Kataja V, Syrjänen K, Syrjänen S, Mäntyjärvi R, Yliskoski M, Saarikoski S, Salonen J T
Kuopio Cancer Research Centre, Finland.
Eur J Epidemiol. 1990 Mar;6(1):9-14. doi: 10.1007/BF00155542.
A series of 532 women with genital HPV infections has been prospectively followed-up without treatment since 1981 for a mean of 50 (+/-21) months. The patients were examined at six month intervals by colposcopy, PAP smears and/or biopsy. HPV typing of all biopsies was completed using in situ, Southern blot and/or sandwich hybridization with DNA probes for types 6, 11, 16, 18, 31 and 33. Survival data analysis was applied to analyse the clinical course (i.e. spontaneous regression and progression) of the HPV lesions stratified by their HPV type, currently available for 458 women. Clinical progression was significantly related to the HPV type present in the lesions. The progression rate was 11.1% (6/54) for HPV 6 lesions, 14.3% (8/56) for HPV 11, 35.2% (32/91) for HPV 16, 12.5% (4/32) for HPV 18, 18.8% (6/32) for HPV 31, 19.4% (6/31) for HPV 33 and 28.6% (4/14) for doubly infected lesions. The lowest progression rate, 6.1% (9/148), was found in lesions which remained constantly HPV DNA-negative. In the survival analysis the probability of progression varied significantly between the six HPV types (p = 0.0005, overall). After grouping the viral types as HPV 6/11 ('low risk'), HPV 16/18 ('high risk') and HPV 31/33 ('intermediate risk') the overall probability of progression remained significantly different (p = 0.0035, overall). In clinical regression, however, the HPV type was not an equally good predictor (p = 0.1952, overall). Within groups HPV 6/11, 16/18 and 31/33 the differences were even less significant (p = 0.4759, overall). In the pairwise comparison significant differences in progression occurred when HPV type 16 was compared to HPV 6, HPV 11 or HPV DNA-negative lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
自1981年以来，对532例患有生殖器HPV感染的女性进行了前瞻性随访，未进行治疗，平均随访时间为50（±21）个月。患者每隔6个月接受一次阴道镜检查、巴氏涂片检查和/或活检。所有活检样本均通过原位杂交、Southern印迹法和/或与针对6、11、16、18、31和33型的DNA探针进行夹心杂交来完成HPV分型。应用生存数据分析按HPV类型分层的HPV病变的临床病程（即自发消退和进展情况），目前有458名女性的数据可用。临床进展与病变中存在的HPV类型显著相关。HPV 6型病变的进展率为11.1%（6/54），HPV 11型为14.3%（8/56），HPV 16型为35.2%（32/91），HPV 18型为12.5%（4/32），HPV 31型为18.8%（6/32），HPV 33型为19.4%（6/31），双重感染病变为28.6%（4/14）。在始终保持HPV DNA阴性的病变中，进展率最低，为6.1%（9/148）。在生存分析中，六种HPV类型之间进展的概率差异显著（总体p = 0.0005）。将病毒类型分为HPV 6/11（“低风险”）、HPV 16/18（“高风险”）和HPV 31/33（“中等风险”）后，总体进展概率仍有显著差异（总体p = 0.0035）。然而，在临床消退方面，HPV类型并不是一个同样好的预测指标（总体p = 0.1952）。在HPV 6/11、16/18和31/33组内，差异甚至更小（总体p = 0.4759）。在两两比较中，当将HPV 16型与HPV 6型、HPV 11型或HPV DNA阴性病变进行比较时，进展存在显著差异。（摘要截选至250字）
