Pirtea Laurențiu, Grigoraş Dorin, Matusz Petru, Pirtea Marilena, Moleriu Lavinia, Tudor Anca, Ilina Răzvan, Secoşan Cristina, Horhat Florin, Mazilu Octavian
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Victor Babeş", Timişoara, 300041 Timiș, Romania.
Department of Anatomy, University of Medicine and Pharmacy "Victor Babeş", Timişoara, 300041 Timiș, Romania.
Can J Infect Dis Med Microbiol. 2016;2016:3076380. doi: 10.1155/2016/3076380. Epub 2016 May 12.
Background. Persistent human papillomavirus (HPV) infection is a necessary event in cervical cancer tumorigenesis. Our objectives were to estimate the rate of HPV infection persistence after large loop excision of the transformation zone (LEEP) in patients with high grade squamous intraepithelial lesions (HSIL) and to investigate if HPV persistence is type related. Methods. We conducted a prospective study on 89 patients with HSIL treated with LEEP. DNA HPV was performed before surgery and at 6, 12, and 18 months after LEEP. Results. Four patients were excluded from the study. The HPV persistence in the remaining 85 patients was 32.95% (6 months), 14.12% (12 months), and 10.59% (18 months). Type 16 had the highest persistence rate, 23.5% (6 months), 11.8% (12 months), and 8.2% (18 months). Coinfection was found to be 54.12% before LEEP and 18.8% (6 months), 4.7% (12 months), and 3.5% (18 months) after LEEP. The rate of coinfections including type 16 was 46.83% of all coinfections. Coinfection including type 16 was not correlated with higher persistence rate compared to infection with type 16 only. Conclusions. HPV infection is not completely eradicated by LEEP in patients with HSIL lesion on PAP smear. HPV persistence after LEEP is influenced by HPV type. HPV type 16 has the highest persistence rate.
背景。持续性人乳头瘤病毒（HPV）感染是宫颈癌发生过程中的必要事件。我们的目标是评估高级别鳞状上皮内病变（HSIL）患者在宫颈转化区大环形切除术（LEEP）后HPV感染持续存在的发生率，并研究HPV持续存在是否与病毒类型相关。方法。我们对89例接受LEEP治疗的HSIL患者进行了一项前瞻性研究。在手术前以及LEEP术后6个月、12个月和18个月进行HPV DNA检测。结果。4例患者被排除在研究之外。其余85例患者的HPV持续感染率在术后6个月为32.95%，12个月为14.12%，18个月为10.59%。16型HPV的持续感染率最高，在术后6个月为23.5%，12个月为11.8%，18个月为8.2%。术前发现合并感染率为54.12%，术后6个月为18.8%，12个月为4.7%，18个月为3.5%。包括16型在内的合并感染率占所有合并感染的46.83%。与仅感染16型HPV相比，包括16型在内的合并感染与更高的持续感染率无关。结论。对于巴氏涂片显示HSIL病变的患者，LEEP不能完全清除HPV感染。LEEP术后HPV持续存在受HPV类型影响。16型HPV的持续感染率最高。
