The Postoperate Outcome Of Human Papillomavirus In Cervical Cancer And Its Clinical Significance

Objective:The persistent infection of human papillomavirus(HPV)is definite pathogenesis of cervical cancer.Surgery is the primary therapeutic method of early cerxical cancer,which not only achieve the goal of lesion resection,but also can remove the infection of HPV.But surgery can't remove the tissue of HPV infection completely.After surgery,the virus turn to be negative,wich was influenced by related factors.The persistent infection of HPV after surgery may be the inducement of some lesions such as vaginal intraepithelial neoplasia(VAIN).The purpose of this study was to learn about the general condition of HPV outcome after surgery for cervical cancer,analyzing the influence factors of the clearance time of HPV.,investigating the predictive effect of HPV outcome on postoperative recurrence and secondary vaginal lesions in cervical cancer.So we can be guided better at the clinical follow-up work.Methods:1.A total of 375 women undergoing excisional treatment were recruited to the study between January 2012 and December 2013 from the affiliated hospital of Qingdao university.2.All of these patients were followed up for three years.In the first year,review once every three months,and the period can be extended to six months when virus became negative.In the second and the third years,review once every six months.The follow-up included gynecological examination,HPV examination(second generation cross capture laboratory technique,HC-II),liquid based cytology(TCT)and imaging examination.3.Learn about the time needed for HPV clearance,then analyze the influence factors,which include age,stage,degree of tumor differentiation,operation pattern(extrafascial total hysterectomy and extensive hysterectomy?open surgery and laparoscopic surgery?retaining ovarian and not retaining ovarian)and adjuvant therapy after surgery.Discussing the predictive significance of HPV detection in cervical cancer recurrence and secondary vaginopathy discuss the impacts of HPVtesting at predicting relapsed cervical cancer and subsequent vaginal lesions.4.The clearance time of human papillomavirus using Kaplan-Meier method analysis and the different groups clearance time of human papillomavirus compares use the Log rank testing.Multivariable effect was determined by Cox's proportional hazards regression model,significant level being 0.05.Result:1.The medium HPV clearance time of the 375 cases is 7 months(95% CI 6.41-7.59).272 cases(78.39%,272/347)are negative in the first year,46 cases(13.26%,46/375)the second year and 13 cases the third year(3.75%,13/375).2.Univariate analysis showed that age(P < 0.05),stage(P < 0.05)and operation pattern(panhysterectomy or radical hysterectomy)(P<0.05)were related factors,wich is associated with HPV clearance.In multivariable analysis,the age was an independent risk factor(P < 0.05).3.The specificity,sensitivity of HPV test at forecasting replapsed cervical cancer is 80.3%,88.2%,and forecasting vaginal intraepithelial neoplasia is 86.8%,93.0%.Conclusion:1.The medium clearance time of HPV after surgery is 7 months,and the clearance rate increases over time.Most cases became negative in two years.2.The age of the patient,the stage of cervical cancer and the extent of hysterectomy were the influencing factors of the postoperative HPV clearance.,while age was the independent risk factor.3.The test of HPV after cervical cancer operation has higher sensitivity and specificity for predicting the recurrence of cervical cancer and secondary vaginal diseases.