Brown D R, Schroeder J M, Bryan J T, Stoler M H, Fife K H
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202-5124, USA.
J Clin Microbiol. 1999 Oct;37(10):3316-22. doi: 10.1128/JCM.37.10.3316-3322.1999.
Condylomata acuminata, or genital warts, are proliferative lesions of genital epithelium caused by human papillomavirus (HPV) infection. HPV types 6 and 11 are most often detected in these lesions. Genital lesions consistent with exophytic condylomata acuminata were removed by excision biopsy from 65 patients, 41 of whom were otherwise healthy individuals (control group) and 24 of whom had conditions known to cause immunosuppression. Histologically, the majority of the lesions were typical condylomata acuminata. Three lesions removed from immunosuppressed individuals also contained foci of moderate to severe dysplasia (intraepithelial neoplasia grade II/III). A recently developed PCR and reverse blot strip assay was used to determine the specific HPV types present in the genital lesions. With a set of oligonucleotide primers based on the same primer binding regions used for the MY09 and MY11 primer pair, this PCR assay detects the presence of 27 HPV types known to infect the genital tract. All but two condylomata acuminata contained either HPV type 6 or 11. The predominant type in the lesions from control patients was HPV 6, while lesions from immunosuppressed types most often contained HPV 11. Condylomata acuminata from immunosuppressed patients contained significantly more overall HPV types than lesions from the control group. HPV types associated with an increased risk of dysplasia (high-risk types) were detected in 42 (64.6%) of the total of 65 specimens; 18 (43.9%) specimens were detected in the 41 otherwise healthy individuals, and 24 (100%) specimens were detected in the 24 immunosuppressed patients. HPV 16 was the most common high-risk type detected, found in 21 of 65 (32.3%) specimens. After HPV types 6 and 11, HPV types 53 and 54 were the most frequently detected low-risk HPV types. This study demonstrates that a high percentage of condylomata acuminata lesions contain multiple HPV types, including types associated with a high risk of dysplastic abnormalities. Further studies are needed to determine the influence these additional HPV types have on the epidemiology of genital tract HPV infections and the natural history of condylomata acuminata, especially in immunosuppressed patients.
尖锐湿疣，又称生殖器疣，是由人乳头瘤病毒（HPV）感染引起的生殖器上皮增生性病变。在这些病变中最常检测到的HPV类型是6型和11型。对65例患者的外生性尖锐湿疣样生殖器病变进行切除活检，其中41例为健康个体（对照组），24例患有已知会导致免疫抑制的疾病。组织学上，大多数病变为典型的尖锐湿疣。从免疫抑制个体切除的3个病变中还含有中度至重度发育异常灶（上皮内瘤变II/III级）。采用最近开发的PCR和反向杂交条带分析法来确定生殖器病变中存在的特定HPV类型。基于与MY09和MY11引物对相同的引物结合区域设计的一组寡核苷酸引物，该PCR分析法可检测出已知感染生殖道的27种HPV类型。除2个尖锐湿疣外，其余均含有HPV 6型或11型。对照组患者病变中的主要类型是HPV 6型，而免疫抑制患者病变中最常含有的是HPV 11型。免疫抑制患者的尖锐湿疣所含的HPV总类型明显多于对照组病变。在65个标本中，共有42个（64.6%）检测到与发育异常风险增加相关的HPV类型（高危型）；41例健康个体中有18个（43.9%）标本检测到，24例免疫抑制患者中有24个（100%）标本检测到。HPV 16是检测到的最常见高危型，在65个标本中有21个（32.3%）检测到。在HPV 6型和11型之后，HPV 53型和54型是最常检测到的低危HPV类型。本研究表明，高比例的尖锐湿疣病变含有多种HPV类型，包括与发育异常异常高风险相关的类型。需要进一步研究以确定这些额外的HPV类型对生殖道HPV感染流行病学和尖锐湿疣自然史的影响，尤其是在免疫抑制患者中。
