| Objective: To investigate the pathology results of LSIL patients infected with different HPV subtypes in this region,and statistics analyze the pathological results after followup,and stratify them by age.This study is a supplement to the prediction of the progression,persistence and regression of LSIL by HPV typing detection in this region,and the results can be obtained to guide the follow-up diagnosis and treatment of LSIL patients in this region.Methods: A total of 200 LSIL patients were selected from the Department of Obstetrics and Gynecology and the Department of Cervical Pathology of the Second Affiliated Hospital of Dalian Medical University from January 2018 to July 2020.They were followed up for 24 months.Retrospective statistics and analysis of cervical biopsy pathology after follow-up of patients in different age groups,HPV positive and negative groups,HPV16,18,58,and remaining HPV positive groups were performed.Chi-square test or Fisher exact probability method was used to analyze the effect of HPV infection on the progression,persistence and regression of LSIL.The number of HPV positive people,the number of HSIL positive people after follow-up and the final number of HSIL were counted,the positive predictive value of HPV infection was calculated,and the diagnostic efficacy of HPV typing test in different age groups was evaluated.Results: A total of 200 patients with LSIL were admitted from January 2018 to July 2020,ranging in age from 19 to 67.The mean age was(40.73±11.70)years old and the median age was 40 years old.The 30-39 and 40-49 age groups share the first place,the 19-29 age group ranks second,the 50-59 age group ranks third,and the 60-69 age group ranks the least.Among HPV-positive patients,the first group was 30 to 39 years old,with 53 patients.The next largest group was 40-49,with 46 members.The third group is the 19-29 group with 38,the fourth group is the 50-59 group with 28,and the last group is the 60-69 group with 17.The pathological results of 68% patients with LSIL showed no cytological changes after follow-up,14% patients still showed LSIL after follow-up,and 16.5% patients progressed to HSIL.The pathological results of HPV-positive and HPVnegative patients after follow-up were 7.171 and 0.053,respectively.The results were not statistically significant.Patients with HPV16 positive and other HPV-positive patients progressed to HSIL chi-square value of 10.131 and P value of 0.011,the results were statistically significant.HPV16,18,58,52 and other HPV positive groups,different HPV infection group progressed to HSIL chi-square value of 28.602,P value of 0.018<0.05,the result was statistically significant.In the 19-29 to 40-49 age group,the progression rate of LSIL patients to HSIL tended to increase with age,and the positive predictive value of HPV also increased with age.In the 50-59 and 60-69 age groups,the positive predictive value of HPV increased again in the 60-60 age group.The chi-square value of HISL was 2.942 and P value was 0.368 between the HPV single infection group and the HPV multiple infection group,showing no statistical difference between the two groups.Conclusion:(1)Pathological results after 24 months of follow-up indicated that LSIL patients had a high regression rate.However,LSIL patients infected with HPV16,18,and 58 still need to be vigilant;Young LSIL patients were more likely to have transient HPV infection than middle-aged patients.(2)Compared with other HPV infections,HPV16 infection has a higher probability of progressing to HSIL in LSIL patients,and colposcopic cervical biopsy should be performed in time for LSIL patients with HPV16 infection.(3)The sensitivity of HPV typing detection is high,and the positive predictive value of patients aged 30-39 years and 40-49 years is high.It is recommended to closely follow up patients with LSIL with HPV infection in these two ages,and perform colposcopic cervical biopsy to avoid the missed diagnosis of HSIL progression.(4)Multiple HPV infection did not increase the probability of LSIL progression to HSIL. |
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