Analysis Of The Related Factors Of Residual Or Recurrent Lesion And HPV Persistent Infection In Patients With Cervical Squamous Intraepithellal Lesion After Surgery

BACKGROUNDCervical cancer is one of the most common malignant tumors of the female reproductive system.Cervical squamous intraepithelial lesion is a precancerous lesion of cervical cancer.Accurate and standardized treatment is the most effective way to prevent cervical cancer.Cervical conization is currently the most important method for the diagnosis and treatment of cervical squamous intraepithelial lesions.However,the positive rate of the margin after cervical conization is about 10.8-47%,and about 30%of patients still have persistent HPV infection.After cervical conization,about 5-25%of patients still have residual disease or relapse.Patients with cervical lesions after treatment are five times more likely to develop cervical cancer than the general population.OBJECTIVETo investigate the high-grade squamous intraepithelial lesion patients with positive cervical margin after CKC,residual/recurrence of postoperative lesions and persistent HPV infection The situation and related clinical factors provide a theoretical basis for improving the postoperative follow-up mode of patients.METHODSThe clinical data of 785 patients who underwent cervical cold knife cone resection for cervical high-grade intraepithelial lesions at Henan Provincial People’s Hospital from September 2017 to December 2018 were retrospectively analyzed.The clinical data collected through the outpatient or inpatient medical record system and telephone follow-up include:name,age,history of pregnancy and birth,menopausal age,previous history(with or without comorbidities),vaginitis,type of HPV infection before surgery,preoperative HPV E6E7,postoperative pathological grade,whether glandular involvement was involved,postoperative pathological margin,etc.were followed up at 3 months,6 months,and 12 months,respectively.Follow-up includes HPV,TCT,colposcopy and cervical biopsy if necessary.Univariate and multifactorial analyses were used to determine whether the positive margin of the cervix,residual or recurrence after surgery,and persistent HPV infection were related to age,maternal history,age at menopause,previous history(with or without comorbidities),vaginitis,preoperative HPV infection type,preoperative HPVE6E7,postoperative pathological grade,whether glandular involvement,postoperative pathological margin,etc.RESULTSA total of 785 patients were included in this study,of which 32 cases were positive.Among them,768 cases were followed up for 3 months,764 cases were followed up for 6 months,and 762 cases were followed up for 12 months.A total of 59 patients had residual or relapsed postoperatively,and a total of 223 patients had persistent HPV infection.A univariate analysis was used to find that the positive margin of the postoperative incision in HSIL patients was significantly related to the patient’s age,menopause,and preoperative HPV classification,and was related to the presence or absence of comorbidities,vaginitis,number of pregnancies,parities,and preoperative levels.Whether there is HPV infection,E6E7,etc.is irrelevant.The residual or recurrence of postoperative lesions is significantly related to the patient’s age,menopause,postoperative pathological grade,postoperative pathologic margin,postoperative HPV persistent infection,and other factors,and is related to the presence of comorbidities,vaginitis,and the number of pregnancy.,Parity,preoperative HPV infection,preoperative HPV infection classification,E6E7 conditions have nothing to do.Postoperative HPV infection is significantly related to factors such as age,menopausal status,vaginitis and parity during follow-up,and is associated with comorbidities,number of pregnancies,HPV infection before surgery,HPV infection classification before surgery,E6E7 is irrelevant.Binary logistic regression analysis was used to find that preoperative HPV16/18 extremely high-risk infection was an independent risk factor for positive postoperative resection margin in HSIL patients,and postoperative HPV infection was an independent risk factor for residual or recurrence of postoperative lesions in HSIL patients.Follow-up Vaginitis during the period was an independent risk factor for persistent HPV infection.CONCLUSIONS1、Positive postoperative resection margins in HSIL patients are significantly related to the patient’s age,menopause,and preoperative HPV classification,etc.,and are related to the presence or absence of comorbidities,vaginitis,number of pregnancies,parities,and whether preoperative HPV infection and E6E7 are not relevant.Preoperative HPV16/18 extremely high-risk infection is an independent risk factor for positive postoperative resection margin in HSIL patients.2、The residual or recurrence of postoperative lesions in HSIL patients is significantly related to the patient’s age,menopause,postoperative pathological grade,postoperative pathologic margin,postoperative HPV persistent infection and other factors,and is related to the presence of comorbidities and the presence of vagina Inflammation,number of pregnancies,parities,HPV infection before surgery,HPV infection classification before surgery,and E6E7 status were not relevant.Persistent HPV infection is an independent risk factor for residual or recurrence of postoperative lesions in HSIL patients.3、Persistent HPV infection in HSIL patients is significantly related to age,menopausal status,infection with vaginitis,parity and other factors during follow-up,and is related to comorbidities,number of pregnancy,HPV infection before surgery,and HPV before surgery.Infection classification and E6E7 status were irrelevant.Vaginitis during follow-up was an independent risk factor for persistent HPV infection after surgery.