对于宫颈癌 (CC)，循环游离 HPV DNA (ccfHPV) 可以确定疾病的严重程度。此外，HPV 整合与病毒载量和存活率相关。本研究收集了139例CC病例（2018-2020年）（50例初次手术患者、22例初次手术辅助肿瘤治疗患者和67例初次肿瘤治疗患者）的治疗前血浆。此外，还收集了 25 名宫颈上皮内瘤变 3 级 (CIN3) 患者和 15 名健康女性（阴性对照）的血浆。使用两个下一代测序 (NGS) 组合来确定 ccfHPV 的存在和人乳头瘤病毒 16 型 (HPV16) 整合状态。 ccfHPV 在 4 名初次手术患者 (8.0%)、8 名初次手术辅助肿瘤患者 (36.4%) 和 54 名原发肿瘤患者 (80.6%) 中检测到。对于患有 HPV16 相关癌症的原发肿瘤患者 (n=37)，ccfHPVneg 患者的 HPV16 整合率高于 ccfHPVpos 患者 (p=0.04)，并且在 HPV16 整合的患者 (n=13) 中，ccfHPVpos 患者的疾病分期高于 ccfHPVneg患者（p=0.05）。总之，ccfHPV 的存在与疾病严重程度相关，并且可能会增加用于识别患者进行辅助肿瘤治疗的有争议的 Sedlis 标准。然而，ccfHPV检测受HPV整合状态和疾病阶段的影响，在ccfHPVneg患者中需要考虑这些因素。本文受版权保护。版权所有。

For cervical cancer (CC), circulating cell-free HPV DNA (ccfHPV) may establish disease severity. Furthermore, HPV integration has been correlated to viral load and survival. In this study, pre-treatment plasma from 139 CC cases (50 primary surgery patients, 22 primary surgery+adjuvant oncological therapy patients, and 67 primary oncological therapy patients) was collected (2018-2020). Furthermore, plasma from 25 cervical intraepithelial neoplasia grade 3 (CIN3) patients and 15 healthy women (negative controls) were collected. Two next-generation sequencing (NGS) panels were used to establish ccfHPV presence and human papillomavirus type 16 (HPV16) integration status. ccfHPV was detected in four primary surgery (8.0%), eight primary surgery+adjuvant oncology (36.4%), and 54 primary oncology (80.6%) patients. For primary oncology patients with HPV16-related cancer (n=37), more ccfHPVneg than ccfHPVpos patients had HPV16 integration (p=0.04), and, in patients with HPV16 integration (n=13), ccfHPVpos patients had higher disease stages than ccfHPVneg patients (p=0.05). In summary, ccfHPV presence is related to disease severity and may add to the debated Sedlis criteria used for identifying patients for adjuvant oncological therapy. However, ccfHPV detection is influenced by HPV integration status and disease stage, and these factors need to be considered in ccfHPVneg patients.This article is protected by copyright. All rights reserved.