Persistent HPV infection after conization of cervical intraepithelial neoplasia-- a systematic review and meta-analysis

Yueyang Zhang; Zhiwen Ni; Ting Wei; Qingsong Liu

doi:10.1186/s12905-023-02360-w

Persistent HPV infection after conization of cervical intraepithelial neoplasia-- a systematic review and meta-analysis

BMC Womens Health. 2023 May 3;23(1):216. doi: 10.1186/s12905-023-02360-w.

Authors

Yueyang Zhang^#¹, Zhiwen Ni^#², Ting Wei³, Qingsong Liu^{4

5}

Affiliations

¹ Department of Medical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, China.
² Department of Radiology, Chengdu First People's Hospital, Chengdu, China.
³ Department of Medical Laboratory, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China.
⁴ Department of Medical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, China. 35590551@qq.com.
⁵ Department of Prenatal Diagnosis, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, 1617#, Riyue Avenue, Qingyang District, 611731, Chengdu, China. 35590551@qq.com.

^# Contributed equally.

Abstract

Objective: To systematically evaluate several factors of persistent human papillomavirus (HPV) infection following conization in patients with cervical intraepithelial neoplasia (CIN).

Methods: PubMed, EMBASE and the Cochrane Library were searched from January 1, 1998 to September 10, 2021. Random-effects models for meta-analyses were used and pooled relative risks with 95% confidence intervals were reported. Literature screening, data extraction, and assessment of the risk of bias in the included studies were conducted independently by two researchers. Data analysis was performed with Stata software, version 12.0.

Results: A total of 28 studies were included in this study. Meta-analysis revealed that surgical margin and residual disease were positively correlated with persistent HPV infection after conization. Compared with patients infected with other types of HPV, CIN patients with HPV 16 had a higher persistent infection rate (OR = 1.967, 95% CI (1.232-3.140), P < 0.05).

Conclusions: CIN patients who are postmenopausal, have positive surgical margins and residual lesions, and are positive for HPV 16 are prone to persistent HPV infection after conization.

Keywords: CIN; Conization; HPV; Human papillomavirus; Persistent infection.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Conization* / adverse effects
Female
Humans
Papillomaviridae
Papillomavirus Infections*
Uterine Cervical Dysplasia*
Uterine Cervical Neoplasms*