宫颈癌治疗后继发不同程度阴道壁病变的影响因素分析OA

Objective:To explore factors influencing the development of varying de-grees of vaginal wall lesions in cervical cancer patients post-treatment,aiming to facilitate early identification of high-grade squamous intraepithelial lesions(HSIL)of the vagina.Methods:Clinical data were collected from 307 patients with post-treatment vaginal wall lesions admitted to Yunnan Cancer Hospital between January 1,2019,and December 31,2023.Patients were categorized based on pathological diagnosis into the low-grade squamous intraepithelial lesion(LSIL)and below group(≤vaginal LSIL)and the HSIL and above group(≥vaginal HSIL).Binary logistic regression models were used to analyze independent factors influencing the severity of vaginal wall lesions.ROC curves assessed the diagnostic performance of each in-dependent risk factor for vaginal HSIL and more severe lesions.Results:Multivariate binary lo-gistic regression analysis revealed that poorly differentiated tumors,HPV16 infection,and thin-layer cytology(TCT)results≥atypical squamous cells of undetermined significance(AS-CUS)were independent risk factors for postoperative occurrence of≥HSIL.HPV53 infection was typically associated with lower-grade vaginal wall lesions.ROC curve analysis demonstrated that the combined predictive model featuring low differentiation,TCT≥ASCUS,and HPV16 positivity yielded an area under the curve(AUC)of 0.827(P<0.001,95%CI:0.763～0.890),indicating significantly elevated risk of vaginal HSIL in cervical cancer patients post-treatment who concurrently possessed all three characteristics.Conclusion:Poor differentiation,HPV16 infection,and TCT≥ASCUS represent high-risk factors for the development of vaginal HSIL and invasive carcinoma following treatment in cervical cancer patients.The risk of vaginal HSIL is markedly elevated when patients concurrently exhibit all three characteristics.