Du R, Meng W, Chen Z F, Zhang Y, Chen S Y, Ding Y
XiangYa Hospital, Central South University, Changsha, China.
Department of Gynecology and Obstetrics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Eur J Gynaecol Oncol. 2013;34(6):548-51.
The aim of the study was to evaluate the rate of human papillomavirus (HPV) infection clearance after loop electrosurgical excision (LEEP) procedure conization for cervical intraepithelial neoplasia (CIN) and the factors related to such clearance and to assess the relation between HPV and recurrence.
A total 141 patients who underwent LEEP owing to high-risk human papillomavirus (HR-HPV) associated with CIN were involved this study. All patients with negative margins on LEEP specimens were followed up with HPV testing and cervical smear after three, six, nine, and 12 months post-treatment. If necessary, cervical biopsy under colposcopy was performed.
LEEP can effectively eliminate HPV infection. Most patients cleared HPV infection within six months. The persistent HPV infection rates were 44.6%,10.6%, 5.7%, and 2.1% after three, six, nine, and 12 months, respectively. The clearance rates were significantly slower in patients with HPV 16 infection, and not differ significantly by age, parity, and pathologic degree. Patients with persistent HR-HPV infection after treatment had a significantly higher risk for recurrence/residual after LEEP compared to patients with negative HPV infection.
The authors concluded that patients who were positive for HPV infection, especially for HPV 16, should be followed up closely after treatment.
本研究旨在评估宫颈上皮内瘤变（CIN）行环形电切术（LEEP）锥切术后人乳头瘤病毒（HPV）感染清除率、与清除相关的因素，并评估HPV与复发之间的关系。
本研究纳入了141例因高危型人乳头瘤病毒（HR-HPV）相关CIN而行LEEP的患者。所有LEEP标本切缘阴性的患者在治疗后3、6、9和12个月进行HPV检测和宫颈涂片随访。必要时，在阴道镜下行宫颈活检。
LEEP能有效清除HPV感染。大多数患者在6个月内清除HPV感染。3、6、9和12个月后的持续HPV感染率分别为44.6%、10.6%、5.7%和2.1%。HPV 16感染患者的清除率明显较慢，且在年龄、产次和病理程度方面无显著差异。与HPV感染阴性的患者相比，治疗后持续HR-HPV感染的患者LEEP术后复发/残留风险明显更高。
作者得出结论，HPV感染阳性的患者，尤其是HPV 16阳性患者，治疗后应密切随访。
