不同年龄患者HPV感染与宫颈病变风险的关系及对术后病变复发的预测

The relationship between human papilloma virus infection and the risk of cervical lesions in patients of different ages and the prediction of postoperative recurrence

目的探讨不同年龄患者人乳头瘤病毒(HPV)感染与宫颈病变风险的关系及对术后病变复发的预测价值。方法选取2019年1月至2022年1月于联勤保障部队第901医院妇科门诊进行宫颈病变筛查并确诊宫颈病变的108例患者作为研究对象。所有患者按年龄分组,A组(18~35岁)42例,B组(36~55岁)36例,C组(>55岁)30例。所有患者术前均进行HPV检查,计算HPV载量,术后随访1年,于末次随访检测HPV,根据随访结果将所有患者分为术后复发组和术后未复发组。对比分析不同组别各级宫颈病变的HPV载量,采用Pearson相关性分析不同年龄患者HPV感染与宫颈病变风险的关系,采用Logistic回归分析术后病变复发的影响因素。结果不同年龄组的各级宫颈病变HPV载量比较存在统计学差异(P<0.05),且A组各级宫颈病变HPV载量均高于B组,B组均高于C组(P<0.05),其中慢性宫颈炎HPV载量低于宫颈上皮内瘤变(CIN)Ⅰ,CINⅠ低于CINⅡ~Ⅲ,CINⅡ~Ⅲ低于宫颈癌,不同年龄患者HPV感染与宫颈病变风险均存在负相关关系(P<0.05);绝经、切缘状态、术后HPV感染是影响术后病变复发的独立影响因素(P<0.05)。结论各级宫颈病变HPV载量随着患者年龄增长而降低,不同年龄患者HPV感染与宫颈病变风险均存在相关性,是否绝经、切缘状态、术后有无HPV感染是术后复发的独立影响因素。

Objective To explore the relationship between human papilloma virus(HPV)infection and the risk of cervical lesions in patients of different ages and its predictive value for postoperative recurrence.Methods A total of 108 patients who underwent cervical lesion screening and were diagnosed with cervical lesions at Gynecology Clinic of the 901st Hospital of Joint Support Force from January 2019 to January 2022 were selected as the research subjects.All patients were grouped by age,with 42 cases in Group A(18-35 years old),36 cases in Group B(36-55 years old),and 30 cases in Group C(55 years old).All patients underwent preoperative HPV examination to calculate their HPV load.They were followed up for 1 year and tested for HPV at the last follow-up.Based on the follow-up results,all patients were divided into postoperative recurrence group and postoperative non-recurrence group.HPV load in different groups and levels of cervical lesions was compared and analyzed.Pearson correlation was used to analyze of the relationship between HPV infection and cervical lesion risk in patients of different ages,and Logistic regression was used to analyze the influencing factors of postoperative lesion recurrence.Results The HPV load of cervical lesions at all levels in different age groups was statistically different(P0.05),and the HPV load of cervical lesions at all levels in Group A was higher than that in Group B,and that in Group B was higher than that in Group C(P0.05).The HPV load of chronic cervicitis was lower than that of cervical intraepithelial neoplasia(CIN)Ⅰ,CINⅠwas lower than CINⅡ-Ⅲ,and CINⅡ-Ⅲwas lower than that of cervical cancer.There is a negative correlation between HPV infection and the risk of cervical lesions in patients of different ages(P0.05).Menopause,incisional edge status,and postoperative HPV infection are independent influencing factors for postoperative lesion recurrence(P0.05).Conclusions The HPV load of cervical lesions at all levels decreases with the age of patients,and there is a correlation between HPV infection and the risk of cervical lesions in patients of different ages.Whether menopause,incisional edge status,and postoperative HPV infection are independent influencing factors for postoperative recurrence.