Su Xiaoqiang, Liu Pan, Zhao Hongwei, Sun Lixin, Wang Wuliang, Jin Shuanglin, Wang Hui, Liu Ping, Chen Chunlin, Hao Min
Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Front Oncol. 2023 Aug 28;13:1264114. doi: 10.3389/fonc.2023.1264114. eCollection 2023.
This study aimed to investigate the differences in long-term oncological outcomes between high-risk human papillomavirus (HR-HPV) negative and HR-HPV positive early-stage cervical cancers.
We retrospectively analysed 2061 cases of early-stage cervical cancer from the Chinese cervical cancer clinical diagnosis and treatment database. Kaplan-Meier curves were used to describe the survival outcomes of different HR-HPV infections. Cox proportional hazard regression model was used to analyze and determine independent risk factors.
K-M analysis revealed no significant difference in 5-year OS between HR-HPV negative and HR-HPV positive groups (OS: 95.0% vs.95.6%, P=0.900). A significant difference was observed in 5-year DFS between the HR-HPV negative and HR-HPV positive groups (DFS: 87.2% vs.91.9%, P=0.025). Cox proportional hazard regression model indicated that HR-HPV infection (negative vs. positive) was an independent factor influencing 5-year DFS after early cervical cancer surgery (DFS: hazard ratio [HR]=1.862, P=0.022). HR-HPV infection (negative vs positive) was not an independent factor influencing 5-year OS after early cervical cancer surgery (OS: P=0.813). After 1:1 PSM pairing, there was no significant difference in 5-year OS and DFS between HR-HPV negative group and HR-HPV positive group (OS: 91.6% vs.95.0%, P=0.297; DFS: 87.2% vs.85.1%, P=0.758). Cox multivariate analysis indicated that HR-HPV infection was not an independent factor influencing 5-year OS and DFS after early cervical cancer surgery (OS: P=0.806, DFS: P=0.251).
The tumour results of HR-HPV negative group and HR-HPV positive group were similar, after eliminating the differences in known variables that affect the oncological outcomes of cervical cancer. The treatment plan of HR-HPV positive cervical cancer is suitable for HR-HPV negative cervical cancer.
本研究旨在探讨高危型人乳头瘤病毒(HR-HPV)阴性与HR-HPV阳性早期宫颈癌的长期肿瘤学结局差异。
我们回顾性分析了中国宫颈癌临床诊疗数据库中的2061例早期宫颈癌病例。采用Kaplan-Meier曲线描述不同HR-HPV感染状态的生存结局。使用Cox比例风险回归模型分析并确定独立危险因素。
K-M分析显示,HR-HPV阴性组与HR-HPV阳性组的5年总生存率(OS)无显著差异(OS:95.0%对95.6%,P=0.900)。HR-HPV阴性组与HR-HPV阳性组的5年无病生存率(DFS)存在显著差异(DFS:87.2%对91.9%,P=0.025)。Cox比例风险回归模型表明,HR-HPV感染(阴性对阳性)是影响早期宫颈癌手术后5年DFS的独立因素(DFS:风险比[HR]=1.862,P=0.022)。HR-HPV感染(阴性对阳性)不是影响早期宫颈癌手术后5年OS的独立因素(OS:P=0.813)。经过1:1倾向评分匹配(PSM)后,HR-HPV阴性组与HR-HPV阳性组的5年OS和DFS无显著差异(OS:91.6%对95.0%,P=0.297;DFS:87.2%对85.1%,P=0.758)。Cox多因素分析表明,HR-HPV感染不是影响早期宫颈癌手术后5年OS和DFS的独立因素(OS:P=0.806,DFS:P=0.251)。
在消除影响宫颈癌肿瘤学结局的已知变量差异后,HR-HPV阴性组和HR-HPV阳性组的肿瘤结果相似。HR-HPV阳性宫颈癌的治疗方案适用于HR-HPV阴性宫颈癌。