不同宫颈病变患者高危型人乳头瘤病毒感染情况及宫颈锥切术后复发的影响因素分析

目的 探讨不同宫颈病变患者高危型人乳头瘤病毒（high-risk human papillomavirus，HR-HPV）感染情况及宫颈锥切术后复发影响因素分析。方法 选取宫颈病变患者287例作为研究对象，根据宫颈锥切术后病理学检查结果分为宫颈炎症组（34例）、低级别鳞状上皮内病变（low-grade squamous intraepithelial lesions，LSIL）组（58例）、高级别鳞状上皮内病变（high grade squamous intraepithelial lesion，HSIL）组（180例）、宫颈浸润癌组（15例）。比较4组人乳头瘤病毒（human papillomavirus，HPV）感染率、HPV单一感染情况与多重感染情况、HR-HPV感染亚型分布情况，统计HSIL组宫颈锥切术后12个月复发率，并根据复发情况分为复发患者与未复发患者，比较不同复发情况患者基线资料、HPV感染亚型，分析HSIL患者宫颈锥切术后复发的影响因素。结果 4组总HRV感染率、HRV多重感染率差异有统计学意义（P＜0.05）；4组HRV 52、58、16、18感染率差异有统计学意义（P＜0.05）。HSIL组术后复发与未复发者术后切缘状态、绝经状态、多象限受累、术后HR-HPV持续感染、术后HR-HPV持续感染亚型、宫颈转化区分型差异有统计学意义（P＜0.05）。术后切缘阳性状态、绝经状态、多象限受累、术后HR-HPV持续感染、术后HPV 52感染、HPV 58感染、宫颈转化区分型Ⅲ型是HSIL患者宫颈锥切术后复发的影响因素（P＜0.05）。结论 不同宫颈病变患者HPV 52、58感染率差异有统计学意义，有助于指导临床评估宫颈锥切术后疗效、预后，为防治宫颈癌及其癌前病变、寻找更合理临床诊疗策略提供科学参考。

Analysis of high-risk human papillomavirus infection in patients with different cervical lesions and influencing factors of recurrence after cervical conization

Objective To investigate the high-risk human papillomavirus(HR-HPV) infection in patients with different cervical lesions and the influencing factors of recurrence after cervical conization.Methods A total of 287 patients with cervical lesions were selected as the research subjects. According to the pathological examination results after cervical conization, they were divided into cervical inflammation group(n=34) and low-grade squamous intraepithelial lesions(LSIL) group(n=58), high-grade squamous intraepithelial lesion(HSIL) group(n=180), and cervical invasive carcinoma group(n=15). Human papillomavirus(HPV) infection rate, HPV single infection and multiple infections, and HR-HPV infection subtype distribution in the four groups were compared, and the recurrence rate of the HSIL group at 12 months after cervical conization was calculated. According to the recurrence, they were divided into recurrent patients and non-recurrent patients.The baseline data and HPV infection subtypes of patients with different recurrences were compared, and the influencing factors of recurrence after cervical conization in HSIL patients were analyzed.Results There were statistically significant differences in the total HRV infection rate and multiple HRV infection rates in the four groups(P＜0.05); the differences in the HRV 52, 58, 16, 18 infection rates in the four groups were statistically significant(P＜0.05).There were statistically significant differences in the postoperative resection margin status, menopausal status, multi-quadrant involvement, postoperative HR-HPV persistent infection, postoperative HR-HPV persistent infection subtypes, and cervical transformation types in the HSIL group with and without recurrence(P＜0.05).Postoperative resection margin positive status, menopausal status, multi-quadrant involvement, postoperative HR-HPV persistent infection, postoperative HPV 52 infection, HPV 58 infection, and cervical transformation type Ⅲ were the influencing factors for the recurrence of HSIL patients after cervical conization(P＜0.05).Conclusion There is a statistically significant difference in HPV 52 and 58 infection rates among patients with different cervical lesions, which is helpful to guide clinical evaluation of the efficacy and prognosis of cervical conization, provide scientific reference for the prevention and treatment of cervical cancer and its precancerous lesions and the search for more reasonable clinical diagnosis and treatment strategies.