Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, College of Medicine, Dankook University, 17, Seoae-ro 1-gil, Jung-gu, Seoul, 04619, Republic of Korea.
Arch Gynecol Obstet. 2019 Jan;299(1):223-227. doi: 10.1007/s00404-018-4936-9. Epub 2018 Oct 19.
To evaluate the risk factors associated with persistent high-risk human papillomavirus (HR HPV) infections in patients undergoing cervical excision for treatment of high-grade squamous intraepithelial lesion (HSIL).
A retrospective cohort study included 160 patients who underwent cervical excision for treatment of HSIL between January 2014 and December 2014. The clinical characteristics, cervical cytology, and HPV test results were reviewed. Persistent HR HPV infections were identified within 6 months after treatment. The effects of various factors such as patient age, menopausal status, parity, HPV type, and histopathological results on persistent HR HPV infections were assessed using univariate and multivariate analyses.
The mean age of patients was 38.1 ± 11.5 years (range 18‒86 years). Among them 148 (92.5%) had HR HPV infections, and persistent infections after surgical treatment were detected in 48 (32.4%) patients. Univariate logistic regression analysis showed that older age (> 50 years), short follow-up duration (< 3 months), and menopause were associated with persistent HR HPV infections. Multivariate analysis showed that menopausal status was the only significant independent predictor for HR HPV persistence after treatment (odds ratio, 5.08; 95% confidence interval, 1.93-13.36; P = 0.001).
Persistent HR HPV infections were detected in approximately 30% of patients within 6 months after cervical excision for HSIL. Elderly patients with menopause are at increased risk of HR HPV persistence after treatment for HSIL.
评估接受宫颈切除治疗高级别鳞状上皮内病变（HSIL）的患者持续高危型人乳头瘤病毒（HR HPV）感染的相关风险因素。
本回顾性队列研究纳入了 160 例于 2014 年 1 月至 2014 年 12 月期间因 HSIL 而行宫颈切除的患者。回顾了他们的临床特征、宫颈细胞学和 HPV 检测结果。治疗后 6 个月内确定是否存在持续 HR HPV 感染。采用单因素和多因素分析评估了患者年龄、绝经状态、产次、HPV 类型和组织病理学结果等各种因素对持续 HR HPV 感染的影响。
患者的平均年龄为 38.1±11.5 岁（18 至 86 岁）。其中 148 例（92.5%）存在 HR HPV 感染，48 例（32.4%）患者在手术后治疗中检测到持续感染。单因素 logistic 回归分析显示，年龄较大（>50 岁）、随访时间较短（<3 个月）和绝经与持续 HR HPV 感染相关。多因素分析显示，绝经状态是治疗后 HR HPV 持续存在的唯一显著独立预测因素（比值比，5.08；95%置信区间，1.93-13.36；P=0.001）。
在接受 HSIL 宫颈切除治疗后 6 个月内，约 30%的患者检测到持续的 HR HPV 感染。绝经的老年患者在 HSIL 治疗后 HR HPV 持续存在的风险增加。
