Prétet Jean-Luc, Jacquard Anne-Carole, Carcopino Xavier, Monnier-Benoit Sylvain, Averous Gerlinde, Soubeyrand Benoit, Leocmach Yann, Mougin Christiane, Riethmuller Didier
EA3181, IFR133, CHU Besançon, France.
Int J Cancer. 2008 Jan 15;122(2):424-7. doi: 10.1002/ijc.23093.
High grade cervical intraepithelial neoplasia (CIN 2/3) have a high potential to progress to invasive cervical cancer (ICC). Pap testing including follow-up and treatment of CIN 2/3 is currently the best prevention of ICC, but is associated with morbidity, namely obstetrical adverse effects and psychological distress. Human papillomavirus (HPV) is universally accepted as the necessary cause of ICC. The objective of the present study was to describe the type-specific prevalence of HPV in CIN 2/3 in France and hereby to locally estimate the potential benefit of an HPV 16/18 L1 virus-like particles (VLP) vaccine. A total of 493 formalin-fixed and paraffin-embedded CIN 2/3 specimens were analyzed. Medical records were examined for patient related data. HPV were genotyped with the INNO-LiPA assay allowing the detection of 24 HPV genotypes. The overall prevalence of LiPA detectable HPV was 98%. The most prevalent genotype was HPV 16 (62%) followed by HPV 31 (15%), 33 (12%), 52 (9%), 51 (8%), 58 (7%), 35 and 18 (4%). Multiple infection with at least two different high-risk (HR) HPV genotypes was observed in 26% of all specimens including 2.6% with HPV 16 and 18 multiple infections. The present study indicates that HPV 16 is by far the most common HPV type associated with CIN 2/3 in France. With an HPV 16 and 18 prevalence of 64%, HPV 16/18 L1 VLP vaccines would be expected to significantly reduce the burden associated with the management and treatment of CIN 2/3 in France.
高级别宫颈上皮内瘤变（CIN 2/3）进展为浸润性宫颈癌（ICC）的可能性很高。目前，包括对CIN 2/3进行随访和治疗的巴氏试验是预防ICC的最佳方法，但会带来发病率，即产科不良反应和心理困扰。人乳头瘤病毒（HPV）被公认为是ICC的必要病因。本研究的目的是描述法国CIN 2/3中HPV的型别特异性流行情况，从而在当地评估HPV 16/18 L1病毒样颗粒（VLP）疫苗的潜在益处。共分析了493份福尔马林固定石蜡包埋的CIN 2/3标本。检查病历以获取患者相关数据。采用INNO-LiPA检测法对HPV进行基因分型，可检测24种HPV基因型。LiPA可检测到的HPV总体流行率为98%。最常见的基因型是HPV 16（62%），其次是HPV 31（15%）、33（12%）、52（9%）、51（8%）、58（7%）、35和18（4%）。在所有标本中，26%观察到至少两种不同高危（HR）HPV基因型的多重感染，其中HPV 16和18多重感染占2.6%。本研究表明，在法国，HPV 16是迄今为止与CIN 2/3相关的最常见HPV类型。由于HPV 16和18的流行率为64%，预计HPV 16/18 L1 VLP疫苗将显著减轻法国CIN 2/3管理和治疗相关的负担。
