Department of Obstetrics and Gynecology, the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China.
Arch Gynecol Obstet. 2021 Dec;304(6):1409-1416. doi: 10.1007/s00404-021-06217-1. Epub 2021 Sep 5.
Persistence of HPV infection in patients with high-grade squamous intraepithelial lesion (HSIL) undergoing cervical excision is considered strongly associated with the recurrence and progression of cervical dysplasia. This study aims to review potential risk factors for persistence of HPV infection in patients with HSIL, thus optimizing the postoperative monitoring program and clinical treatment.
Through literature review, published data about estimated prognostic risk factors for persistence of HPV infection in patients with HSIL after conization within two decades were searched and analyzed, and their references were manually reviewed as well.
Women with persistence of HPV infection after cervical excision were at an extremely high risk of disease recurrence and progression to cervical cancer. Some clinicopathological and even physiological elements involving viral, organic human body and treatment factors, such as human papillomavirus (HPV) 16, high viral load, age older than 50 years and positive surgical margin were of prognostic significance in persistent HPV infection in patients with HSIL, yet some of which still remained controversial.
Monitoring prognostic factors in women with persistence of HPV infection who have underwent cervical excision for HSIL are of great significance, especially the follow-up within 2 years postoperatively, which significantly improves the clinical outcome.
在接受宫颈切除术的高级别鳞状上皮内病变（HSIL）患者中，HPV 感染的持续存在被认为与宫颈上皮内瘤变的复发和进展密切相关。本研究旨在回顾分析 HSIL 患者 HPV 感染持续存在的潜在危险因素，从而优化术后监测方案和临床治疗。
通过文献回顾，检索并分析了近 20 年来宫颈锥切术后 HSIL 患者 HPV 感染持续存在的估计预后危险因素的相关数据，并对其参考文献进行了手动审查。
宫颈切除术后 HPV 感染持续存在的患者疾病复发和进展为宫颈癌的风险极高。一些临床病理甚至生理因素，包括病毒、人体有机因素和治疗因素，如 HPV16、高病毒载量、年龄大于 50 岁和阳性手术切缘，与 HSIL 患者 HPV 持续感染的预后相关，但其中一些仍存在争议。
监测宫颈切除术后 HSIL 患者 HPV 感染持续存在的预后因素具有重要意义，特别是术后 2 年内的随访，这显著改善了临床结局。
