Analysis Of Related Factors Affecting HPV Negative Conversion After Cold-knife Conization Of Cervical Intraepithelial Lesions

Objective:By analyzing the clinical data of HSIL patients after Cold-knife,to explore the related factors that affect the negative conversion of Human Papiloma Virus(HPV)after operation.Thereby blocking the recurrence and progression of cervical lesions and preventing the occurrence of cervical cancer.Method:Selected from December 2017 to December 2019 at the First Affiliated Hospital of Hebei North University Cervical biopsy for cervical high-grade intraepithelial lesions in patients admitted to gynecology inpatient department Cold-knife conization,All 98 patients were HPV positive for HR-HPV,with complete clinical and pathological data,and followed up regularly in our hospital for 2 years after surgery.Combined with preoperative and postoperative pathological results,it is divided into CIN II(p16 positive)and CIN III group.Compare the distribution of HPV infection between the two groups and whether there is a correlation between the two.According to different time of HPV negative conversion after Cold-knife Conization,98 cases are divided into 3 groups: ≤6 months,6-12 months,> 12 months(inciuding during the experimental follow-up non-negative patients).Explore the cervical epithelium Correlative factors affecting HPV negative conversion after cervical conization in patients with internal lesions.The contents of comparative analysis include: age,age at menarche,number of pregnancy,number of deliveries,HPV infection subtypes,absolute Menstrual status,pathological margins,glandular involvement,pathological grade of conization,cervical TCT results,application of antibiotics after conization HPV medication status,postoperative condom use.Result:1.The subtypes with the highest infection rate of HR-HPV in patients with cervical high-grade intraepithelial lesions contain HPV16 rate is66.33%(65 cases),followed by 11 other subtypes except HPV16,18 and45(41 cases),accounting for 41.84%,HPV18 or 45 rate is 15.31%(15cases),accounting for 41.84%,and the multiple HR-HPV rate is 20.41%(20 cases).2.In this study,the age range of the 98 patients ranged from 19 to 61 years,with an average age of 40.38±7.99 years,the age distribution of35-39 years old is the most,accounting for 27.55%,followed by 40-44 years old,accounting for 22.45%.The age distribution of multiple HR-HPV infection is 40-44 years old,accounting for 35.0%.3.According to the pathological results after cervical cold knife conization,98 patients are divided into CIN II and CIN Ⅲ group(if postoperative pathological grade is downgraded,the highest pathological grade shall prevail).Among the patients with cervical lesions of CIN II and CIN III,the infection rate with positive HPV16 subtype was the highest,accounting for 62.96% and 70.45%,and the other 11 high-risk HPV types accounted for 48.15% and 34.09%,and HPV18/45 positive infection rates were 11.11% and 20.45%.The infection rates in patients of multiple HR-HPV infection in CIN Ⅱ and CIN III are 22.22% and 18.18%,respectively,and the difference among various types of HPV infection rates is not statistically significant(P>0.05).4.According to the time of HPV negative conversion after conization,it can be divided into 3 group: ≤6 months,6-12 months,> 12 months.There were 29 patients in the ≤6 months group,52 patients in the 6-12 months group,and 17 patients in the >12 months group(11 patients were negative within 24 months).The rate of HPV negative conversion within≤6 months was 29.59%,the negative conversion rate within 12 months was 82.65%,and the HPV negative conversion rate within 24 months was93.88%.Compare clinical data indicators among the 3 groups: age,age at menarche,number of pregnancy,number of deliveries,HPV infection subtypes,absolute Menstrual status,pathological margins,glandular involvement,pathological grade of conization,cervical TCT results,application of antibiotics after conization HPV medication status,postoperative condom use.Univariate analysis showed: the age distribution,cervical TCT grade,positive pathological margin and postoperative condom use in 98 patients were statistically significant(P<0.05),the differences of age at menarche,number of deliveries,number of pregnancy,Menopausal status,HPV infection,glandular involvement,conization pathological grade and postoperative medication are not statistically significant(P>0.05).5.Including statistically significant factors logistic analysis,the results show: Cervical TCT grading and postoperative surgical margins were independent risk factors for HPV negative conversion(P<0.05),condoms use is a protective factor for HPV negative conversion(P<0.05),age is a non independent factors affecting HPV negative conversion(P>0.05).Conclusion:1.The grade of cervical TCT and positive pathological margins are independent influencing factors affecting HPV negative conversion.2.The use of condoms during postoperative sex is a protective factor for HPV negative conversion after cervical conization.3.Age is a non independent factors affecting HPV negative conversion.