宫颈癌与HPV感染的关系及患者术后肿瘤分期升级的影响因素分析

Analysis of the relationship between cervical cancer and HPV infection and the postoperative pathological staging escalation of HPV-associated cervical cancer

目的:探讨宫颈癌与人类乳头瘤病毒(HPV)感染的关系及患者术后肿瘤分期升级的影响因素,为宫颈癌防治、临床管理及流行病学研究提供数据支持。方法:利用电子病历系统检索并收集2020年南京医科大学附属妇产医院收治的宫颈癌住院患者的临床资料,统计宫颈癌患者HPV感染情况、不同年龄组肿瘤分期、病理类型之间的差异以及术后分期升级的危险因素。结果:宫颈癌患者以早期鳞癌为主,其中HPV 16、18、53、33、52型为患者感染的主要亚型。不同年龄组患者肿瘤分期、病理类型之间差异均无统计学意义(P>0.05);术后病理检查显示34例患者肿瘤分期升级,行多因素Logistic回归分析显示肌层浸润深度、脉管癌栓是其独立危险因素。结论:宫颈癌患者多有HPV感染病史,加强HPV筛查,有利于宫颈癌的防治;HPV相关宫颈癌治疗时应充分考虑肌层浸润深度、脉管癌栓的因素,选择最优治疗方案。

Objective: To analyse the relationship between cervical cancer and human papillomavirus(HPV) infection and the postoperative pathological staging escalation of HPV-associated cervical cancer, to provide scientific basis for cervical cancer prevention, clinical management and epidemiological research.Methods: Based on the diagnosis and treatment of cervical cancer cases in the Women’s Hospital of Nanjing Medical University in 2020, clinical data of cervical cancer patients were retrieved and collected using electronic medical record system in 2020. The HPV infection, tumor stages in different age groups, differences between pathological types and risk factors for postoperative stage escalation of HPV-associated cervical cancer patients were analyzed. Results: Most of the patients with cervical cancer in our hospital were squamous cell carcinoma at early stage, mainly with HPV subtypes 16, 18, 53, 33, 52. There was no statistical difference in staging and pathological type among different age groups. According to postoperative pathological results, 34 patients were upgraded. Multifactor Logistic regression analysis showed that the depth of muscular invasion and vascular cancer embolus were independent risk factors. Conclusion: Most cervical cancer patients had a history of HPV infection. Enhancing HPV screening is beneficial to the prevention and treatment of cervical cancer. The depth of muscular invasion, vascular cancer thrombolysis should be fully considered in the optimal treatment of HPV associated cervical cancer.