The Effect Of Intrauterine Devices On Progress Of HSIL Or Cervical Cancer In High-risk HPV-infected Population

Objective: International multicenter and large-scale epidemiological studies have shown that the use of intrauterine device(IUD)has a certain negative correlation with the occurrence of cervical cancer,but there is no clear study on the potential relationship between the long-term use of IUD and CINII/III lesions.The purpose of this study was to investigate the relationship between the use of IUD and cervical high-grade squamous intraepithelial lesions or cervical cancer in high-risk positive cervical HPV typing.Methods: From March 4 to June 4,2017,we investigated 206 patients in the gynecology clinic of the Affiliated Hospital of Jining Medical University with high-risk HPV positive,53 patients with IUD and 153 patients without IUD as the control group.We collected the general data of patients’ age,HPV infection type and prognosis,follow-up time,cytology type and histological credit type and the observation deadline is December 31,2019.To analyze the impact of IUD users and non users on the outcome of high-risk HPV infection and the risk ratio between IUD users and high-level squamous intraepithelial lesions or cervical cancer.Results: Among the high-risk HPV positive patients,other types(except 16 and 18 types)accounted for the vast majority(79.25% in IUDgroup and 73.20% in non IUD group),16.98% in IUD group and 0.00%in 18 types.There was a significant difference in HPV clearance between IUD group and non IUD group(P<0.001),and 40 patients(75.47%)in IUD group and 75 patients(49.02%)in non IUD group.The rate of HPV positive in IUD group was 69% lower than that in non IUD Group [OR0.31,95% CI(0.15,0.63),P=0.0012],and the risk of HPV positive in IUD group was 83% lower after adjusting the confounding factors such as different age,cytology,HPV infection and histological classification [OR0.17,95% CI(0.05,0.51),P=0.0018].There was no significant correlation between age,HPV infection type and cell-type and cervical high-grade squamous intraepithelial lesions or cervical cancer(P>0.05),and also no significant correlation between the use of IUD and cervical biopsy histology and postoperative histology.Conlusions: There was no significant correlation between the use of IUD and high-level cervical squamous intraepithelial lesions or cervical cancer in high-risk HPV positive patients;the clearance rate of HPV in patients with IUD was significantly higher than that of non users,and the difference between the two was significant.For women with HPV infection,the use of IUD showed a certain protective effect.