Meta Analysis Of The Follow-up Period Of HR-HPV Test In Patients With High Grade Cervical Intraepithelial Neoplasia After Conization

Cervical intraepithelial neoplasia (CIN) is the precancerous lesion which isclosely related to cervical carcinoma and divided into3grades according to cellularatypia. CIN Ⅱ and CIN Ⅱ are known as high grade intraepithelial neoplasia, whoseoccurrence and development have intensely connected to high risk humanpapilomavirus (HR-HPV) infection.There are two kinds of human papillomavirus(HPV):the low risk human papillomavirus and the hige risk one.Only HR-HPV isbelieved in causing CIN Ⅱ and CIN Ⅱeven developing into cervicalcarcinoma.Though most of the lesion can be eliminated by CKC with a high level ofHR-HPV dispelling,however,there are1%to21%of the patients who have diseaseresidual or recurrent.Therefore,the HR-HPV test in patients with CIN II/III after CKCis very inmportant to discover the residual or recurren.But how exactly the HR-HPVtest results at different points of the follow-up influence the ending of disease andhow we decide the treatments after CKC accouting to those are extremely importantand valuable.Objectives:To analysis the significance in follow-up period of HR-HPV test in patients withhigh grade cervical intraepithelial neoplasia after conization.Methods:Search the database such as Pubmed database, Medline database, Elsevierdatabase, CNKI website, WanFang website, VIP website about HR-HPV test inpatients with high grade cervical intraepithelial neoplasia after conization. All the datawere analyzed by Revman5.2software.Results:24case-control studies about the significance in follow-up period of HR-HPVtest in patients with high grade cervical intraepithelial neoplasia after conizationaccording to the include criteria and the exclude criteria were assessed.Thecumulative cases and controls were478and718respectively. Meta analysis results show that HR-HPV infection test positive in the third month after CKC has a higherproportion of the residual or recurrent than HR-HPV infection test negative.AndHR-HPV infection test positive in the sixth to twelfth month after CKC has a higherproportion of the residual or recurrent than HR-HPV infection test positive in thethird month.However compareing HR-HPV infection test positive in the sixthmonth after CKC with that in the second year shows less meaningful incomparability.What’s more, HR-HPV infection test positive in the twelfth month afterCKC and that in the second year has none comparability at all.Conclusion:HR-HPV infection test in the third month after CKC one of the high risk ofdisease residual after operation.HR-HPV infection test in the sixth to twelfth monthafter CKC is the highest risk period related to the residual or recurrent.The negativeresults of HR-HPV infection tests show a great deal of very low proportion of theresidual or recurrent after cold knife conization.Otherwise，having the HR-HPVinfection test in the second year after CKC can be great meaningful in refluctingcontinuing infection and repeatly infection of the virus after CKC.