Department of Pathology, Hospital Universitario de Salamanca, Spain.
APMIS. 2011 Mar;119(3):204-15. doi: 10.1111/j.1600-0463.2010.02711.x. Epub 2011 Jan 25.
Cervical cancer and its precursors low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) are associated with infection by human papillomavirus (HPV), in particular HPV 16 and 18. The distribution of the HPV genotype varies with the severity of cervical disease, age and the geographic location of the patients. We report the results of a population study carried out in a region of north-western (NW) Spain aimed at determining the prevalence of single and multiple infections by 35 types of HPV using low-density microarrays for 113 cases with negative for intraepithelial lesions or malignancies; 588 with atypical squamous cells of undetermined significance (ASCUS)/LSIL; 183 with HSIL; and seven cases of squamous cell carcinomas. Of the 891 patients analysed, 50.2% had single infections and 49.8% had multiple HPV infections. In women aged below 30 years, there was a predominance of multiple infections (p = 0.027). ASCUS/LSIL was associated with multiple and HSIL with single infections (p = 0.025). We observed significant increases in the percentage of infections due to a high-risk (HR) type of HPV when the severity of the cytological lesion increased (p = 0.001). No relationship was found between greater aggressiveness in the cytological diagnosis and a higher number of HPV types involved in multiple infections. The five most frequent genotypes were HPV 16 (26.3%), 53 (18.2%), 51 (17.3%), 6 (14.8%) and 66 (13.1%). The prevalence of HPV 16, 33 and 58 increased significantly from ACUS/LSIL to HSIL and the prevalence of HPV 51, 53 and 66 decreased. HPV 16 was the only genotype that showed a significant increase in prevalence when the severity of the cytological disease increased in single infections (p = 0.0001). The implementation of bivalent prophylactic vaccination could potentially lead to prevention in 32% of the population included in the study - in at least a quarter of patients with ACUS/LSIL (26.7%), and in half of HSIL (50.2%).
宫颈癌及其前体低度鳞状上皮内病变（LSIL）和高度鳞状上皮内病变（HSIL）与人类乳头瘤病毒（HPV）感染有关，尤其是 HPV 16 和 18。HPV 基因型的分布随宫颈疾病的严重程度、年龄和患者的地理位置而变化。我们报告了在西班牙西北部（NW）进行的一项人群研究的结果，该研究旨在使用低密度微阵列确定 113 例上皮内病变或恶性肿瘤阴性、588 例非典型鳞状细胞意义不明确（ASCUS）/LSIL、183 例 HSIL 和 7 例鳞状细胞癌患者的 35 种 HPV 单一和多重感染的流行率。在分析的 891 名患者中，50.2%为单一感染，49.8%为多重 HPV 感染。在年龄低于 30 岁的女性中，多重感染更为常见（p = 0.027）。ASCUS/LSIL 与多重感染相关，HSIL 与单一感染相关（p = 0.025）。随着细胞学病变严重程度的增加，高危型（HR）HPV 的感染百分比显著增加（p = 0.001）。在更严重的细胞学诊断中，没有发现与涉及多重感染的 HPV 类型数量增加之间的关系。最常见的五种基因型是 HPV 16（26.3%）、53（18.2%）、51（17.3%）、6（14.8%）和 66（13.1%）。HPV 16、33 和 58 的流行率从 ASCUS/LSIL 到 HSIL 显著增加，而 HPV 51、53 和 66 的流行率下降。HPV 16 是在单一感染中，随着细胞学疾病严重程度的增加，流行率显著增加的唯一基因型（p = 0.0001）。实施二价预防性疫苗接种可能会导致研究中所包括人群的 32%得到预防-至少四分之一的 ASCUS/LSIL 患者（26.7%），以及一半的 HSIL 患者（50.2%）。
