Correlation Analysis Of Serum Estradiol,Progesterone And Other Influencing Factors With Persistent Cervical HR-HPV Infection

Objective:1.The main cause of the occurrence and development of Cervical cancer（CC）is the persistent infection of High-risk human papillomavirus（HR-HPV）.Many studies have shown that female serum estrogen and progesterone are associated with CC,but there are few studies on the correlation between serum estrogen,progesterone and HR-HPV persistent infection at home and abroad.The aim of this study was to analyze the effect of estradiol（E₂）and progesterone（P）on persistent cervical HR-HPV infection prior to the development of CC.2.In addition to serum estrogen and progesterone,there are many factors that affect the persistent infection of cervical HR-HPV.We will discuss other influencing factors of persistent infection of cervical HR-HPV.Methods:According to the inclusion criteria and exclusion criteria,151 women who underwent cervical HPV screening in the gynecological clinic of our hospital from January 2021 to October 2022 were finally selected as the research objects.According to HR-HPV infection status,the patients were divided into HPV negative group（51 cases）,HPV transient infection group（50 cases）and HPV persistent infection group（50 cases）.The general information（age,education level,place of residence）,clinical data（age of first sexual intercourse,number of lifetime sexual partners,long foreskin or phimosis of sexual partners,number of pregnancies,number of births,abortion history,family history of cervical cancer,contraceptive methods,etc.）,vaginal microecology,fasting serum E₂and P levels at 7am to 9am in the luteal phase（1 week before the next menstruation）of the three groups of patients were collected.The association between them and HR-HPV persistent infection was analyzed.SPSS 26.0 software was used for statistical analysis.P<0.05 indicated that the difference was statistically significant.Results:1.Analysis and comparison of serum E₂and P levels among the three groups:Single factor analysis:there were significant differences in E₂and P levels among the three groups（P<0.05）.The levels of E₂and P in the persistent HPV infection group were higher than those in the other two groups（P<0.05）,and the level of P in the transient HPV infection group was higher than that in the HPV negative group（P<0.05）.Multivariate analysis showed that P（OR=1.547,95%CI 1.171-2.043）had a statistically significant impact on HPV transient infection（P<0.05）.E₂（OR=1.082,95%CI 1.039-1.126）and P（OR=2.333,95%CI 1.581-3.442）had statistically significant effects on persistent HPV infection（P<0.05）.2.Analysis and comparison of clinical data among the three groups:Univariate analysis showed that there were no significant differences among the three groups in family history of cervical cancer,age of first sexual intercourse,number of lifetime sexual partners,rate of long prepuce or phimosis of sexual partners,number of pregnancies,number of deliveries and history of abortion（P>0.05）.There were significant differences in contraceptive methods among the three groups（P<0.05）.The rate of condom use in the HPV-negative group was higher than that in the other two groups,and the rate of IUD use was lower than that in the persistent HPV infection group（P<0.05）.Multivariate analysis showed that sexual partners without foreskin or phiphia（OR=0.104,95%CI 0.014-0.784）and contraceptive condom（OR=0.019,95%CI 0.001-0.231）were protective factors for persistent HPV infection（P<0.05）.3.Analysis and comparison of vaginal microecology among the three groups:There were statistically significant differences in the abnormal rate of dominant bacteria,the abnormal rate of vaginal flora density,the abnormal rate of hydrogen peroxide,the rate of cleanlinessⅢ-Ⅳdegree and the rate of vaginal microecological imbalance among the three groups（P<0.05）.The results showed that the abnormal rate of these indicators in the persistent HPV infection group was higher than that in the other two groups（P<0.05）.4.Comparison of clinical data between patients with normal and imbalance of vaginal microecology:Compared with women with normal vaginal microecology,women with vaginal microecology imbalance had a higher incidence of persistent HPV infection（P<0.05）.5.Types of HPV infection:Among the 44 patients with single type of transient HPV infection,the top three infection types were HPV52（18.18%,8/44）,HPV58（18.18%,8/44）and HPV16（13.64%,6/44）,and there were 6 cases of mixed HR-HPV in the transient infection group.There were 2 cases of HPV52 co-infection with other types of infection.Among the 30 patients with persistent single type HPV infection,the top three types of infection were HPV16（33.33%,10/30）,HPV52（16.67%,5/30）and HPV56（16.67%,5/30）,and there were 20 cases of mixed HPV persistent infection.Among them,70%of the patients were infected with HPV16 and other types.Compared with the transient HPV infection group,the incidence of single infection in the persistent HPV infection group was lower,and the incidence of mixed infection was higher（P<0.05）.Conclusions:1.P is a risk factor for HR-HPV transient infection and persistent infection;E₂is a risk factor for HR-HPV persistent infection.2.The protective factors of HR-HPV persistent infection were non-prepuce or phimosis of sexual partner and contraceptive method（condom）.3.Vaginal microecological imbalance may be associated with persistent cervical HR-HPV infection.4.Compared with patients infected with single HPV type,patients infected with multiple mixed HPV types are more likely to have virus persistence.