摘要
目的分析宫颈上皮内瘤变(CIN)患者人乳头瘤病毒(HPV)感染亚型的特点及影响宫颈锥切术后HPV感染转阴的风险因素。方法收集2017年1月-2020年3月在南昌大学第三附属医院门诊经宫颈活组织检查(简称活检)确诊为CIN且HPV感染呈阳性,后续行宫颈锥切术的175例患者资料。根据纳入和排除标准,有29例患者在宫颈锥切术后行子宫全切术,30例失访;最终共纳入116例患者。确诊为CIN 1级25例,CIN 2级52例,CIN 3级39例。于术前检测患者HPV感染亚型,并对患者宫颈锥切术后3、6、12个月HPV感染转阴情况进行随访,分析HPV感染亚型的分布特点,以及影响宫颈锥切术后HPV感染转阴的风险因素。结果术前HPV感染前3位的亚型分别为HPV 16、52、33型,比例分别为50.86%(59/116)、18.97%(22/116)、16.38%(19/116)。术前HPV单一亚型感染者61例,多重亚型感染者55例,其中感染HPV 16型59例。宫颈锥切术后3个月,63例(54.31%)患者HPV感染转阴;53例持续感染,17例单一亚型感染,36例多重亚型感染,其中感染HPV 16型23例。宫颈锥切术后6个月85例(73.28%)转阴;31例持续感染,8例单一亚型感染、23例多重亚型感染,其中感染HPV 16型12例。宫颈锥切术后12个月95例(81.90%)转阴;21例持续感染,7例单一亚型感染、14例多重亚型感染,其中HPV 16型6例。在术后3、6、12个月,HPV阳性组和阴性组分别有53和63例、31和85例、21和95例。单因素分析结果显示,在术后3、6、12个月,HPV阳性组与阴性组间各病理分级患者占比的差异均有统计学意义(χ^(2)=8.51、9.10、7.02,P=0.014、0.011、0.029)。在术后3、6个月,HPV阳性组与阴性组间不同HPV感染类型的患者占比的差异均有统计学意义(χ^(2)=16.47、12.17,P值均<0.001),但在术后12个月两组间不同HPV感染类型的患者占比的差异无统计学意义(χ^(2)=3.81,P=0.051)。在术后3、6、12个月,HPV阳性组与阴性组间术后各病理切缘状态的患者占比的�
Objective To analyze the subtype features of human papillomavirus(HPV)infection in patients with cervical intraepithelial neoplasia(CIN)and related factors affecting HPV turning negative after cervical conization.Methods Clinical data of 175 patients who were diagnosed as CIN by biopsy(HPV positive)and underwent cervical conization in the Third Affiliated Hospital of Nanchang University from January 2017 to March 2020 were collected.Of them,29 patients underwent total hysterectomy after conization,30 patients were lost to follow-up,and 116 patients were ultimately selected as the object of the study.There were 25 patients with CIN grade 1,52 with CIN grade 2,and 39 with CIN grade 3.The subtypes of HPV infection were detected before operation.HPV turning negative was investigated at 3,6 and 12 months after conization.The features of HPV infection were retrospectively analyzed to investigate the risk factors of HPV turning negative after cervical conization.Results The top three subtypes of HPV infection before operation were HPV 16(50.86%,59/116),HPV 52(18.97%,22/116)and HPV 33(16.38%,19/116),respectively.And there were 61 cases with single subtype infection and 55 cases with multiple infection,including 59 cases infected with HPV 16.HPV infection turned negative in 63(54.31%)patients at 3 months after cervical conization;in 53 patients with persistent infection,17 had single subtype infection and 36 had multiple subtype infection,among whom 23 patients were infected with HPV 16.HPV infection turned negative in 85(73.28%)patients at 6 months after cervical conization;in 31 patients with persistent infection,8 had single subtype infection and 23 had multiple subtype infection,among whom 12 patients were infected with HPV 16.HPV infection turned negative in 95(81.90%)patients at 12 months after cervical conization;in 21 patients with persistent infection,7 had single subtype infection and 14 had multiple subtype infection,among whom 6 patients were infected with HPV 16.There were 53 and 63 patients,31 and 85 patient
作者
吴绿
朱虹
WU Lü;ZHU Hong(Department of Obstetrics and Gynecology,The Third Affiliated Hospital,Nanchang University,Nanchang 330000,Jiangxi,China)
出处
《上海医学》
CAS
2023年第5期297-302,共6页
Shanghai Medical Journal
基金
南昌市科技支撑计划项目(洪科字[2019]258号-6)。
关键词
宫颈上皮内瘤变
人乳头瘤病毒
宫颈锥切术
风险因素
Cervical intraepithelial neoplasia
Human papillomavirus
Cervical conization
Risk factors
