Factors Associated With HPV16, 18Variation After Treatment For High-Grade CIN With LEEP

Objective: (1) To report the curative effect of LEEP on HPV 16,18 clearance in high-grade CIN patients. (2) To observe the determinants of persistent human papillomavirus (HPV) 16,18 infection in patients with high-grade cervical intraepithelial neoplasia (CIN) underwent loop electrosurgical excision procedure (LEEP).Methods: Chosing 167 cases who received treatment in the department of gynecology of Liuzhou People's Hospital from January 2007 to June 2009, who confirmed CINII / III by colposcopy cervical biopsy .All of the people were detected the HPV16,18 DNA and treated by the cervical LEEP. HPV16,18 DNA and TCT were followed up 6 months after detection.Results: Among 167 women received LEEP, there were 87 with CIN II, 64 with CIN III and 16 with invasive carcinoma. At the 6 month follow-up visit, there are 127 patients who joined in the visit. 99 women were positive for HPV16,18 before LEEP , the HPV infection rate was 77.95%. At the 6 month follow-up visit ,10 remained positive, compared with 117 negative. The HPV16,18 infection rate was 7.87% and remarkably varied in contrast to preoperatively (P<0.05). As shown by a multivariate logistic regression analysis, the predictors of persistent HPV16,18 infection in high grade CIN after LEEP treatment include patient age at operation, age at first sexual activity, multiple delivery and margin involvement. Cervix biopsy was performed in 43 women with persistent positive HPV-DNA, abnormal TCT or positive surgical margin. The results showed 4 with residual lesions; the rate of residual lesions was 9.3%. Among the 4 cases, 3 was surgical margin positive. Surgical margin positive and negative present a notable difference in the residual lesion rate(P<0.05).Conclusions: 1. HPV16,18 infection in female genital tract can be effectively cleared by LEEP. 2.The affecting factors of persistent HPV16,18 infection of high-grade CIN post LEEP include age at operation, age at first sexual activity, multiple delivery and margin involvement. 3.Margin involvement is the risk factor for the residual lesion of high-grade CIN.