目的:探讨手术治疗早期宫颈癌对人乳头瘤病毒(HPV)亚型和临床预后的影响。方法:选取2008年1月~2009年7月武汉市中心医院收治的早期宫颈癌患者88例,按随机数字表法将患者分为A组和B组,每组44例患者。采用免疫组化法对术前病理活检宫颈样本进行HPV亚型检测,检测后A组患者均在腹腔镜下行子宫和盆腔淋巴结切除术,B组采用经腹子宫和盆腔淋巴结切除术,术后复检HPV亚型。术后随访5年,统计分析治疗前后两组患者的HPV亚型和患者的复发率、转移率、5年生存率以及术后生存质量。结果:治疗前患者15种HPV亚型阳性表达率比较差异无统计学意义(P>0.05),治疗后两组15种HPV亚型的阳性表达率均显著降低,且A组各HPV亚型的阳性表达率低于B组(P<0.05)。A组患者随访5年后的生存率高于B组,复发率和转移率低于B组,差异均有统计学意义(P<0.05)。A组治疗前的FACT-Cx得分为(65.78±7.94)分,低于术后3个月、术后1、3及5年的FACT-Cx得分;B组治疗前的FACT-Cx得分为(66.48±8.24)分,低于术后3个月、术后1、3及5年的FACT-Cx得分;A组术后3个月、术后1、3及5年的FACT-Cx得分高于B组,差异均有统计学意义(P<0.05)。结论:腹腔镜下子宫和盆腔淋巴结切除术治疗早期宫颈癌可有效抑制HPV亚型表达,预防宫颈癌复发和转移,提高患者生存质量和5年生存率,值得临床推广使用。 Objective: To investigate the effect of surgical treatment of early cervical cancer on HPV subtypes and clinical prognosis. Methods: From January 2008 to July 2009 in Wuhan Central Hospital, 88 patients with early cervical cancer were selected. According to the random number table, patients were divided into group A and group B, 44 patients in each group. The HPV subtypes were detected by immunohistochemistry in preoperative pathological biopsy cervical specimens. All patients in group A underwent laparoscopic hysterectomy and pelvic lymphadenectomy, while those in group B received abdominal hysterectomy and pelvic lymphadenectomy. Check HPV subtypes. The patients were followed up for 5 years. The recurrence rate, metastasis rate, 5-year survival rate and postoperative quality of life of HPV subtypes and patients in both groups before and after treatment were statistically analyzed. Results: There was no significant difference in the positive expression rates of 15 HPV subtypes before treatment (P> 0.05). The positive rates of 15 HPV subtypes in both groups were significantly decreased after treatment The positive expression rate was lower than that in group B (P <0.05). The survival rate of group A was significantly higher than that of group B after 5 years of follow-up, and the recurrence rate and metastasis rate were lower than those of group B (P <0.05). The score of FACT-Cx in group A before treatment was (65.78 ± 7.94) points, lower than that of 3 months after surgery and 1,3 and 5 years after operation. The score of FACT-Cx in group B before treatment was ( 66.48 ± 8.24), lower than 3 months postoperatively, 1, 3 and 5 years postoperative FACT-Cx score; 3 months postoperatively in group A, 1, 3 and 5 years postoperative FACT-Cx scores were high In group B, the differences were statistically significant (P <0.05). Conclusion: Laparoscopic hysterectomy and pelvic lymphadenectomy for early cervical cancer can effectively inhibit the expression of HPV subtypes, prevent the recurrence and metastasis of cervical cancer, improve the quality of life and 5-year survival rate of patients, which is worthy of clinical promotion.