Is surgical plume developing during routine LEEPs contaminated with high-risk HPV? A pilot series of experiments
Is surgical plume developing during routine LEEPs contaminated with high-risk HPV? A pilot series of experiments
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DOI：
10.1007/s00404-017-4615-2
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发表时间：
2018-02-01
影响因子：
2.6
通讯作者：
Beyer, Daniel A.
中科院分区：
文献类型：
--
作者：
Neumann, Kay;Cavalar, Markus;Beyer, Daniel A.
越来越多的证据表明，高危人类乳头瘤病毒（HPV）感染在头颈癌的发展中起着因果作用。最近的一份病例报告显示，两名患者患有扁桃体癌，除了他们作为妇科医生进行激光消融和环形电切除术（LEEP）外，没有任何危险因素。本调查的目的是评估是否手术羽造成的常规LEEPs的子宫颈HSIL的可能与高危HPV的DNA污染。前瞻性试点研究是在德国吕贝克大学妇产科。主要结局定义为宫颈HSIL LEEP导致的切除锥和手术羽中的HPV亚型。使用Whatman FTA洗脱指示卡分析LEEP产生的烟羽，该指示卡放置在用于去除产生的气溶胶的排气抽吸装置的管中。为了检测HPV及其亚型分析，进行了新型EUROArray HPV检测。分别对LEEPs的切除锥进行HPV亚型评估。常规LEEPs产生的4个手术羽流样本表明被高危HPV污染，并显示与切除锥中鉴定的HPV亚型相同。宫颈HSIL的常规LEEPs产生的手术羽流具有被高危HPV污染的风险。有必要对手术羽流的感染性进行进一步调查，以评估对相关医疗保健专业人员的潜在危害。
Growing evidence shows a causal role of high-risk humane papillomavirus (HPV) infections in the development of head and neck cancer. A recent case report shows two patients suffering from tonsillar cancer without any risk factors apart from their work as gynecologists doing laser ablations and loop electrosurgical excision procedures (LEEP). The aim of the present investigation is to evaluate whether surgical plume resulting from routine LEEPs of HSIL of the cervix uteri might be contaminated with the DNA of high-risk HPV.The prospective pilot study is done at the Department of Gynecology and Obstetrics of the University of Lubeck, Germany. The primary outcome was defined as HPV subtype in resected cone and in surgical plume resulting from LEEPs of HSIL of the cervix uteri. Plume resulting from LEEPs was analyzed using a Whatman FTA Elute Indicating Card which was placed in the tube of an exhaust suction device used to remove the resulting aerosols. For detection of HPV and analysis of its subtype, the novel EUROArray HPV test was performed. Resected cones of LEEPs were evaluated separately for HPV subtypes.Four samples of surgical plume resulting from routine LEEPs indicated contamination with high-risk HPV and showed the same HPV subtype as identified in the resected cones.Surgical plume resulting from routine LEEPs for HSIL of the cervix uteri has the risk of contamination with high-risk HPV. Further investigations of infectiousness of surgical plume are necessary for evaluation of potential hazards to involved healthcare professionals.