目的探讨人乳头状瘤病毒(HPV)分型检测在高级别宫颈上皮内瘤变(CIN)患者宫颈电热圈环切术(LEEP)治疗后随访中的价值。方法 373例CINⅡ~Ⅲ级患者行LEEP治疗后第6、12、24个月均进行HPV分型、HPV-DNA检测和新柏氏液基细胞学检测(TCT),根据结果或有可疑病变者行宫颈病理活检,比较各年龄组患者术前HPV亚型感染及术后不同随访时间的HPV消除情况。结果 373例患者术前HPV感染率为95.44%;其中高危HPV感染率为91.42%,低危HPV感染率为1.88%;单一HPV亚型感染率为54.16%,双重或多重HPV亚型感染率为61.13%,多重感染最多可达4重感染。检出率排名前5位的亚型是HPV16、HPV58、HPV52、HPV18、HPV33,HPV16检出率明显高于其他各亚型,并在不同年龄组患者中均居第1位(P<0.05);低危型HPV以HPV11亚型最多见。在宫颈LEEP治疗后第6、12、24个月,HPV-DNA总转阴率分别为70.79%、81.46%和89.04%,HPV16/18亚型转阴率分别为75.65%、86.01%和93.26%,随着时间的延长,转阴率均明显升高(P<0.05);但≥50岁组患者中,术后6和12个月的HPV16/18亚型转阴率与术前比较差异无统计学意义,随着时间的延长,转阴率无明显变化(P>0.05)。各年龄组术后6个月HPV-DNA转阴率比较差异无统计学意义(P>0.05),术后12和24个月HPV-DNA转阴率组间比较差异有统计学意义,≤40岁的年轻患者有更高的转阴率(P<0.05)。各年龄组术后不同随访时间HPV16/18亚型转阴率比较差异有统计学意义,≤40岁年轻患者有更高的转阴率(P<0.05)。结论 HPV在CINⅡ~Ⅲ患者中的感染率较高,尤其是HPV16亚型。术后第6个月HPV分型检测是LEEP治疗后监测疾病转归的一种较好方法。对年龄较大,术后HPV16亚型持续感染的患者应密切长时间随访。 Objective To investigate the value of human papillomavirus (HPV) typing in the follow-up of patients with high-grade cervical intraepithelial neoplasia (CIN) treated with cervical ring electrosurgery (LEEP). Methods 373 cases of CIN Ⅱ ~ Ⅲ patients underwent LEEP treatment of HPV type 6, 12, 24 months after HPV genotyping and neo-Boer liquid-based cytology (TCT), according to the results or suspicious lesions were Cervical pathological biopsy was performed to compare the preoperative HPV subtype infection in all age groups with the elimination of HPV at different follow-up times. Results The preoperative HPV infection rate was 95.44% in 373 patients, of which the high-risk HPV infection rate was 91.42%, the low-risk HPV infection rate was 1.88%, the single HPV subtype infection rate was 54.16%, the double or multiple HPV subtype infection rate was 61.13%, multiple infections up to 4 infections. The detection rate of the top 5 subtypes was HPV16, the detection rate of HPV58, HPV52, HPV18, HPV33 and HPV16 was significantly higher than those of other subtypes, ranking the first among all age groups (P <0.05) ; Low-risk HPV HPV11 subtype most common. The total negative conversion rates of HPV-DNA were 70.79%, 81.46% and 89.04% at the 6th, 12th and 24th month after cervical LEEP treatment respectively. The negative rates of HPV16 / 18 was 75.65%, 86.01% and 93.26% , With the extension of time, the negative conversion rate was significantly increased (P <0.05); However, ≥ 50-year-old group of patients, 6 and 12 months after the HPV16 / 18 subtype conversion rate was no difference compared with preoperative Statistical significance, with the extension of time, no significant change in negative rate (P> 0.05). There was no significant difference in HPV-DNA negative rates at 6 months postoperatively among all age groups (P> 0.05). There was a significant difference in HPV-DNA negative rates at 12 and 24 months after operation Young patients have higher rates of negative conversion (P <0.05). There was significant difference in the negative conversion rate of HPV16 / 18 subtype between different age groups at different follow-up. Patients younger than 40 years old had higher negative conversion rate (P <0.05). Conclusion The infection rate of HPV in CINⅡ ~ Ⅲ patients is high, especially HPV16 subtype. HPV genotyping at the 6th month after surgery is a good way to monitor the outcome after LEEP treatment. For older, postoperative HPV16 subtype persistent infection patients should be closely followed for a long time.