patients with cervical cancer stageⅠ.The changes of HPV infection rate,negative rate,HR-HPV load and cervical lesion and recurrence rate in cervical lesions were observed.RESULTS The infection rates of cervical intraepithelial neoplasiaⅠ,cervical intraepithelial neoplasiaⅡ,cervical intraepithelial neoplasiaⅢand cervical cancer stageⅠwere 88.71%,70.37%,83.72%and 86.49%,the differences between cervical intraepithelial neoplasiaⅠandⅡ,and cervical intraepithelial neoplasiaⅡand Ⅲ,were significant（χ^2=7.474,P=0.058）.The HR-HPV load of cervical intraepithelial neoplasiaⅠ,cervical intraepithelial neoplasiaⅡ,cervical intraepithelial neoplasiaⅢ and cervical cancer stage I after 6 months and 12 months of treatment were significantly lower than those before treatment（P〈0.05）.After treatment of cervical lesions,the total negative of HR-HPV was 140 cases,and the total negative rate was 71.43%,including42 cases of cervical intraepithelial neoplasia,accounting for 30.00%,34 cases of cervical intraepithelial neoplasiaⅡ,accounting for 24.29%,34 cases of cervical intraepithelial neoplasiaⅢ,accounting for 24.29%,and 30 cases of cervical cancer,accounting for 21.43%,but there was no significant difference in HR-HPV negative rate between all levels（P=0.814）.CONCLUSION HPV infection is an important indicator of follow-up in patients with cervical lesions,it can effectively prevent and reduce the incidence of cervical cancer in patients,and it deserves to be used clinically.