Ding Dah-Ching, Hsu Han-Chuan, Huang Rui-Lan, Lai Hung-Cheng, Lin Ching-Yu, Yu Mu-Hsien, Chu Tang-Yuan
Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan.
Eur J Obstet Gynecol Reprod Biol. 2008 Oct;140(2):245-51. doi: 10.1016/j.ejogrb.2008.03.014. Epub 2008 May 27.
The distributional trend of different types of human papillomavirus (HPV) along the spectrum of cervical diseases from non-neoplastic HPV infection (Normal), cervical intraepithelial neoplasia 1 (CIN1), cervical intraepithelial neoplasia 2/3 (CIN2/3) to invasive cancer (CC) reflects the transformation potential of each HPV type.
Type-specific distribution of HPV in four hospital- and population-based HPV surveys in Taiwan was analyzed.
Among the 1605 (out of 6356) women positive for HPV, the prevalence of HPV infection in Normal, CIN1, CIN2/3, and CC was 10%, 60%, 70%, and 86%, respectively. The order of type-specific prevalence was HPV 52 (20.9%), HPV 16 (16.9%), HPV 58 (9.0%), and HPV 18 (8.5%) in Normal; HPV 52 (16.5%), HPV 16 (10.2%), HPV 51 (8.4%), and HPV 58 (6.5%) in CIN1; HPV 16 (29.8%), HPV 52 (17.1%), HPV 58 (16.4%), and HPV 33 (10.3%) in CIN2/3; and HPV 16 (50.7%), HPV 18 (11.9%), HPV 58 (10.1%), and HPV 33 (8.4%) in CC. We compared the step-wise distributional changes of five major HPV types along the spectrum of cervical neoplasia. The CIN1 vs. Normal distributional ratio of each HPV type varied from 0.41 to 0.97, indicating a relatively similar chance of giving rise to CIN1. In the CIN2/3 vs. CIN1 and CC vs. CIN2/3 comparisons, the distributional changes varied dramatically among different HPV types. Upon progression to CIN2/3, the distributional proportions of HPV 16, 33, and 58 became 2.1- to 5.4-fold higher, and that of HPV 18 became 0.3- to 0.5-fold lower than their CIN1 and normal counterparts. In the CC vs. CIN2/3 comparison, the change in distributional proportion was highest in HPV 18 (5.7-fold), followed by HPV 16 (1.7-fold), HPV 33 (0.8-fold), HPV 58 (0.6-fold), and HPV 52 (0.18-fold).
The distribution-defined progression from subclinical infection to CC was highest for HPV 16, followed by HPV 33, 18, 58, and 52. The differential disease progression potential of different HPV types reflects their transformational capability at different steps of cervical carcinogenesis and warrants the clinical attention of HPV infection type specifically.
不同类型的人乳头瘤病毒（HPV）在从非肿瘤性HPV感染（正常）、宫颈上皮内瘤变1级（CIN1）、宫颈上皮内瘤变2/3级（CIN2/3）到浸润癌（CC）的宫颈疾病谱中的分布趋势反映了每种HPV类型的转化潜力。
分析了台湾四项基于医院和人群的HPV调查中HPV的型别特异性分布。
在6356名女性中，1605名HPV检测呈阳性。HPV在正常、CIN1、CIN2/3和CC中的感染率分别为10%、60%、70%和86%。型别特异性感染率排序如下：在正常组中，HPV 52（20.9%）、HPV 16（16.9%）、HPV 58（9.0%）和HPV 18（8.5%）；在CIN1组中，HPV 52（16.5%）、HPV 16（10.2%）、HPV 51（8.4%）和HPV 58（6.5%）；在CIN2/3组中，HPV 16（29.8%）、HPV 52（17.1%）、HPV 58（16.4%）和HPV 33（10.3%）；在CC组中，HPV 16（50.7%）、HPV 18（11.9%）、HPV 58（10.1%）和HPV 33（8.4%）。我们比较了五种主要HPV类型在宫颈肿瘤谱中的逐步分布变化。每种HPV类型的CIN1与正常分布比率在0.41至0.97之间，表明产生CIN1的可能性相对相似。在CIN2/3与CIN1以及CC与CIN2/3的比较中，不同HPV类型之间的分布变化差异很大。进展到CIN2/3时，HPV 16、33和58的分布比例比其在CIN1和正常组中的对应比例高出2.1至5.4倍，而HPV 18的分布比例比其在CIN1和正常组中的对应比例低0.3至0.5倍。在CC与CIN2/3的比较中，分布比例变化最高的是HPV 18（5.7倍），其次是HPV 16（1.7倍）、HPV 33（0.8倍）、HPV 58（0.6倍）和HPV 52（0.18倍）。
从亚临床感染到CC的分布定义进展中，HPV 16最高，其次是HPV 33、18、58和52。不同HPV类型的疾病进展潜力差异反映了它们在宫颈癌发生不同阶段的转化能力，值得临床特别关注HPV感染类型。
