| Objective:To study the time span from persistent infection of different types of high-risk HPV to high-grade squamous intraepithelial lesion(HSIL)or cervical cancer,and to guide the clinical screening of cervical cancer.Methods:In the HPV-positive population coming from the southern Hunan who were screened for continuous cervical cancer screening,97patients with CINII,103 patients with CINIII,and 91 patients with cervical cancer were enrolled in our hospital from January 2016 to December 2018.The first screening for HPV positive in the same period was confirmed.CINII224 cases,CINIII 496 cases and 437 cases of cervical cancer as a control group.Data to analyze the time span of HPV infection to precancerous lesions and cancer.Results:(1)97 cases of persistent HPV infection developed into CIN II.The HPV types were 16/18 high-risk group(26.8%),16/18 combined with other high-risk group(23.7%)and non-16/18 high-risk group(49.5%).There was significant difference between the two groups(?~2=17.29,P<0.001).The duration of persistent infection in 16/18 high-risk group was 1.25-3.25 years(2.1±0.52)significantly shorter than that in non-16/18 high-risk group1.25-6.17 years(2.86±0.99)(P<0.001).16/18 high-risk group 1.25-3.25 years(2.1±0.52)was significantly shorter than 16/18 combined with other high-risk group 1.17-4.60 years(2.84±0.75)(P=0.003).The duration of persistent infection in non-16/18 high-risk HPV group ranged from 1.25 to6.1 7 years(2.8 6±0.9 9)and there was no significant difference betweennon-16/18 high-risk HPV group and 16/18 combined with other high-risk groups(P=0.927).(2)There were 103 cases of persistent HPV infection in CIN III.The HPV types were 16/18 high-risk group(40 cases,38.83%),16/18 combined with other high-risk group(21 cases,20.39%)and non-16/18 high-risk group(42 cases,40.78%).There were significant differences between groups(?~2=11.74,P=0.003).The duration of persistent infection in 16/18 high-risk group was 1.50-6.00 years(2.83±0.93)significantly shorter than that in non-16/18 high-risk group(2.08-6.00 years(3.75±1.11)(P<0.001).The duration of persistent infection in 16/18 high-risk group was significantly shorter than that in 16/18 combined with other high-risk groups for 2.00-7.58 years(3.57±1.34)(P=0.014).There was no significant difference in the duration of persistent infection between non-16/18high-risk HPV group and 16/18 combined with other high-risk HPV groups(P=0.523).(3)Among the persistent HPV infection population,91 cases progressed to cervical cancer.HPV types were 16/18 high-risk group(50 cases,54.95%),16/18 combined with other high-risk group(22 cases,24.17%)and non-16/18 high-risk group(19 cases,20.88%).There was significant difference between groups(?~2=28.91,P<0.001).The duration of persistent infection in 16/18 high-risk group was 2.00-10.00 years(4.08±1.54)significantly shorter than that in non-16/18 high-risk group(3.00-6.00 years(5.06±0.88)(P=0.004).There was no significant difference in the duration of persistent infection between 16/18 high-risk group and 16/18 combined with other high-risk groups(3.16-5.50 years(4.09±0.50)(P=0.986).The duration of persistent infection in 16/18 combined with other high-risk groups in3.16-5.50 years(4.09±0.50)was significantly shorter than that in non-16/18high-risk HPV group in 3.00-6.00 years(5.06±0.88)(P=0.014).(4)There was no significant difference in the age of CINII between the continuous screening group and the first screening group(P=0.107).There was no significant difference in the age of CINIII between the continuous screening group and the first screening group(P=0.578).The age of cervical cancer in the continuous screening group was significantly earlier than that in the first screening group(P=0.001).(5)The detection rate of CIN II in the continuous screening group(33.3%)was higher than that in the first screening group(19.4%).The difference was statistically significant(?~2=26.31,P<0.001).The detection rate of CIN III in the continuous screening group(35.4%)was lower than that in the first screening group(42.9%).The difference was statistically significant(?~2=5.36,P=0.021).The detection rate of cervical cancer in the continuous screening group(31.3%)was lower than that in the first screening group(37.8%).The difference was statistically significant(?~2=4.239,P=0.040).Conclusions:(1)We should pay attention to the persistent infection of high-risk HPV.We should be alert to cervical precancerous lesions for 2-3years and cervical cancer for 4-5 years.(2)Mixed high-risk HPV persistent infection does not accelerate the occurrence of precancerous lesions. |
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