Li Zhuo-Yi, Wang Kai, Shen Xiao-Ling, Li Qing
Women's Health Care Department, Department of Obstetrics and Gynecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen City, Fujian Province, China.
Department of Aristogenesis, Department of Obstetrics and Gynecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen City, Fujian Province, China.
Hum Vaccin Immunother. 2025 Dec;21(1):2469410. doi: 10.1080/21645515.2025.2469410. Epub 2025 Feb 21.
Cervical intraepithelial neoplasia, grade 2-3 (CIN2-3), classified as histologic high-grade squamous intraepithelial lesion (HSIL), is associated with a higher recurrence rate and an increased risk of developing cervical cancer. The predictive and influencing factors for CIN2+ relapse are still uncertain and controversial. This study aims to further clarify the risk factors of CIN 2-3 recurrence. The retrospective cohort study enrolled 142 patients with CIN 2-3, aged between 20 to 60 years, all of whom received treatments to remove the lesions. All patients were followed for at least two years to assess outcomes. The primary outcome indicators were high-risk HPV (HR-HPV) status and cervical lesions status within two years after treatment. Fisher's exact test or Pearson's chi-squared test and the Kruskal-Wallis (K-W/H) test were used for univariate analysis. Logistic regression analysis was applied to identify independent risk factors, and the results were presented using a forest plot. The study found no significant differences in basic characteristics and HR-HPV status, except for parity ( = .020). HPV genotype before treatment and margin status were significantly associated with cervical lesion status after treatment, with P-values of 0.003 and 0.031, respectively. Cytology before treatment and HPV vaccination were independent factors influencing cervical lesions status two years after treatment, with odds ratios (OR) of 0.634 (95% CI: 0.443-0.908) and 0.340 (95% CI: 0.121-0.952), respectively. This study is the first to report independent factors influencing CIN 2-3 recurrence and underscores the importance of considering adjuvant HPV vaccination for women with cervical preinvasive disease.
宫颈上皮内瘤变2-3级（CIN2-3），归类为组织学高级别鳞状上皮内病变（HSIL），与较高的复发率及宫颈癌发生风险增加相关。CIN2+复发的预测和影响因素仍不确定且存在争议。本研究旨在进一步阐明CIN 2-3复发的危险因素。这项回顾性队列研究纳入了142例年龄在20至60岁之间的CIN 2-3患者，所有患者均接受了病变切除治疗。所有患者均随访至少两年以评估结局。主要结局指标为治疗后两年内的高危型人乳头瘤病毒（HR-HPV）状态和宫颈病变状态。采用Fisher精确检验或Pearson卡方检验以及Kruskal-Wallis（K-W/H）检验进行单因素分析。应用逻辑回归分析确定独立危险因素，并使用森林图展示结果。研究发现，除产次外（P = 0.020），基本特征和HR-HPV状态无显著差异。治疗前HPV基因型和切缘状态与治疗后宫颈病变状态显著相关，P值分别为0.003和0.031。治疗前的细胞学检查和HPV疫苗接种是影响治疗后两年宫颈病变状态的独立因素，比值比（OR）分别为0.634（95%置信区间：0.443-0.908）和0.340（95%置信区间：0.121-0.952）。本研究首次报告了影响CIN 2-3复发的独立因素，并强调了考虑对宫颈浸润前病变女性进行辅助性HPV疫苗接种的重要性。
