Petrillo Marco, Dessole Margherita, Tinacci Elettra, Saderi Laura, Muresu Narcisa, Capobianco Giampiero, Cossu Antonio, Dessole Salvatore, Sotgiu Giovanni, Piana Andrea
Biomedical Sciences, University of Sassari, Sassari 07100, Italy.
Gynecologic and Obstetric Clinic, University of Cagliari, Cagliari 09126, Italy.
Vaccines (Basel). 2020 Jan 25;8(1):45. doi: 10.3390/vaccines8010045.
The aim of this study was to assess the role of a human papilloma virus (HPV) vaccine after loop electrosurgical excision procedure (LEEP) in reducing recurrent cervical dysplasia. A series of 503 women with cervical dysplasia received LEEP between January 2012 and October 2018. Of these patients, 379 were treated between January 2012 and June 2017, thus ensuring an adequate follow-up time. We made three attempts to establish telephone contact with each patient; 77 women did not respond and were excluded from the final study population, which consisted of 302 patients. One hundred eighty-two (60.7%) women were vaccinated with an HPV vaccine within 4 weeks of LEEP and 103 (34.3%) were followed up with but not vaccinated. Recurrence of cervical dysplasia requiring a further LEEP procedure occurred in 30 (10.5%) women, of whom 17 (16.5%) were not vaccinated and 13 (7.1%) were vaccinated (-value = 0.010). At univariate analysis, HPV vaccination after LEEP (odds ratio (OR) = 0.4, -value = 0.020) emerged as an independent protective factor. Choosing as an outcome of the analysis only recurrence as severe cervical lesions, the protective role of HPV vaccination after LEEP was found to be much more relevant with an odds ratio of 0.2 (95% CI = 0.1-0.6, -value = 0.02). Administration of an HPV vaccine after LEEP seems to reduce the risk of recurrence, thus suggesting that HPV vaccination has a role as an adjuvant treatment after LEEP.
本研究的目的是评估在环形电切术（LEEP）后接种人乳头瘤病毒（HPV）疫苗在降低复发性宫颈发育异常方面的作用。2012年1月至2018年10月期间，一系列503例宫颈发育异常的女性接受了LEEP治疗。在这些患者中，379例在2012年1月至2017年6月期间接受治疗，从而确保了足够的随访时间。我们三次尝试与每位患者进行电话联系；77名女性未回复，被排除在最终研究人群之外，最终研究人群由302名患者组成。182名（60.7%）女性在LEEP后4周内接种了HPV疫苗，103名（34.3%）女性接受了随访但未接种疫苗。30名（10.5%）女性出现了需要再次进行LEEP手术的宫颈发育异常复发，其中17名（16.5%）未接种疫苗，13名（7.1%）接种了疫苗（P值=0.010）。在单因素分析中，LEEP后接种HPV疫苗（比值比（OR）=0.4，P值=0.020）是一个独立的保护因素。仅将严重宫颈病变的复发作为分析结果，发现LEEP后接种HPV疫苗的保护作用更为显著，比值比为0.2（95%可信区间=0.1-0.6，P值=0.02）。LEEP后接种HPV疫苗似乎可以降低复发风险，因此表明HPV疫苗在LEEP后具有辅助治疗作用。
