宫颈鳞状上皮内病变环形电切术后HPV持续感染的相关因素分析
Analysis of Factors Associated with Persistent HPV Infection after Loop Eelectrosurgical Excision Procedure of Cervical Intraepithelial Lesions
摘要: 人乳头瘤病毒(HPV)感染是宫颈癌的主要病因，宫颈上皮内瘤变(CIN)是宫颈癌的癌前病变，可分为CIN I、CIN II和CIN III。国内对CIN II+的患者主要行手术治疗，宫颈环形电切术(Loop Eelectrosurgical Excision Procedure, LEEP)是现阶段治疗CIN的主要手段之一，应用较为广泛，在临床上取得了一定的疗效。然而依旧存在大量LEEP术后HPV依旧持续感染的问题，导致病变复发甚至进展至宫颈癌阶段，因此分析其影响因素是急需解决的问题。目前依旧有很多不确定因素，现对于已有相关研究做一篇综述。
Abstract: Human papillomavirus (HPV) infection is a major cause of cervical cancer and cervical intraepitheli-al neoplasia (CIN) is the early stage of cervical cancer. It can be divided into CIN I, CIN II and CIN III. Domestic CIN II and above patients are mainly taken for surgical treatment. Loop Eelectrosurgical Excision Procedure (LEEP) is one of the most important means to treat CIN at this stage, which is widely used and has achieved certain clinical effect. However, there are still a large number of HPV persistent infections after LEEP, which lead to disease recurrence and even progress to cervical cancer. Therefore, the analysis of the influencing factors is an urgent problem to be solved. There still have a lot of uncertain factors, thus to do a review of the existing relevant research.
文章引用：张小云, 杜蓉. 宫颈鳞状上皮内病变环形电切术后HPV持续感染的相关因素分析[J]. 临床医学进展, 2023, 13(2): 1994-1999. https://doi.org/10.12677/ACM.2023.132277

