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年龄至少45岁的宫颈上皮内瘤变3级患者锥切术后高危型人乳头瘤病毒感染清除情况

High-risk human papillomavirus infection clearance following conization among patients with cervical intraepithelial neoplasm grade 3 aged at least 45 years.

作者信息

Zhang Guorui, Lang Jinghe, Shen Keng, Zhu Lan, Xiang Yang

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Int J Gynaecol Obstet. 2017 Jan;136(1):47-52. doi: 10.1002/ijgo.12000. Epub 2016 Oct 24.

Abstract

OBJECTIVE

To investigate high-risk human papillomavirus (HPV) infection clearance rates following successful cold knife conization and factors predictive of HPV clearance among patients with cervical intraepithelial neoplasm grade 3.

METHOD

The present retrospective study analyzed clinical data from patients aged at least 45 years with cervical intraepithelial neoplasm grade 3 who had undergone successful cold knife conization and attended regular follow-up at Peking Union Medical College Hospital, China, between January 1, 2002 and December 31, 2012. HPV clearance rates and potential indicators for HPV clearance were analyzed.

RESULTS

Data from 156 patients were included; persistent high-risk HPV infection was recorded in 78 (50.0%), 45 (28.8%), 35 (22.4%), 24 (15.4%), and 21 (13.5%) patients at 4, 8, 12, 18, and 24 months after conization, respectively. Clearance rates were significantly lower among patients aged at least 55 years compared with younger patients, with increased odds of persistent HPV infection at 8 months (odds ratio [OR] 4.038; 95% confidence interval [CI] 1.766-10.839), 12 months (OR 5.923; 95% CI 2.450-16.604), 18 months (OR 5.957; 95% CI 2.031-17.469), and 24 months (OR 5.327; 95% CI 1.909-17.971) compared with patients aged 45-49 years.

CONCLUSION

Age was a prognostic factor for post-operative high-risk HPV infection clearance. Lower clearance rates were observed among patients aged at least 55 years.

摘要

目的

探讨宫颈上皮内瘤变3级患者成功行冷刀锥切术后高危型人乳头瘤病毒(HPV)感染的清除率及HPV清除的预测因素。

方法

本回顾性研究分析了2002年1月1日至2012年12月31日期间在中国北京协和医院接受成功冷刀锥切并定期随访的年龄至少45岁的宫颈上皮内瘤变3级患者的临床资料。分析HPV清除率及HPV清除的潜在指标。

结果

纳入156例患者的数据;锥切术后4、8、12、18和24个月时,分别有78例(50.0%)、45例(28.8%)、35例(22.4%)、24例(15.4%)和21例(13.5%)患者存在持续性高危HPV感染。与年轻患者相比,年龄至少55岁的患者清除率显著更低,在8个月(比值比[OR]4.038;95%置信区间[CI]1.766 - 10.839)、12个月(OR 5.923;95% CI 2.450 - 16.604)、18个月(OR 5.957;95% CI 2.031 - 17.469)和24个月(OR 5.327;95% CI 1.909 - 17.971)时持续性HPV感染的几率增加。

结论

年龄是术后高危HPV感染清除的一个预后因素。年龄至少55岁的患者清除率更低。

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