Analysis of the regression of high-risk human papillomavirus and related factors in the patients after hysterectomy for high-grade squamous intraepithelial neoplasia and cervical cancer in early stage

doi:10.3969/j.issn.1006-7795.2018.06.013

Abstract

Abstract: Objective To investigate the regression of high-risk human papillomavirus (HR-HPV) and related factors in vaginal stump after hysterectomy for high-grade squamous intraepithelial lesion (HSIL) and cervical cancer in early stage. Methods A retrospective cohort study included data from patients with hysterectomy for HSIL and cervical cancer in early stage at the Beijing Chaoyang Hospital, Capital Medical University from January 1, 2013 to March 31, 2018. The Kaplan-Meier method was used to analyze the virus regression time and related factors, and obtained the virus regression curve. Cox proportional hazard regression model was performed to obtain the factors affecting time of the virus regression. Results A total of 276 patients were enrolled, including 85 patients with HSIL (30.8%) and 191 patients with cervical cancer in early stage (69.2%). The average age of all was (49.43±9.80)years. There were 208 patients (94.9%) appeared positive HR-HPV test before operation. The HPV regression rates of patients with HSIL and cervical cancer were respectively 78.4% and 94.1% during 2 years after operation. There was a statistical difference between the time of viral regression and the main diagnosis of HSIL or cervical cancer(P=0.040), but not the age and the mixed infection of multiple subtypes. The regression curve of the virus in vaginal stump suggested that the virus disappeared rapidly in a short term after operation, and the rate was considerably slowed down after a certain time. The corresponding time points of HSIL and cervical cancer patients were 15 months and 13 months, respectively. Also the time of regression varied between the different types. A small number of patients still had persistent infection with the same subtype. However, the affecting factors are still inconclusive. The factors affecting the regression time were the patient's blood type (P=0.025), family history (P=0.007), and body mass index (BMI) grade (P=0.003). Conclusion Patients with hysterectomy due to cervical factors have a higher rate of HR-HPV regression. There is a risk of persistent infection, recurrence of lesions and vaginal lesions progression in patients without HPV regression for a long time after operation. However, the affecting factors are still inconclusive, further research is needed to determine the affecting factors.

Key words: high-risk human papillomavirus, high-grade squamous intraepithelial lesion, cervical cancer in early stage, hysterectomy, vaginal stump, virus regression

CLC Number:

R711.74

Zhang Yang, Luo Mei, He Xin, Jiang Ying, Li Weihua, Zhang Xuefang, Wang Shuzhen. Analysis of the regression of high-risk human papillomavirus and related factors in the patients after hysterectomy for high-grade squamous intraepithelial neoplasia and cervical cancer in early stage[J]. Journal of Capital Medical University, 2018, 39(6): 864-870.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2018.06.013

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2018/V39/I6/864

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