Infection Of HPV16/18 In LEEP Specimens And Effect Of LEEP On HPV Clearance

Cervical cancer is the second most common cancer in women worldwide and is the most common cancer in many developing countries. There are over 370,000 new cases of cervical cancer each year, accounting for over 10% of cancers in women. And the young patients have a dramatic increase in both the incidence and mortality rates of cervical cancer,which someone has suggested has correlation with increased rate of high-risk human papillomavirus(HR-HPVs) infection.Since Hausen^{【1】} proposed HPV was the main cause of cervical cancer, a great deal of research from all over the world proved that the persistence of HPV infection had close relationship with cervical intraepithelial neoplasia(CIN) and cervical cancer. Recently, a worldwide study^{【11】} demonstrated that over 99% of cervical cancers have detectable HPV DNA sequences, that is to say cervical cancer was a infectious disease in a sense.More than 30 types of HPV has been found in genital tract disease which are further grouped into low-risk and high-risk HPV. While low-risk HPVs, e.g., HPV-6 and-11,occur mainly in benign condyloma of the uterine cervix,high-risk HPVs, e.g., HPV-16 and -18, are commonly detected in high-grade cervical intraepithelial neoplasia (CIN) and invasive cervical cancer lesions.HPV E6 and E7 oncoproteins are most important inductive molecules of cervical cancer. E6 and E7 products from oncogenic viral types like HPV 16 and HPV 18 can bind to, inactivate, and cause the degradation of cellular tumor suppressor gene products, p53and pRb. Because HPV 16 and HPV 18 are most common in CIN and cervical cancer,and the two types have no regional difference,so the author only detect the two types in this text. There has been more than one hundred years since conization was used in the therapy of cervical intraepithelial neoplasia (CIN). The loop electrosurgical excision procedure(LEEP) became the best conization because of its saving time,simple operation,safety and cheap cost.LEEP is a method not only for diagnosis but also for treatment which can not be replaced by coloscopy.【4】Two hundred and sixteen cases underwent LEEP excision. The LEEP specimens were all sent to histological diagnosis and also immunohistochemical detection for HPV16/18.Six months later,the team of HPV(+) were followed up, and underwent biopsies and HPV16/18 detection again to evaluate the effect of HPV infection treated by LEEP and also discuss the issue about CIN recurrence. The argument about the association between clear or unclear resection margins of cervical cones and the risk of recurrence is hot in recent years. A lot of research【7,8】suggested that women with extension of CIN to the margins they have much greater risk of reappearance of CIN.While others【9,10】hold opposition to this viewpoint.To avoid this argumental point,the discuss on reappearance of CIN in the text focus on patients of clear margins. Seven cases conversed to laparotomy were excluded.The remained two hundred and nine cases were divided into three groups according to histological diagnosis: chronic cervicitis group(n=102),CINⅠgroup(n=66),CINⅡ/Ⅲgroup(n=41).HPV16/18 infectious rates were...