Xu Yuanchun, Dotto Jorge, Hui Yiang, Lawton Kara, Schofield Kevin, Hui Pei
Department of Gynecology and Obstetrics, Beijing Aero-space General Hospital, Beijing, 100076, P. R. China.
Int J Clin Exp Pathol. 2009;2(2):169-75. Epub 2008 Jul 25.
High-risk human papillomavirus (HR-HPV) is recognized as the primary cause for the development of cervical cancers and their precursor lesions. We investigated whether high-grade cervical dysplasia correlates with high viral load of HR-HPV in an age-dependent manner. Cases were retrospectively selected to include patients with a prior cytological diagnosis of ASCUS or higher grade squamous intraepithelial lesions, and a positive Digene Hybrid Capture II (HC-II) HR-HPV testing within 2 months before or after cervical biopsy. The quantitative viral load data was classified as negative, low, moderate and high according to the manufacturer's instruction. Cases were then stratified into 4 age groups: </=22 years, 23-30 years, 31-40 years and >40 years. Chi-Square analysis and logistic regression were performed where appropriate. A total of 995 patients were identified. Age categories were significantly associated with HPV loads (p=0.046). Moderate to high viral loads of HPV were significantly related to the histological grade of dysplasia (p=0.029). Logistic regression analysis further confirmed the association of HPV with histological grades, even after adjusting for age factor. In particular, high-grade dysplasia (p=0.011) but not low grade dysplasia (p=0.140) was significantly associated with moderate to high HPV loads. Patients of 22 years old or younger were the only group found significantly correlated with high viral loads of HPV (p=0.015). In conclusion, high-grade squamous intraepithelial lesions and patients' age of 22 years old or younger are significantly associated with a moderate to high viral load of HR-HPV.
高危型人乳头瘤病毒(HR-HPV)被认为是宫颈癌及其癌前病变发生的主要原因。我们研究了高级别宫颈发育异常是否与HR-HPV的高病毒载量存在年龄依赖性关联。回顾性选取病例,纳入先前细胞学诊断为非典型鳞状细胞(ASCUS)或更高级别鳞状上皮内病变,且在宫颈活检前或后2个月内Digene杂交捕获二代(HC-II)HR-HPV检测呈阳性的患者。根据制造商的说明,将定量病毒载量数据分为阴性、低、中、高四类。然后将病例分为4个年龄组:≤22岁、23 - 30岁、31 - 40岁和>40岁。在适当情况下进行卡方分析和逻辑回归。共确定了995例患者。年龄类别与HPV载量显著相关(p = 0.046)。HPV的中高病毒载量与发育异常的组织学分级显著相关(p = 0.029)。逻辑回归分析进一步证实了HPV与组织学分级的关联,即使在调整年龄因素后也是如此。特别是,高级别发育异常(p = 0.011)而非低级别发育异常(p = 0.140)与HPV的中高病毒载量显著相关。22岁及以下的患者是唯一与HPV高病毒载量显著相关的组(p = 0.015)。总之,高级别鳞状上皮内病变和22岁及以下的患者与HR-HPV的中高病毒载量显著相关。