Krambeck W M, Cadidé R M, Dalmarco E M, de Cordova C M M
Faculty of Medicine, Universidade Regional de Blumenau, Blumenau-SC, Brazil.
Clin Exp Obstet Gynecol. 2008;35(3):175-8.
Human papillomavirus (HPV) infection is the leading risk factor for cervical intraepithelial neoplasia (CIN) and cervical cancer. More than 100 virus genotypes have been identified so far, some of them strongly associated with the development of neoplasia. The aim of this study was to evaluate the prevalence of the different HPV genotypes in women presenting no cytological alterations in cervical cells, in women presenting light alterations, and in women presenting severe alterations at routine gynecological examination. We retrospectively analyzed 97 HPV results of women submitted to cervical cancer screening compared to their Papanicolaou and colposcopy examinations. Data were analyzed individually and within groups to correlate the HPV genotypes identified by polymerase chain reaction (PCR) and the respective alterations in cervical cells. Among the nine cases diagnosed as CIN I (9.3%), two were positive for low-risk HPV genotypes (22%), and the other seven were negative for HPV by PCR (78%). CIN II or CIN III diagnoses were associated with positive HPV results by PCR in four cases (36%), for high-risk as well as low-risk genotypes. There were two patients with severe cytological alterations in cervical cells, but with an indeterminate HPV genotype (18%), and one case with a negative HPV result (9%). Among the 57 cases without cytological alterations, seven were positive for low-risk HPV (12%) and two for high-risk HPV genotypes (3.5%). In the 48 remaining cases, we observed one with an indeterminate HPV genotype (2%), and the other 47 were negative for HPV by PCR (47%). Our study demonstrates an important prevalence of high- and low-risk HPV genotypes in our population, including those not present in the commercially available vaccine, even in patients with no evidence of cytological alterations in cervical cells. These results highlight the usefulness of HPV detection and typing as an early approach for cervical cancer screening and prevention.
人乳头瘤病毒（HPV）感染是宫颈上皮内瘤变（CIN）和宫颈癌的主要危险因素。迄今为止已鉴定出100多种病毒基因型，其中一些与瘤变的发生密切相关。本研究的目的是评估在常规妇科检查中宫颈细胞无细胞学改变的女性、有轻度改变的女性和有重度改变的女性中不同HPV基因型的流行情况。我们回顾性分析了97名接受宫颈癌筛查的女性的HPV检测结果，并与她们的巴氏涂片和阴道镜检查结果进行对比。对数据进行单独分析和分组分析，以关联通过聚合酶链反应（PCR）鉴定的HPV基因型与宫颈细胞的相应改变。在诊断为CIN I的9例病例中（9.3%），2例低风险HPV基因型呈阳性（22%），另外7例PCR检测HPV呈阴性（78%）。4例（36%）CIN II或CIN III诊断与PCR检测HPV阳性结果相关，包括高风险和低风险基因型。有2例宫颈细胞有严重细胞学改变，但HPV基因型不确定（18%），1例HPV检测结果为阴性（9%）。在57例无细胞学改变的病例中，7例低风险HPV呈阳性（12%），2例高风险HPV基因型呈阳性（3.5%）。在其余48例病例中，我们观察到1例HPV基因型不确定（2%），另外47例PCR检测HPV呈阴性（47%）。我们的研究表明，在我们的人群中，高风险和低风险HPV基因型有重要的流行情况，包括那些不在市售疫苗中的基因型，即使在宫颈细胞无细胞学改变证据的患者中也是如此。这些结果突出了HPV检测和分型作为宫颈癌筛查和预防早期方法的有用性。
