Risk factors of persistent HPV infection after treatment for cervical complicated with vaginal intraepithelial neoplasia
Objective To evaluate the HPV prognosis after surgical treatment for cervical intraepithelial neoplasia(CIN)complicated with vaginal intraepithelial neoplasia(VaIN),and analyze the influencing factors of persistent human papillomavirus(HPV)infection 24 months after surgery.Methods Clinical data of 262 patients pathologically diagnosed with cervical high-grade squamous intraepithelial lesion(HSIL)at the Affiliated Hospital of Chengde Medical University were collected.Among them,67 cases of cervical HSIL complicated with vaginal HSIL were included in the study group,and 195 cases with only cervical HSIL were included in the control group.The clinical characteristics of the two groups and HPV negative rates at 6 months,12 months,18 months,and 24 months after surgery were analyzed.Patients in the study group were divided into negative group and persistent infection group based on whether HPV turned negative 24 months after surgery,and the risk factors of persistent HPV infection after surgery were analyzed.Results The median age of study group was 53 years.The proportion of postmenopausal patients and the rate of multiple HPV infections in study group were significantly higher than those in the control group(P＜0.05).HPV negative rates of study group at 6 months,12 months,18 months,and 24 months after surgery was 49.3％,61.2％,65.7％and 71.6％respectively,all of them lower than that of control group(P＜0.05).The persistent HPV infection rate in study group at 24 months after surgery was as high as 28.4％,univariate analysis showed that multiple HPV infections and multicentric lesions in the vagina were high-risk factors affecting persistent HPV infection after surgery(P＜0.05),however,menopausal status,whether infected with HPVI6,CIN level,and VaIN level were not correlated with postoperative persistent HPV infection(P＞0.05).Logistic regression multivariate analysis showed that multicentric vaginal lesions was independent risk factor for persistent HPV infection in patients with cervical HSIL complicated with vaginal HSIL after surgery(OR=7.157,95％CI:1.909-26.841,P=0.004).Conclusion The persistent HPV infection rate is high after surgical treatment for cervical HSIL complicated with vaginal HSIL.Multicentric vaginal lesions is independent risk factor for persistent postoperative HPV infection.Close follow-up should be conducted after surgery to detect recurrence early and handle it promptly.
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