Pathological changes of high-risk human papillomavirus-positive cervical lesions after surgery and analysis of risk...

To investigate the postoperative pathological changes and risk factors for persistent positivity of high-risk human papillomavirus (HPV) in cervical lesions.

A total of 186 female patients who underwent either outpatient and inpatient loop electrosurgical excision procedure (LEEP) or cold-knife conization for CIN II, CIN III of the cervix were included in this study. Postoperative pathological changes were analyzed, and high-risk HPV (HR-HPV) infection and persistent positivity were assessed at 3, 6, 12, and 24 months after surgery. Patient characteristics, including age, parity, endocervical glandular involvement, HPV subtypes, and type of conization, were recorded. Factors associated with persistent HR-HPV positivity after surgery were analyzed.

The concordance rate between colposcopically directed biopsy and postoperative cervical conization pathology was 77.9%, with a Kappa value of 0.537. During follow-up, persistent HPV infection was observed in 101, 83, 46, and 42 patients at postoperative 3, 6, 12, and 24 months, respectively. Logistic regression analysis identified CINIII pathology, viral load ≥1,000 copies/mL, endocervical glandular involvement, and LEEP as independent risk factors for persistent HR-HPV infection after surgery.

Patients with higher pathological grade, elevated viral load, and endocervical glandular involvement are at increased risk of persistent HR-HPV infection after surgery for cervical lesions. Postoperative cervical cancer screening should remain a priority, as some patients remain positive for HR-HPV after LEEP.