早期宫颈癌子宫切除术后HR⁃HPV清除及其影响因素研究

Observation and influencing factors of HR⁃HPV clearance after hysterectomy in early cervical cancer

目的探讨早期宫颈癌子宫切除术后高危型人乳头瘤病毒(HR⁃HPV)清除情况及其影响因素。方法回顾性分析2017年5月至2020年5月在河北北方学院附属第一医院因早期宫颈癌行子宫切除术的100例患者临床资料。根据HR⁃HPV清除情况,将患者分为清除组(81例)和未清除组(19例)。统计HR⁃HPV清除情况及其影响因素,并用Logistic逐步回归分析HR-HPV未清除的影响因素。结果术后100例患者中HR⁃HPV清除81例,清除率为81.00%(81/100);未清除为19例,未清除率为19.00%(19/100)。未清除组中年龄≥55岁、首次性交年龄<20岁、淋巴结转移、性伴侣人数≥2人、孕次≥2次、术后未接受辅助治疗、肿瘤浸润深度较深的人数占比均高于清除组(P<0.05)。多因素Logistic回归分析表明,年龄≥55岁、首次性交年龄<20岁、淋巴结转移、性伴侣人数≥2人、孕次≥2次、术后未接受辅助治疗、肿瘤浸润深度较深均是早期宫颈癌子宫切除术后HR⁃HPV未清除的危险因素(P<0.05)。结论早期宫颈癌子宫切除术后患者的年龄、首次性交年龄、淋巴结转移、性伴侣人数、孕次、术后辅助治疗、肿瘤浸润深度等是HR⁃HPV未能完全清除的影响因素。针对这些因素,应采取有效的措施进行干预,以提高术后HR⁃HPV的完全清除率。

Objective To investigate the clearance of high⁃risk human papillomavirus(HR⁃HPV)after hysterectomy in the patients with early cervical cancer and its influencing factors.Methods The clinical data of 100 patients who underwent hysterectomy for early cervical cancer in the First Affiliated Hospital of Hebei North University from May 2017 to May 2020 were retrospectively analyzed.The patients were divided into the cleared group(n=81)and the uncleared group(n=19)by the HR⁃HPV elimination.The clearance of HR⁃HPV virus and related influencing factors were analyzed,and the influencing factors of virus failure were analyzed by Logistic stepwise regression.Results Of the 100 patients after surgery,81 were cleared of HPV,with a clearance rate of 81.00%(81/100),and 19 were not cleared,with a non⁃clearance rate of 19.00%(19/100).The age of the non⁃cleared group was≥55 years old and the age of having first sexual intercourse was<20 years old.Lymph node metastasis,the number of sexual partners≥2,the number of pregnancies≥2,the proportion of the patients who did not receive adjuvant treatment after surgery and the depth of tumor infiltration were all higher or greater than those of the cleared group(P<0.05).Multivariate Logistic regression analysis showed that age≥55 years,age of having first sexual intercourse<20 years old and other indexes were all risk factors of non⁃cleared HR⁃HPV after hysterectomy in treatement of early cervical cancer(P<0.05).Conclusion The patients with early cervical cancer after hysterectomy were influenced by age,age of having first sexual intercourse,lymph node metastasis,the number of sexual partners,the number of pregnancies,the depth of tumor infiltration,postoperative adjuvant therapy after surgery and other factors,resulting in incomplete clearance of HR HPV.In light of these factors,effective measures should be taken,so as to improve the rate of complete clearance of HR⁃HPV after surgery.