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锥切术后HPV疫苗接种及其对病毒状态的影响:2022年特罗姆瑟和芬马克郡的一项回顾性队列研究

Post-Conization HPV Vaccination and Its Impact on Viral Status: A Retrospective Cohort Study in Troms and Finnmark, 2022.

作者信息

Rykkelid Marie, Wennberg Helga Marie, Richardsen Elin, Sørbye Sveinung Wergeland

机构信息

Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9019 Tromsø, Norway.

Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9019 Tromsø, Norway.

出版信息

Pathogens. 2024 May 2;13(5):381. doi: 10.3390/pathogens13050381.

Abstract

Human papillomavirus (HPV) is associated with cellular changes in the cervix leading to cancer, which highlights the importance of vaccination in preventing HPV infections and subsequent cellular changes. Women undergoing the loop electrosurgical excision procedure (LEEP), a treatment for high-grade cervical intraepithelial neoplasia (CIN2+), remain at risk of recurrence. This study assessed the effect of post-conization HPV vaccination on the viral status of women at six months post-conization, aiming to evaluate the vaccine's effectiveness in preventing recurrence of CIN2+. A retrospective cohort study was conducted among women in Troms and Finnmark who underwent conization in 2022. Using the SymPathy database and the national vaccination register (SYSVAK), we analyzed the vaccination statuses and HPV test results of women born before 1991, who had not received the HPV vaccine prior to conization. Out of 419 women undergoing conization, 243 met the inclusion criteria. A significant association was found between post-conization HPV vaccination and a negative HPV test at six months of follow-up (ARR = 12.1%, = 0.039). Post-conization HPV vaccination significantly reduced the risk of a positive HPV test at the first follow-up, suggesting its potential in preventing the recurrence of high-grade cellular changes. However, the retrospective design and the insufficient control of confounding variables in this study underscore the need for further studies to confirm these findings.

摘要

人乳头瘤病毒(HPV)与导致癌症的宫颈细胞变化相关,这凸显了接种疫苗在预防HPV感染及后续细胞变化方面的重要性。接受环形电切术(LEEP)治疗高级别宫颈上皮内瘤变(CIN2+)的女性仍有复发风险。本研究评估了锥切术后HPV疫苗接种对锥切术后六个月女性病毒状态的影响,旨在评估该疫苗预防CIN2+复发的有效性。对2022年在特罗姆瑟和芬马克接受锥切术的女性进行了一项回顾性队列研究。利用Sympathy数据库和国家疫苗接种登记系统(SYSVAK),我们分析了1991年以前出生、在锥切术前未接种HPV疫苗的女性的疫苗接种状况和HPV检测结果。在419名接受锥切术的女性中,243名符合纳入标准。随访六个月时,发现锥切术后HPV疫苗接种与HPV检测阴性之间存在显著关联(归因风险率=12.1%,P=0.039)。锥切术后HPV疫苗接种显著降低了首次随访时HPV检测阳性的风险,表明其在预防高级别细胞变化复发方面具有潜力。然而,本研究的回顾性设计以及对混杂变量控制不足,强调需要进一步研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59a5/11124440/72f9a04d5ca2/pathogens-13-00381-g001.jpg

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