Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 of Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
BMC Womens Health. 2023 Feb 23;23(1):82. doi: 10.1186/s12905-023-02159-9.
To investigate the influencing factors of the recurrence of IB1-IIA2 cervical squamous cell carcinoma after surgical treatment, and to explore the relationship between high-risk human papillomavirus (HR-HPV) infection and postoperative cervical squamous cell carcinoma recurrence.
Patients (n = 312) diagnosed with stage IB1-IIA2 cervical cancer and treated by radical hysterectomy and lymphadenectomy at this hospital were accrued between January 2014 and December 2016. The clinical data of these patients were analysed, and the association among clinicopathological factors, the association among clinicopathological factors, HPV infection and recurrences was investigated through Cox regression.
The median follow-up time was 59.2 months (with a range of 14-77.9 months). The pre-operative HPV infection rate was 85.3% (266/312), and 74 patients had a high level of HPV-DNA (> 5 × 10 copy number / 10 cells). Twenty-nine patients had a postoperative persistent high level of HPV-DNA (9.3%). On multivariate analysis, deep 1/3 stromal invasion (hazard ratio [HR] 114.79, 95% confidence interval [CI] 2.821-4670.111, p = 0.012*) and postoperative persistence of high HPV-DNA levels within 12 months (HR 269.044, 95% CI 14.437-5013.754, p < 0.001*) and 24 months (HR 31.299, 95% CI 1.191-822.215, p = 0.039*) were associated with a higher local recurrence rate.
Continuous high HPV-DNA levels within 24 months of an operation and deep 1/3 interstitial infiltration were independent risk factors for local recurrences of cervical cancer.
探讨影响 IB1-IIA2 期宫颈鳞癌术后复发的相关因素，探讨高危型人乳头瘤病毒（HR-HPV）感染与术后宫颈鳞癌复发的关系。
回顾性分析 2014 年 1 月至 2016 年 12 月在我院行根治性子宫颈切除术和淋巴结切除术的 312 例 IB1-IIA2 期宫颈癌患者的临床资料，采用 Cox 回归分析临床病理因素之间的关系、HPV 感染与复发之间的关系。
中位随访时间为 59.2 个月（14-77.9 个月）。术前 HPV 感染率为 85.3%（266/312），74 例 HPV-DNA 水平高（>5×10 拷贝数/10 细胞）。29 例术后持续高水平 HPV-DNA（9.3%）。多因素分析显示，深 1/3 间质浸润（HR 114.79，95%置信区间[CI]2.821-4670.111，p=0.012*）和术后 12 个月内 HPV-DNA 持续高水平（HR 269.044，95%CI 14.437-5013.754，p<0.001*）和 24 个月（HR 31.299，95%CI 1.191-822.215，p=0.039*）与局部复发率升高有关。
术后 24 个月内持续高水平的 HPV-DNA 和深 1/3 间质浸润是宫颈癌局部复发的独立危险因素。
