Effect Of Cervical High-grade Squamous Intraepithelial Lesions Involving Glands On Postoperative Persistent Infection And Recurrence Of HPV

Objective: Endocervical glandular involvement（EGI）after coldknife colonization（CKC）The persistent infection and recurrence of highrisk human papillomavirus（HR-HPV）in EGI patients were compared with those in the EGI group to explore the effect of ECI on the persistent infection and recurrence of HR-HPV after CKC.It provides an important theoretical basis for the prevention of cervical cancer.Methods: In this study,221 female patients who underwent CKC due to high-grade cervical lesions in the Department of Gynecology of Affiliated Hospital of Jining Medical College from January to December2018 were selected and divided into two groups according to postoperative pathological results: EGI group and without EGI group.Preoperative,intraoperative,and postoperative data of patients in the two groups were collected,including general information of patients in the two groups,preoperative HR-HPV infection,Thinprep cytologic test（TCT）,colposcopy,cervical biopsy pathology,postoperative pathological results,and HR-HPV infection within 24 months after CKC.The data of persistent infection and recurrence of HR-HPV and related influencing factors were analyzed by X64 software and R software of Yi-Er statistics.Results:（1）There were 95 cases in the EGI free group,and the incidence of persistent HPV infection at 3,6,12,and 24 months after the operation was 12.63%（12/95）,5.26%（5/95）,8.42%（8/95）and 5.26%（5/95）,respectively.A total of 126 patients in the EGI group had sustained infection rates of 14.29%（18/126）,9.52%（12/126）,7.94%（10/126）,8.73%（11/126）at 3,6,12,24 months after the operation.There was no significant difference in HPV infection rate between the EGI group and EGI group at 3,6,12,and 24 months after operation（P>0.05）.（2）There was no significant difference in the recurrence rate between the EGI group and the EGI group（P>0.05）.（3）There was no significant difference in the length and width of the cone resection between the EGI group and the EGI group（P>0.05）,but there was a significant difference in the cone depth between the two groups（P<0.05）.Patients with EGI in preoperative cervical biopsy also had a higher probability of EGI in postoperative pathology（P<0.05）.The postoperative pathological grade of EGI was significantly higher than that of the EGI group（P<0.05）,and postoperative HSIL was significantly increased（P<0.05）.（4）Conical incision depth had an effect on HPV infection rate in both groups within 6months after surgery（P<0.05）.Conclusion:1.Among CKC patients with high-grade squamous intraepithelial disease caused by HPV infection,there was no correlation between EGI group and postoperative persistent infection and recurrence of HPV.2.The depth of conical resection in EGI patients is related to the persistence of postoperative HPV infection,and sufficient conical resection depth can reduce the probability of HPV infection within 24 months after surgery.3.EGI are more complicated with multiple HPV infections,involving multiple cervical lesions.