Chan P K, Chan M Y, Li W W, Chan D P, Cheung J L, Cheng A F
Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China.
J Clin Pathol. 2001 Jan;54(1):48-53. doi: 10.1136/jcp.54.1.48.
BACKGROUND/AIM: Human papillomaviruses (HPVs) are important, but not sufficient, for the development of cervical cancer. All three human beta-herpesviruses--cytomegalovirus (CMV) and human herpesviruses (HHV) types 6 and 7--have been detected in the cervix. In addition, CMV and HHV-6 can interact with HPVs in vivo. This study examined the possible role of beta-herpesviruses in cervical cancer development.
HPV, CMV, HHV-6, and HHV-7 were detected by the polymerase chain reaction using cervical scrapes taken at colposcopy from 388 women. HPV types were identified using restriction fragment length polymorphisms. Colposcopy guided biopsies were taken from abnormal areas, and the histological findings were regarded as the final diagnoses. The associations between herpesvirus infection and the degree of cervical lesion were analysed with respect to HPV status.
Of the 388 women, 51.8% had a normal cervix, 14.4% had cervical intraepithelial neoplasia grade 1 (CIN1), 8.2% had CIN2, 19.3% had CIN3, and 6.2% had invasive carcinoma. Overall, the positive rates for high, intermediate, and low risk HPVs were 18.8%, 21.4%, and 5.2%, respectively. Fifteen patients harboured HPVs for which the genotype could not be identified. Positive rates for CMV, HHV-6, and HHV-7 were 9.5%, 3.6%, and 3.4%, respectively. HPV positive patients carried a higher risk for high grade lesions (CIN2/3 or carcinoma) (odds ratio (OR), 5.24; 95% confidence interval (CI), 3.19 to 8.62; chi 2 = 51.79; p < 0.001), whereas those positive for CMV, HHV-6, or HHV-7 did not. Thirteen of 131 patients with high grade lesions had HPV/herpesvirus coinfections, but no association with the cervical lesion was noted. Furthermore, positive rates for herpesviruses among HPV negative, high/intermediate risk HPV negative, and high risk HPV negative subgroups were similarly low and without a significant association.
The ubiquitous nature of herpesviruses may pose difficulty in elucidating their pathogenic role. These results indicate that CMV, HHV-6, and HHV-7 are bystanders rather than cofactors in the oncogenesis of cervical cancer.
背景/目的：人乳头瘤病毒（HPV）对于宫颈癌的发生发展很重要，但并非唯一因素。在宫颈中已检测到所有三种人β疱疹病毒——巨细胞病毒（CMV）以及人疱疹病毒（HHV）6型和7型。此外，CMV和HHV - 6可在体内与HPV相互作用。本研究探讨了β疱疹病毒在宫颈癌发生发展中可能的作用。
采用聚合酶链反应，对388名女性在阴道镜检查时采集的宫颈刮片进行HPV、CMV、HHV - 6和HHV - 7检测。利用限制性片段长度多态性鉴定HPV类型。在阴道镜引导下从异常区域取活检组织，组织学检查结果作为最终诊断。根据HPV感染状态分析疱疹病毒感染与宫颈病变程度之间的关联。
388名女性中，51.8%宫颈正常，14.4%有1级宫颈上皮内瘤变（CIN1），8.2%有CIN2，19.3%有CIN3，6.2%有浸润癌。总体而言，高危、中危和低危HPV的阳性率分别为18.8%、21.4%和5.2%。15名患者感染的HPV无法鉴定其基因型。CMV、HHV - 6和HHV - 7的阳性率分别为9.5%、3.6%和3.4%。HPV阳性患者发生高级别病变（CIN2/3或癌）的风险更高（优势比（OR）为5.24；95%置信区间（CI）为3.19至8.62；χ2 = 51.79；p < 0.001），而CMV、HHV - 6或HHV - 7阳性的患者则不然。131名高级别病变患者中有13名存在HPV/疱疹病毒合并感染，但未发现与宫颈病变有关联。此外，HPV阴性、高危/中危HPV阴性以及高危HPV阴性亚组中疱疹病毒的阳性率同样较低，且无显著关联。
疱疹病毒的普遍存在可能使其致病作用难以阐明。这些结果表明，CMV、HHV - 6和HHV - 7在宫颈癌发生过程中是旁观者而非辅助因素。
