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高级别宫颈上皮内瘤变与高危型人乳头瘤病毒病毒载量:22岁及以下患者中的显著相关性

High grade cervical intraepithelial neoplasia and viral load of high-risk human papillomavirus: significant correlations in patients of 22 years old or younger.

作者信息

Xu Yuanchun, Dotto Jorge, Hui Yiang, Lawton Kara, Schofield Kevin, Hui Pei

机构信息

Department of Gynecology and Obstetrics, Beijing Aero-space General Hospital, Beijing, 100076, P. R. China.

出版信息

Int J Clin Exp Pathol. 2009;2(2):169-75. Epub 2008 Jul 25.

Abstract

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.

摘要

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。

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