参考文献

[1] Bruni, L., Serrano, B., Mena, M., et al. (2022) Human Papillomavirus and Related Diseases in the World. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre), Spain.
https://hpvcentre.net/statistics/reports/XWX.pdf
[2] Zheng, X.D., Chen, G.Y. and Huang, S.F. (2021) Updates on Adenocarcinomas of the Uterine Corpus and the Cervix in the 5th Edition of WHO Classification of the Female Geni-tal Tumors. Chinese Journal of Pathology, 50, 437-441.
[3] 赵超, 毕蕙, 赵昀, 等. 子宫颈高级别上皮内病变管理的中国专家共识[J]. 中国妇产科临床杂志, 2022, 23(2): 220-224.
[4] 李春梅, 林琳. LEEP手术在子宫颈/阴道病变中的治疗价值新探[J]. 实用妇产科杂志, 2021, 37(12): 898-900.
[5] 林兰, 吴冬梅, 邓勇, 等. 高级别宫颈上皮内瘤变LEEP术后HPV持续感染的危险因素及预测模型构建[J]. 福建医药杂志, 2019, 41(6): 1-5.
[6] So, K.A., Lee, I.H., Kim, T.J., et al. (2019) Risk Factors of Persistent HPV Infection after Treatment for High-Grade Squa-mous Intraepithelial Lesion. Archives of Gynecology and Obstetrics, 299, 223-227. [Google Scholar] [CrossRef] [PubMed]
[7] Kim, Y.-T., Lee, J.M., Hur, S.-Y., et al. (2010) Clearance of Hu-man Papillomavirus Infection after Successful Conization in Patients with Cervical Intraepithelial Neoplasia. International Journal of Cancer, 126, 1903-1909. [Google Scholar] [CrossRef] [PubMed]
[8] Bottari, F., Iacobone, A.D., Passerini, R., et al. (2019) Human Papilloma-virus Genotyping Compared with a Qualitative High-Risk Human Papillomavirus Test after Treatment of High-Grade Cervical Intraepithelial Neoplasia: A Systematic Review. Obstetrics & Gynecology, 134, 452-462. [Google Scholar] [CrossRef] 
[9] 杨建梅, 邓慧, 朱建雯, 等. 宫颈鳞状上皮内病变患者高危型人乳头瘤病毒(HPV)转阴率的影响因素研究[J]. 中外医疗, 2018, 37(27): 33-35.
[10] Ouh, Y.-T., Cho, H.W., et al. (2020) Risk Factors for Type-Specific Persistence of High-Risk Human Papillomavirus and Residu-al/Recurrent Cervical Intraepithelial Neoplasia after Surgical Treatment. Obstetrics & Gynecology Science, 63, 631-642. [Google Scholar] [CrossRef] [PubMed]
[11] Bruno, M.T., Cassaro, N., Garofalo, S., et al. (2019) HPV16 Persistent In-fection and Recurrent Disease after LEEP. Virology Journal, 16, 148. [Google Scholar] [CrossRef] [PubMed]
[12] Petrillo, M., Dessole, M., Tinacci, E., et al. (2020) Efficacy of HPV Vaccination in Women Receiving LEEP for Cervical Dysplasia: A Single Institution’s Experience. Vaccines, 8, 45. [Google Scholar] [CrossRef] [PubMed]
[13] Ghelardi, Parazzini, Martella, et al. (2018) SPERANZA Project: HPV Vaccination after Treatment for CIN2. Gynecologic Oncology, 151, 229-234. [Google Scholar] [CrossRef] [PubMed]
[14] Byun, J.M., Jeong, D.H., Kim, Y.N., et al. (2018) Persistent HPV-16 Infection Leads to Recurrence of High-Grade Cervical Intraepithelial Neoplasia. Medicine (Baltimore), 97, e13606. [Google Scholar] [CrossRef] 
[15] 李娇, 王梦琦. 高危型HPV感染在宫颈上皮内瘤变术后的转归及相关因素分析[J]. 医药论坛杂志, 2021, 42(3): 37-44.
[16] 赵欣. 高危HPV持续感染与宫颈病变级别的关系及治疗前后的清除状况研究[J]. 中国医学创新, 2019, 16(4): 81-84.
[17] 赵昀, 魏丽惠. CSCCP关于中国宫颈癌筛查及异常管理相关问题专家共识解读[J]. 实用妇产科杂志, 2018, 34(2): 101-104.
[18] Spinillo, A., Dominoni, M. and Boschi, A.C. (2020) The Relationship of Human Papillomavirus Infection with Endocervical Glandular Involvement on Cone Specimens in Women with Cervical Intraepithelial Neoplasia. Gynecologic Oncology, 159, 630-635. [Google Scholar] [CrossRef] [PubMed]
[19] 袁静, 孟戈, 臧春逸, 等. LEEP术后持续性高危型HPV感染相关因素分析[J]. 北京医学, 2018, 40(9): 841-844.
[20] 周美华, 张莉. 子宫颈上皮内瘤变患者治疗前后高危人乳头瘤病毒感染及阴道微生态变化研究[J]. 山西医药杂志, 2019, 48(13): 1572-1575.
[21] 马向薇. 阴道微生态状况与高危型人乳头瘤病毒感染和宫颈病变间的关系[J]. 中国现代药物应用, 2021, 15(1): 62-63.
[22] 秦勤, 常淑芳, 孙江川, 等. 宫颈上皮内瘤变患者HPV感染与阴道微生态关系研究[J]. 重庆医科大学学报, 2017, 42(5): 587-590.
[23] 顾燕楠, 曾莉, 黄永彤, 等. 宫颈高危型HPV感染程度与阴道菌群、宫颈局部调节性T细胞的关系分析[J]. 中国妇产科临床杂志, 2021, 22(1): 10-13.
[24] Wiik, J., Sengpie, V., Kyrgiou, M., et al. (2019) Cervical Microbiota in Women with Cervical Intra-Epithelial Neoplasia, Prior to and after Local Excisional Treatment: A Norwegian Cohort Study. BMC Women’s Health, 19, 30. [Google Scholar] [CrossRef] [PubMed]
[25] Patrícia, P., et al. (2016) Multivariate Analysis of Risk Factors for the Persistence of High-Grade Squamous Intraepithelial Lesions Following Loop Electrosurgical Excision Procedure. In-ternational Journal of Gynecology and Obstetrics, 133, 234-237. [Google Scholar] [CrossRef] [PubMed]
[26] 周曙光, 刘波, 谢婷婷, 等. 三联药物治疗宫颈鳞状上皮内瘤变患者LEEP术后高危型HPV持续感染的效果[J]. 安徽医学, 2018, 39(3): 309-311.
[27] Cao, D., Shen, K.Y., Chen, Y., et al. (2020) Value of Endocervical Curettage in Follow-Up for Patients with Cervical Intraepithelial Neoplasia Stage 2+ after Loop Electrosurgical Excision. Gynecologic Oncology, 158, 584-589. [Google Scholar] [CrossRef] [PubMed]
[28] Zhang, L., Yang, B.L., Zhang, A., et al. (2016) Association be-tween Human Papillomavirus Type 16 E6 and E7 Variants with Subsequent Persistent Infection and Recurrence of Cer-vical High-Grade Squamous Intraepithelial Lesion after Conization. Journal of Medical Virology, 88, 1982-1988. [Google Scholar] [CrossRef] [PubMed]

为你推荐