Multivariate Analysis Of HPV Negative Conversion After Cervical Cold Knife Conization In CIN ? Patients

Objective(s):(1)To understand the characteristics of human papillomavirus infection and the distribution of single infection and multiple infection in different age groups in gynecological inpatient department of the first affiliated hospital of Kunming medical university because of cervical CIN ? hospitalization.(2)The HPV infection of the same patient before and 3 months after surgery was compared,and the related factors of HPV negative 3 months after surgery were analyzed,so as to provide some theoretical basis for the prevention of HPV reinfection after surgery.(3)After 6 months of follow-up,all patients were divided into two groups.HPV typing test was performed in 30 cases in the experimental group and cell DNA quantitative analysis was performed in 25 cases in the control group.the results of follow-up protocol were compared between the two groups.To explore a more favorable follow-up plan for early detection of CIN recurrence or progression after surgery to provide a reliable follow-up basis.Method(s):(1)From January 2016 to September 2017,55 patients underwent HPV typing and colposcopy biopsy of CIN ? in the gynecological inpatient department of the first affiliated hospital of Kunming medical university,and cervical cold knife conization at the same time.(2)Fifty-five patients were followed up for at least 6 months after operation,and specific clinical data were recorded,such as age,menstrual history,maternal history,smoking,alcohol consumption,family history of tumor,educational attainment,menopause,preoperative HPV,colposcopy,biopsy,surgery:residual after conization,HPV typing test after operation,sexual life after operation,postoperative use of anti-inflammatory drugs,postoperative pathological examination cutting edge,whether tired gland,etc.Logistic regression analysis was used to analyze the risk factors of HPV negative after operation.During the follow-up period,all patients were followed up every 3 months.all patients were tested for HPV typing 3 months after operation.55 patients were randomly divided into two groups 6 months after operation.30 patients in the experimental group were tested for HPV typing and 25 patients in the control group were analyzed quantitatively for cellular DNA.In the experimental group patients,in a separate line of HPV types after testing,if the result is negative,then again after six months follow-up;If the result is positive,the further line of TCT detection,immediately when the TCT positive biopsy under colposcope.If the type of HPV infection is HPV-and(or)HPV 16 to 18,also don't after TCT detection biopsy under colposcope directly.While the control group in cell DNA quantitative analysis also has carried on the TCT detection,when the two results are all positive or TCT result positive:biopsy under colposcope.If a single cell DNA quantitative analysis of the positive may continue to follow-up.Compare the two plans to detect the positive rate.Results:Of 55 CIN III patients who underwent HPV typing test before operation,52(94.5%)were infected with HPV.Hpv infection subtypes mainly include:HPV-16,HPV-18,HPV-31,HPV-33,HPV-52,HPV-58,HPV-66,HPV-81.Among them,27 cases(51.92%)were infected with HPV-16,followed by 6 cases(11.54%)with HPV-52.Hpv-66,HPV-81 type accounted for the least,were 1.92%.All the patients were divided into 4 groups according to age,5 patients(9.62%)were infected with HPV,21 patients(40.38%)were infected with HPV between 30 and 39 years old,and 17 patients(32.69%)were infected with HPV between 40 and 49 years old.5 cases(9.62%)were infected with HPV aged 50 years and over.Among them,the single HPV infection was mainly 30-39 years old,a total of 22 cases,accounting for 42.31%of the total number of infection,and multiple HPV infection patients mainly concentrated in 40?49 years old,accounting for 7.69%of the total number of infection.After single factor logistic regression analysis,age,menarche,menopause,number of pregnancies,number of births,smoking,drinking,family history of tumor,educational level,gland(C2 values:0.176,0.289,0.001,0.904,0.676,-,1,533,2.272,2,075,0.074,p>0.05),there was no statistical significance,indicating that it had no correlation with HPV after operation.The value of C2 was 14.03 and 20.935 respectively.P values were less than 0.05),the difference was statistically significant,indicating that postoperative sexual life and cutting edge and HPV negative after surgery.The results of logistic regression analysis showed that the sexual life and cutting margin(or value:0.160,0.088;95%ci:2.7%94.3%,1.7%?45.3%,p<0.05),the difference was statistically significant,indicating that postoperative sexual life and cutting edge can be used as an independent influencing factor of HPV negative after surgery,and shows that patients with positive sexual life and cutting edge after surgery HPV negative.After 6 months of follow-up,the results of the two groups were compared and analyzed:HPV typing test in the experimental group was better than quantitative analysis of cell DNA in early prediction of cervical lesions.Conclusion(s):Hpv infection was detected in most of CINIII patients,and HPV-16 was the most common type of HPV infection,followed by HPV-52.Single HPV infection is more common in the 30?49 age group,multiple HPV infection is more common in the 40?49 age group;The negative rate of HPV was 65.38%3 months after operation,which indicated that cervical cold knife conization could promote the removal rate of HPV.The most common subtype of HPV was HPV-58.Patients with positive sexual life and margin were not easy to turn negative after operation.Hpv typing can guide the postoperative follow-up of CINIII patients to a certain extent.