Study Of Human Papillomavirus Typing Test In Cervical Cancer Patients With Postoperative Following-up

Objective:The purpose of this study aimed to analysis the genotyping of HPV pre and post operative and the outcome influencing factors in cervical cancer patients,discuss the characteristics of the outcome in different HPV genotyping、single infection and multiple infection;and understand the predictive value of HPV typing test in recurrent cervical cancer or secondary VAIN patients.And then provide corresponding basis for intervention and treatments.Method:This was a study of 402 cervical cancer postoperative patients.Collected the patient’s general information and HPV infection in preoperative,detect HPV infection of vaginal stump every six months after the surgery by the HPV detection technique, at the same time use thin layer liquid based cytology test(TCT) technique.Take the way of outpatient service checks regularly followed up for 2 years.Following-up time for patients that were diagnosed VAIN or recurrent cervical cancer by histopathology or imaging tests was up to the secondary or recurrence.We analysis the HPV genotyping in the infected patients and the outcome influencing factors after the surgery,and the relationship between the outcome of postoperative HPV with secondary VAIN and relapsed cervical cancer.Result:1. 377 cases were infected HPV in 439 patients before the surgery,the total infection rate of HPV was 93.7%,including 370 cases were infected HR-HPV,98.1%(370/377),7cases were infected LR-HPV, 1.9%(7/377).2. 298 cases(79.0%) were infected single HPV in a total of 377 cases before the surgery.The infection rate in the top five subtype of HPV is 16、58、52、18、53,respectively.3. 79 cases(21.0%) were detected HPV multiple infection in 377 cases infected HPV before the surgery.Double infection(48 cases) has a high proportion,and triple infection、fourfold infection and fivefold infection has 18 cases,9 cases, 4 cases,respectively.No more than fivefold infection or more complex multiple infection were detected.The most common type of multiple infection was HPV16、HPV18 merged other types.4. 322 cases(85.41%) of patients with HPV negative detection at the end of follow-up in 377 cases before the surgery.5. The difference in the natural transnegative rate between single infection(84.2%)and multiple infection(89.9%) of different HPV genotyping in 377 cases infected HPV before the surgery was no significant(P<0.05).6. Significant differences between somking and non-smoking patients in the natural transnegative rate were indicated in 377 cases infected HPV before the surgery(P>0.05);Significant differences between menopausal and not menopausal in the natural transnegative rate were indicated in 377 cases infected HPV before the surgery(P>0.05).7. The natural transnegative rate between different clinical stages of cervical cancer with postoperative HPV was no statistically significant(P<0.05);The natural transnegative rate between different pathological type of cervical cancer with postoperative HPV was no statistically significant(P<0.05).8. 17 cases(4.2%) were diagnosed secondary VAIN in 402 cases.HPV testing of 17 cases were positive and all secondary to cervical squamous cell carcinoma patients.9. 48 cases(11.9%) were diagnosed recurrent in 402 cases, 36 cases local recurrent and 12 cases distant metastasis.Patients with local recurrence of HPV infection ate higher than of patients with distant metastasis.Differences were significant(P>0.05).Conclusion:1. The outcome of HPV infection has certain correlation with the prognosis of cervical cancer. Outcome of HPV infection should be included in cervical cancer patients with postoperative follow-up.2. HPV eradication rate in cervical cancer patients after surgery gradually increase with the extension of time,about 85.4%(322/377) of patients’ HPV genotyping turn negative within two years after the surgery.3. Smoking and menopause are high risk factor for HPV persistent positive in postoperative patients.There should be strengthen close follow-up for those patients.4. The persistent infection of HPV in postoperative patients with cervical cancer led to more local recurrent and secondary VAIN,such patients should be early intervention.