Analysis Of HPV Outcome After Coning Of High-grade Squamous Intraepithelial Lesions Of Cervix

Objective: Patients with preoperative diagnosis of "high-grade squamous intraepithelial lesion of the cervix" with lesion grade CIN2 to CIN3,excluding patients with positive margins and invasive carcinoma,excluding patients with other serious medical and immune system diseases,were selected from the Second Affiliated Hospital of Dalian Medical University from June 2020 to January 2023,and first admissions for cervical conization were recorded.The risk factors and protective factors affecting the postoperative regression were statistically analyzed,and postoperative adjuvant hpv regression management guidance and individualized treatment plans were provided for patients with real high-risk factors to strengthen postoperative management and avoid further progression of hpv infection,while The results of this study can also be used to avoid excessive medical treatment for people without high-risk factors,which may lead to waste of medical resources and increase the economic burden of patients.Objective: Patients with preoperative diagnosis of "high-grade squamous intraepithelial lesion of the cervix" with lesion grade CIN2 to CIN3,excluding patients with positive margins and invasive carcinoma,excluding patients with other serious medical and immune system diseases,were selected from the Second Affiliated Hospital of Dalian Medical University from June 2020 to January 2023,and first admissions for cervical conization were recorded.The risk factors and protective factors affecting the postoperative regression were statistically analyzed,and postoperative adjuvant hpv regression management guidance and individualized treatment plans were provided for patients with real high-risk factors to strengthen postoperative management and avoid further progression of hpv infection,while The results of this study can also be used to avoid over-medication in people without high-risk factors,resulting in waste of medical resources and increasing the economic burden on patients.We recorded age,menopausal status,number of births,type of hpv infection,TCT results,preoperative serum protein and squamous cell carcinoma antigen SCC levels,intraoperative conization height,postoperative pathology results indicating the extent of lesions(<2quadrants,≥2 quadrants),postoperative pathology diagnosis of lesion grade,postoperative instructions to patients for regular follow-up,and postoperative 6th month and 12 th month hpv infection.month,12 th month hpv and TCT results.RESULTS: Through close postoperative follow-up,a total of 201 patients were included in this trial according to the inclusion and exclusion criteria,of whom 40patients(19.9%)had persistent infection within 1 year postoperatively,and by univariate analysis,chi-square test revealed that persistent postoperative infection was associated with age(>45 years),menopausal status,lesion extent(>2 quadrants),and preoperative serum protein level(>75 g/L)(χ~2 were: 31.453,29.895,5.161,33.857).Ttest analysis revealed that persistent HPV infection 1 year after conization was associated with the number of births and length of the coned cervix,with a statistically significant difference(P < 0.05),but not with the number of pregnancies,HPV infection typing,preoperative squamous cell antigen level,lesion grade,or whether the infection was compound.There was no significant correlation with the number of pregnancies,HPV infection typing,preoperative squamous cell antigen level,lesion level,and whether it was a compound infection,and age(>45 years),menopausal status,and lesion extent(>2 quadrants)were independent risk factors for persistent HPV infection after conization by multifactorial logistic analysis,and preoperative serum protein level(>75 g/L)was a protective factor for true HPV conversion after surgery.Their ORs were(12.327,7.85,10.979,0.014),and their differences were statistically significant.And there was no significant correlation with the number of pregnancy,number of delivery,HPV infection typing,whether it was a compound infection,preoperative squamous cell antigen level,lesion grade,and conization cervical length.(P > 0.05).Conclusion.1.persistent HPV infection after conization was associated with patient’s age,menopausal status,number of births,and conization cervical length,while there was no significant correlation with the number of pregnancies,HPV infection typing,preoperative squamous cell antigen level,lesion grade,and whether it was a coinfection.2.Age(>45 years),menopausal status,lesion extent(>2 quadrants),and preoperative serum protein level(>75 g/L)were independent risk factors for persistent HPV infection after conization.To avoid the progression of lesions due to persistent HPV infection,health education and close follow-up should be strengthened in the abovementioned groups,and pharmacological intervention can be used if necessary.