Effect of prophylactic HPV vaccine on cervical lesion outcomes after LEEP
Objective To investigate the effect of prophylactic HPV vaccine on the postoperative prognosis of patients treated with LEEP for cervical lesions.Method Retrospective analysis of clinical data of patients who underwent cervical LEEP treatment in the Gynecology Department of the First Affiliated Hospital of Nanjing Medical University from January 2018 to August 2021 and were followed up for≥12 months,and divided them into vaccine group(111 cases)and control group(281 cases)according to whether they were vaccinated with prophylactic HPV vaccine.Compared the preoperative and postoperative clinical data,as well as the incidence of cervical and vaginal lesions between two groups of patients after surgery.Analyzed the impact of vaccination time and type on cervical lesion recurrence,and compared the postoperative HPV positive rate and TCT abnormal rate between the two groups of patients.Results There was no significant difference in the preoperative general information and postoperative pathological data between the two groups(P>0.05).After 12 months of follow-up,it was found that 3 patients(2.7%)in the vaccine group and 29 patients(10.3%)in the control group experienced recurrence of cervical lesions after LEEP surgery,respectively.Vaccination reduced the risk of recurrence of cervical lesions by about 73.8%(95%CI:43.5%-91.1%),and the difference was statistically significant(P<0.05).Vaccination with different types of vaccines showed statistical differences in reducing postoperative HPV positivity rate(P<0.05).Univariate analysis showed that,vaccination was a protective factor against recurrence of cervical lesions after LEEP surgery(OR =0.241,95%CI:0.072-0.809).Only analyzing the results of postoperative CIN2+ recurrence showed statistically significant differences(P<0.05).Preoperative vaccination of LEEP could reduce the risk of recurrence of cervical lesions compared to postoperative vaccination and reduce postoperative HPV infection and TCT abnormality rate,but the difference was not statistically significant(P>0.05).The difference of HPV positive rate after different vaccine types was statisitically significant(P<0.05),there was no significant difference in the recurrence of lesions and the abornal rate of TCT after operation(P>0.05).Vaccination can significantly reduce the HPV positive rate and TCT abnormal rate of patients undergoing LEEP surgery at the first screening 6 months after surgery,and the differences were statistically significant(P<0.05).Conclusions Timely vaccination with prophylactic HPV vaccine can significantly reduce the risk of cervical lesion recurrence in patients after LEEP and the positive rate of HPV and the abnormal rate of TCT after LEEP,the preoperative vaccination may benefit patients more significantly than postoperative vaccination,but there is no significant difference between different vaccine types in preventing recurrence of cervical lesions.
万方数据
维普
