Department of Gynecology, the Obstetrics and Gynecology Hospital of Fudan University, 419 Fang-xie Road, Shanghai 200011, PR China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, PR China; Zhabei Central Hospital, Jing 'an District, Shanghai, PR China.
Department of Gynecology, the Obstetrics and Gynecology Hospital of Fudan University, 419 Fang-xie Road, Shanghai 200011, PR China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, PR China; International Peace Maternal and Child Health Hospital, Shanghai, PR China.
Diagn Microbiol Infect Dis. 2024 Apr;108(4):116201. doi: 10.1016/j.diagmicrobio.2024.116201. Epub 2024 Jan 30.
To determine the rate of human papillomavirus (HPV) persistence after surgery in patients with cervical cancer, and to analyze the factors associated with HPV persistence and viral load after surgery.
Medical records of women who underwent surgery for treatment of cervical cancer between 1 January 2018 and 30 June 2019 at Obstetrics and Gynecology Hospital of Fudan University in Shanghai, China, were retrospectively analyzed. Patients with persistent HPV infection after 2 years of follow-up were identified. Univariate and multivariate analyses were employed to determine the impact of various factors including patient age, menopausal status, parity, and surgical margin status on HPV persistence. The Wilcoxon test was used to analyze the factors that influenced postoperative HPV viral load.
Altogether, 607 women were eligible for the final analysis. The persistence rates of HPV at 6 months, 1 year, and 2 years after surgery were 17.3, 13.7, and 10.2 %, respectively. In univariate analysis, the factors that were predictive of the persistence of HPV infection were old age, postmenopausal status, and positive vaginal incision margin with cancer. In multivariate analysis, the significant independent predictive factors were postmenopausal status and positive vaginal incision margin with cancer (P < 0.05, odds ratio (OR) = 2.289, 95 % confidence interval (CI): 1.262-4.150 and OR = 3.271, 95 % CI: 1.253-8.537, respectively). A vaginal lesion with cancer or squamous intraepithelial lesion (SIL) and positive vaginal incision margin influenced HPV viral load at 6 months after surgery (P < 0.05).
Postmenopausal patients and those with positive vaginal incision margin with cancer are at an increased risk of HPV persistence after surgical treatment for cervical cancer. Vaginal lesions with cancer or SILs and positive vaginal incision margin are risk factors for high HPV viral load after surgery.
确定宫颈癌患者手术后人乳头瘤病毒（HPV）持续感染的发生率，并分析与术后 HPV 持续感染和病毒载量相关的因素。
回顾性分析 2018 年 1 月 1 日至 2019 年 6 月 30 日在复旦大学妇产科医院接受宫颈癌手术治疗的女性患者的病历。确定随访 2 年后 HPV 持续感染的患者。采用单因素和多因素分析确定患者年龄、绝经状态、产次和手术切缘状态等多种因素对 HPV 持续感染的影响。采用 Wilcoxon 检验分析影响术后 HPV 病毒载量的因素。
共有 607 名女性符合最终分析标准。术后 6 个月、1 年和 2 年 HPV 持续感染率分别为 17.3%、13.7%和 10.2%。单因素分析显示，年龄较大、绝经后状态和阴道切缘阳性与 HPV 感染持续存在相关。多因素分析显示，绝经后状态和阴道切缘阳性是 HPV 感染持续存在的显著独立预测因素（P<0.05，比值比（OR）=2.289，95%置信区间（CI）：1.262-4.150 和 OR=3.271，95%CI：1.253-8.537）。阴道病变有癌症或鳞状上皮内病变（SIL）且阴道切缘阳性影响术后 6 个月 HPV 病毒载量（P<0.05）。
绝经后患者和阴道切缘阳性伴癌的宫颈癌患者手术后 HPV 持续感染的风险增加。阴道病变有癌症或 SIL 且阴道切缘阳性是术后 HPV 病毒载量高的危险因素。
