Department of Obstetrics and Gynecology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50028 Kaunas, Lithuania.
Medicina (Kaunas). 2012;48(1):22-30.
The aim of the study was to determine the prevalence of human papillomavirus (HPV) types 16, 18, and 45 in women with cervical intraepithelial changes caused by high-risk HPV in relation to colposcopic and histological findings. MATERIAL AND METHODS. A prospective study of 393 women with cervical cytologic changes confirmed by the Papanicolaou test was undertaken from April 3, 2006, to April 3, 2007. The Hybrid Capture 2 assay was performed. HPV-positive women underwent genotyping for types 16, 18, and 45. Colposcopy and biopsy were performed in 317 (80.7%) and 249 women (63.4%), respectively. The results were analyzed by age groups. RESULTS. Of all the women with cervical intraepithelial changes, 59% were positive for HR HPV, and 62% were positive for HPV types 16, 18, and 45. HPV types 16, 18, and 45 were detected in 54.8% of women with ASC-US/AGUS/ASC-H, 50.0% of women with LSIL, and 75.6% of women with HSIL. After confirmation of any histological and colposcopic changes, HPV types 16, 18, and 45 were detected in 68.0% and 69.0% of women, respectively. Moreover, 84.2% of the women with HSIL and high-grade colposcopic changes, and 78.5% of the women with HSIL and CIN 2/CIN 2-3/CIN 3/carcinoma in situ were positive for HPV types 16, 18, and 45. The sensitivity of the Papanicolaou test together with the Hybrid Capture 2 test compared with the Papanicolaou test together with the HPV 16/18/45 test diagnosing CIN 2+ changes did not differ (96.7% vs. 97.1%), but the specificity was higher (40.3% vs. 8.0%). CONCLUSIONS. The majority of the cytologic, colposcopic, and histological changes were caused by HPV types 16, 18, and 45. Despite the high prevalence of HPV types 16, 18, and 45, testing for these genotypes together with the Papanicolaou test did not improve the diagnosis of high-grade cervical intraepithelial lesions.
本研究旨在确定高危型 HPV 引起的宫颈上皮内病变妇女中 HPV 型 16、18 和 45 的流行率，并与阴道镜和组织学发现相关。
2006 年 4 月 3 日至 2007 年 4 月 3 日，对 393 例经巴氏涂片检查证实为宫颈细胞学改变的妇女进行了前瞻性研究。采用杂交捕获 2 检测法。HPV 阳性妇女进行 HPV 型 16、18 和 45 的基因分型。317 例（80.7%）和 249 例妇女（63.4%）分别行阴道镜检查和活检。按年龄组分析结果。
所有宫颈上皮内病变妇女中，59%为 HR HPV 阳性，62%为 HPV 型 16、18 和 45 阳性。在 ASC-US/AGUS/ASC-H 中，54.8%的妇女、LSIL 中 50.0%的妇女和 HSIL 中 75.6%的妇女检测到 HPV 型 16、18 和 45。在任何组织学和阴道镜变化得到证实后，HPV 型 16、18 和 45 在分别在 68.0%和 69.0%的妇女中检测到。此外，84.2%的 HSIL 和高级别阴道镜改变妇女，78.5%的 HSIL 和 CIN 2/CIN 2-3/CIN 3/原位癌妇女，HPV 型 16、18 和 45 均为阳性。巴氏涂片检查联合杂交捕获 2 试验与巴氏涂片检查联合 HPV 16/18/45 试验诊断 CIN 2+病变的敏感性无差异（96.7%比 97.1%），但特异性更高（40.3%比 8.0%）。
细胞学、阴道镜和组织学改变主要由 HPV 型 16、18 和 45 引起。尽管 HPV 型 16、18 和 45 的流行率较高，但与巴氏涂片检查联合检测这些基因型并不能提高对高级别宫颈上皮内病变的诊断。
