Comparative analysis of preoperative and postoperative HPV infection dynamics in patients with cervical intraepithelial neoplasia and cervical cancer: implications for screening and management

宫颈上皮内瘤变和宫颈癌患者术前术后HPV感染动态的比较分析:对筛查和管理的启示

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Abstract

BACKGROUND: Human papillomavirus (HPV) transmission poses significant health risks, particularly in women. This study aims to detail the prevalence and characteristics of HPV infections both before and after surgical treatment in patients with cervical intraepithelial neoplasia (CIN) and cervical cancer. METHODS: We recruited 370 patients diagnosed with CIN or cervical cancer. The study first assessed the overall prevalence of preoperative HPV infections, analyzing variations across different age groups and histological diagnoses. We then investigated the relationships between postoperative HPV positivity rates and various factors including age, histological diagnoses, HPV genotypes, and the presence of multiple HPV infections. A comparative analysis was also conducted to observe the dynamics of HPV infections before and after cervical operations. RESULTS: An overall HPV positivity rate of 97.0% was observed in patients diagnosed with CIN or cervical cancer, with HPV16, HPV52, HPV58, HPV33, HPV51, and HPV18 being the most prevalent genotypes. The distribution of HPV infection varied significantly by age and histological diagnosis. Notably, the prevalence of HPV16 showed significant differences across age and histological diagnoses groups. Among the 282 patients who underwent surgical treatment, 40.1% remained HPV positive postoperatively, with those aged ≥ 60 years and those with multiple HPV infections showing higher rates of postoperative HPV positivity. CONCLUSIONS: The findings confirm the strong association between high-risk HPV infection and the development of CIN and cervical cancer. They also highlight the need for tailored approaches in the postoperative management of HPV to prevent recurrence, offering new insights for improving screening and treatment strategies.

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