Palmisano Melanie E, Gaffga Ann M, Daigle Jennifer, Brinkman Joeli, Mire Kristina, Lenczyk Karen, Martin David H, Hagensee Michael E
Department of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, 1542 Tulane Ave, LA 70112, USA.
Int J STD AIDS. 2003 Aug;14(8):560-7. doi: 10.1258/095646203767869183.
The primary risk factor for cervical cancer is infection with high-risk genotypes of human papillomavirus (HPV). This study compared HPV DNA detection between cervical swabs (CX) and self-administered vaginal swabs (SV). Phase I participants were 199 women chosen from a study comparing the detection of Chlamydia trachomatis from various anogenital sites. Phase II participants were 135 women from either the Colposcopy or HIV Outpatient Clinic. HPV DNA testing was performed using polymerase chain reaction and Roche reverse line blot hybridization. In Phase I samples, more CX samples amplified and more HPV genotypes (P < 0.05) were detected in CX. Genotype 52 were seen more in the cervix, whereas genotype 82 (MM4) was detected solely in the vagina. The presence of high-risk HPV genotypes in the cervix was a predictor of an abnormal Papanicolaou (Pap) smear. In Phase II samples, CX samples amplified more, but similar rates of HPV genotypes were seen in SV and CX samples. Higher concordance rates of high-risk genotypes were seen in Phase II compared to Phase I samples. Phase II demonstrated the feasibility of utilizing SV sampling to reflect cervical status. If validated, a self-vaginal swab method to detect cervical HPV DNA status could be utilized to triage women with indeterminate Pap smears and be a useful method to collect epidemiological data from large populations.
宫颈癌的主要危险因素是感染高危基因型的人乳头瘤病毒（HPV）。本研究比较了宫颈拭子（CX）和自行采集的阴道拭子（SV）之间的HPV DNA检测情况。第一阶段的参与者是从一项比较不同肛门生殖器部位沙眼衣原体检测的研究中选取的199名女性。第二阶段的参与者是来自阴道镜检查门诊或HIV门诊的135名女性。使用聚合酶链反应和罗氏反向线印迹杂交进行HPV DNA检测。在第一阶段的样本中，CX样本扩增更多，且在CX中检测到更多的HPV基因型（P<0.05）。52型在宫颈中更常见，而82型（MM4）仅在阴道中检测到。宫颈中高危HPV基因型的存在是巴氏涂片异常的一个预测指标。在第二阶段的样本中，CX样本扩增更多，但在SV和CX样本中观察到的HPV基因型比例相似。与第一阶段的样本相比，第二阶段高危基因型的一致性率更高。第二阶段证明了利用SV采样反映宫颈状况的可行性。如果得到验证，一种自行采集阴道拭子检测宫颈HPV DNA状态的方法可用于对巴氏涂片结果不确定的女性进行分流，并且是从大量人群中收集流行病学数据的有用方法。
