| ObjectiveScreening of HR-HPV infections in opportunistically screened female patients,analysis of postoperative HR-HPV outcome,recurrence,and influencing factors in patients with different cervical lesions,and further investigation of factors associated with postoperative recurrence in patients with cervical lesions,HR-HPV continuous positive and SCC-Ag positive in predicting postoperative recurrence of cervical cancer provides a theoretical basis for cervical cancer screening,postoperative follow-up of cervical lesions,and early warning the recurrence.MethodsA total of 17,989 female patients with concurrent HR-HPV testing were collected from January 2012 to December 2016 for various reasons in our hospital.Of these,15,898 were normal cervical,718 were CIN ?-?,and 620 were CIN ?.662 cases of cervical cancer were retrospectively analyzed.Surgical treatment and regular follow-up of patients with HR-HPV were performed.Case data of cervical cancer and CIN patients meeting the requirements were screened according to the corresponding exclusion criteria.Analyzing opportunistic Screening in our hospital Relationship between HR-HPV infection and age,cervical lesions,HR-HPV infection and viral load.And analyzing the relationship between HR-HPV negative and age,surgical methods,and preoperative viral load after different cervical lesions.And analyzing correlation of postoperative recurrence of different cervical lesions with persistent positive HR-HPV,surgical methods,preoperative viral load and other factors.And analyzing single detection of HPV,SCC-Ag and their combined detection in the prediction of cervical cancer differences in sensitivity,specificity,positive predictive value,and negative predictive value of postoperative recurrence.Results1.The overall rate of HR-HPV infection in female patients with opportunistic screening in our hospital was 30.9%.The infection rate had two peaks,which were in the ?20 years old,>60 years old age groups,and were consistent with the distribution of high viral load age groups(P <0.05);cervical lesions were positively correlated with HR-HPV infection rate(r=1,P<0.05).The higher the lesions,the higher the HR-HPV infection rate,but there was no significant correlation with the viral load(r = 0.231,P>0.05);There was a significant difference in HR-HPV infection rate and viral load between different types of cervical cancer patients(P < 0.05).The squamous cell carcinoma had the highest HPV infection rate and viral load(P <0.05).2.The conversion rate of HR-HPV in patients with cervical cancer was related to age and extent of tumor invasion(P<0.05).The older the tumor,the wider the tumor infiltration and the lower the negative rate of HPV at each time point(P<0.05).There was no significant correlation between HPV negative rate and stage,viral load,surgical methods,postoperative therapy,and lymph node metastasis(P>0.05).For those CIN patients,HPV negative rate was negatively correlated with age.The older the age,the lower the negative rate of HPV at each time point after detection(P<0.05);however,there was no significant correlation with the surgical method and viral load(P>0.05).3.The recurrence of cervical cancer patients was associated with persistent positive HPV and lymph node metastasis(P<0.05).There was no significant correlation between the recurrence of cervical cancer and the stage,viral load,surgical method,tumor infiltration range and postoperative therapy(P>0.05).The recurrence of CIN was associated with persistent positive HPV and surgical methods(P <0.05)and no significant correlation with viral load(P> 0.05).4.The positive rate of HR-HPV and positive rate of SCC-Ag in patients with recurrent cervical cancer were significantly higher than those without recurrence(P<0.05).The positive rate of HR-HPV in pelvic recurrence group was higher than that in distant metastasis group(P<0.05).The positive rate of SCC-Ag was not statistically different between the two groups(P>0.05).The sensitivities of HR-HPV,SCC-Ag and combined detection alone in predicting cervical cancer recurrence were 57.9%,39.5%,and 76.3%.The specificity was 90.8%,95.1%,and 83.7%.Compared with HR-HPV and SCC-Ag alone,the combined sensitivity was higher(P<0.05)and the specificity was lower(P<0.05);There was no significant difference between the positive predictive value and the negative predictive value between the detection methods(P>0.05).Conclusions1.The overall infection rate of women in our hospital for HR-HPV examination was 30.9%,which was higher than that in other regions of China.The two infections and viral loads were in the ?20 and >60 age groups.Cervical cancer screening should be strengthened;HR-HPV infection rate is positively correlated with cervical lesions.2.The negative rate of HR-HPV negative conversion in patients with cervical cancer was negatively correlated with age and tumor invasion.The older the tumor,the wider the range of tumor invasion and the lower the negative rate of HR-HPV,suggesting a wide range of age and tumor invasion.For patients,follow-up HR-HPV should be followed more closely;the negative rate of HR-HPV turnover after CIN is negatively correlated with age.The older patients with CIN should follow HR-HPV more closely.3.Postoperative recurrence of cervical cancer is associated with persistent positive HR-HPV and lymph node metastasis.Patients with lymph node metastasis and persistent positive HR-HPV are more likely to have recurrence,and follow-up should be strengthened;recurrence after CIN is associated with persistent positive HR-HPV and surgical methods,CIN patients with persistent positive HR-HPV need to be alert to the recurrence of CIN.4.Sustained positive HR-HPV and positive SCC-Ag can predict postoperative recurrence of cervical cancer to a certain extent.Among them,HR-HPV has certain early warning significance for localized recurrence,but individual detection has certain limitations,and joint detection can be used to improve sensitivity. |
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