摘要
目的探讨不同手术治疗方式对高级别子宫颈鳞状上皮内病变(HSIL)术后生殖道人乳头瘤病毒(HPV)感染转归的影响。方法选取2018年1月至2022年8月于新疆医科大学第一附属医院妇科,行子宫颈切除性治疗或补充性全子宫切除的667例HSIL患者为研究对象,平均随访(33.74±16.22)个月。观察手术治疗后患者生殖道HPV感染的转归,对比分析两种手术方式治疗后生殖道HPV感染转归的差异。结果(1)我国西北地区HSIL人群手术治疗前后的主要生殖道感染亚型基本一致,主要为HPV16、52和58。(2)HSIL合并高危型HPV感染,在手术治疗后发生生殖道HPV感染阴转的比例较高,术后半年、1年、2年、3年及4年的阴转率分别为77.386%(308/398)、80.769%(357/442)、85.386%(298/349)、83.111%(187/225)和85.964%(98/114)。(3)HSIL全子宫切除治疗后的持续性生殖道HPV感染率为12.389%(14/113),低于子宫颈切除性治疗后的21.119%(117/554)(χ^(2)=4.532,P=0.033)。结论手术治疗HSIL在切除病灶的同时也有效清除了生殖道HPV感染,符合指征的补充性全子宫切除治疗从某种程度上可改善HSIL患者的预后。
Objective To investigate the effect of different surgical treatments on the outcome of genital human papillomavirus(HPV)infection for high-grade cervical squamous intraepithelial lesions(HSIL).Methods A total of 667 patients with HSIL who underwent cervical excisional procedures or complementary total hysterectomy were retrospectively analyzed at the Department of Gynecology,the First Affiliated Hospital of Xinjiang Medical University,between January 2018 and August 2022.The average follow-up period was(33.74±16.22)months.The outcomes of genital tract HPV infection after surgical treatment were observed and the differences in the outcomes of genital tract HPV infection between the two surgical procedures were comparatively analyzed.Results(1)HPV16,52 and 58 were both the main genital infection subtypes before and after surgical treatment in HSIL population in northwest of China.(2)For HSIL associated with high-risk HPV infection,the proportions of negative conversion of genital HPV infection after surgical treatment were high.The negative conversion rates at 6 months,1 year,2 years,3 years and 4 years were 77.386%(308/398),80.769%(357/442),5.386%(298/349),83.111%(187/225)and 85.964%(98/114),respectively.(3)The persistent genital HPV infection rate after hysterectomy was 12.389%(14/113),which was lower than that after cervical excision 21.119%(117/554)(χ^(2)=4.532;P=0.033).Conclusion Surgical treatment of HSIL can effectively remove genital HPV infection while removing the lesion,and complementary hysterectomy in accordance with the indications can improve the prognosis of HSIL patients to some extent.
作者
李瑶
梁凌云
马彩玲
LI Yao;LIANG Lingyun;MA Cailing(Department of Gynecology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,830054,China)
出处
《新疆医学》
2025年第4期394-398,共5页
Xinjiang Medical Journal
基金
国家自然科学基金(项目编号:82260613)。
