宫颈锥切术后高危型人乳头瘤病毒转归的相关因素分析

目的 研究子宫颈鳞状上皮内病变（SIL)伴高危型人乳头瘤病毒（HR-HPV）感染患者行锥切术后影响HR-HPV转归的危险因素。方法回顾性分析行宫颈锥切术治疗的468例SIL患者的临床资料，分析术后HR-HPV持续感染情况及危险因素。结果468例患者术后HR-HPV持续感染55例。单因素分析发现年龄≥45岁、术前HR-HPV 16型、HR-HPV高负荷量(≥500 RLU/CO)及多重感染、病变点数≥3、高度鳞状上皮内病变（HSIL)、锥切标本厚度≤1 cm与术后HR-HPV持续感染密切相关（P<0.05)。多因素logistic回归分析发现患者术前HPV高负荷量（≥500 RLU/CO）、病变点数（≥3）及锥切标本厚度（≤1 cm)是术后高危型HPV持续性感染的独立危险因素(OR值分别为0.012、0.070、2.275，P<0.05)。结论SIL患者行锥切术后的独立危险因素有术前HPV高负荷量（≥500 RLU/CO）、病变点数（≥3）及锥切标本厚度（≤1 cm)。

Analysis of prognostic factors of high-risk human papillomavirus infection after cervical conization

Objective To study the prognostic factors those affect the high-risk human papillomavirus (HR-HPV) in patients with cervical squamous intraepithelial lesion (SIL) and HR-HPV infection after conization. Methods The clinical data of 468 patients with SIL who received cervical conization at the Second Affiliated Hospital of Zhengzhou University from January 2010 to December 2014 were retrospectively analyzed. The persistent postoperative HR-HPV infection and its risk factors were analyzed. Results There were 55 cases of persistent HR-HPV infection among 468 patients. Univariate analysis found that age ≥45years, preoperative HR-HPV 16 classification, HR-HPV load ≥500 RLU/CO and multiple infections, number of lesions ≥3, HSIL and conization specimen thickness ≤1 cm were closely correlated to postoperative HR-HPV persistent infection (P<0.05). Multivariate logistic regression analysis found that the high preoperative HPV load (≥500 RLU/CO), the number of lesions (≥3) and the thickness of the conic specimen (≤1 cm) were significant independent risk factors for postoperative persistent infection of HR-HPV (OR: 0.012, 0.070, 2.275; P<0.05). Conclusion The independent risk factors for postoperative persistent infection of HR-HPV in patients with SIL undergoing conization include preoperative high HPV load (≥500 RLU/CO), number of lesions (≥3) and thickness of conization specimen (≤1 cm).