早期宫颈癌术后HPV持续感染的危险因素分析

Risk Factors of Persistent HPV Infection in Patients with Early Cervical Cancer after Operation

目的分析早期宫颈癌根治术后高危型人乳头瘤病毒(HR-HPV)持续感染的相关危险因素。方法选取2021年1月至2023年11月之间,在昆明市妇幼保健院行开腹或腹腔镜下宫颈癌根治术的159例早期宫颈癌患者,根据术后1a返院复查HR-HPV持续感染情况分为2组:HR-HPV阳性组(n=41)和HR-HPV转阴组(n=118)。对2组患者的一般资料、阴道微生态情况、手术入路途径、术后病检结果等分析,研究早期宫颈癌患者术后HR-HPV持续阳性的相关危险因素。结果2组的单因素和多因素回归分析显示,绝经、手术期别晚、阴道微生态失调/亚失调是早期宫颈癌患者术后HR-HPV持续阳性的危险因素(P<0.05),而腹腔镜微创手术不是其危险因素。其中阴道微生态异常OR为12.574,绝经OR为3.510。结论绝经、阴道微生态失调为影响早期宫颈癌患者术后HR-HPV清除的重要危险因素。

Objective To analyze the risk factors of persistent infection of high-risk human papillomavirus after radical hysterectomy for early cervical cancer.Methods A total of 159 early-stage cervical cancer patients who underwent radical hysterectomy or laparoscopic radical hysterectomy at the Kunming Maternal and Child Health Hospital between January 2021 and November 2023 were selected.Based on the postoperative 1a follow-up visit for HR-HPV persistent infection status,they were divided into two groups:HR-HPV positive group(n=41)and HRHPV negative group(n=118).The general data,vaginal microbiota status,surgical approach,postoperative pathology results,etc.,of the two groups of patients were analyzed to study the risk factors associated with postoperative HR-HPV persistence in early-stage cervical cancer patients.Results Univariate and multivariate regression analysis showed that the HR-HPV persistent positive group and HR-HPV negative group,the risk factors of HR-HPV persistent positivity in patients with early cervical cancer after operation were menopause,late stage of operation,vaginal microecological disorder/sub-disorder(P<0.05),but laparoscopic minimal invasive surgery was not.OR of vaginal microecological abnormality was 12.574,OR of menopause was 3.510.Conclusion Menopausal and vaginal microecological disorders are important risk factors for HR-HPV clearance in patients with radical hysterectomy for early cervical cancer.