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高危型人乳头瘤病毒与宫颈高级别病变:一项欧洲多中心研究的奥地利数据。

Human papillomavirus in high-grade cervical lesions: Austrian data of a European multicentre study.

机构信息

Department of Gynaecology and Obstetrics, Comprehensive Cancer Center, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria,

出版信息

Wien Klin Wochenschr. 2013 Oct;125(19-20):591-9. doi: 10.1007/s00508-013-0403-6. Epub 2013 Sep 17.

Abstract

BACKGROUND

The purpose is to present the Austrian data of an observational, cross-sectional, multicentre study conducted in 13 European countries. This study was undertaken to assess human papillomavirus (HPV) type distribution in high-grade cervical lesions.

METHODS

Two hundred and ninety cases of high-grade cervical intraepithelial neoplasia (CIN2, CIN3) or adenocarcinoma in situ of the cervix from 2004 to 2007 were analysed by histopathological review and polymerase chain reaction for HPV.

RESULTS

Two hundred and nine cases were "histologically eligible" and of those 206 were HPV+. Median age was 34 years (19-76 years). CIN3 was the most frequent diagnosis (64.6 %), followed by CIN2/3 (19.4 %) and CIN2 (13.6 %). Adenocarcinoma in situ was only detected together with a squamous lesion in 2.4 % cases. Majority of women (75.2 %) were infected with a single HPV type, 98.1 % of them with high-risk HPV types: HPV 16 (56.1 %), HPV 33 (12.3 %), HPV 31 (11.0 %), HPV 18 (3.9 %), HPV 35 (3.9 %), HPV 51 (3.2 %) and HPV 52 (2.6 %), HPV 58 (1.9 %) and HPV 45 (0.6 %). The low-risk HPV 6 was found in 1.3 % cases. Forty-six lesions (22.3 %) contained multiple infections, 71.1 % of those were HPV 16 or 18 and 91.1 % were HPV 16, 18, 31, 33 or 45 positive.

CONCLUSIONS

These Austrian data clearly demonstrate that HPV 16 is the predominant type in high-grade CIN, the immediate precursor lesions of cervical cancer. More than 60 % of the lesions were associated with HPV 16 and 18 and more than 85 % with HPV 16, 18, 31, 33 or 45. The prevalence of adenocarcinoma in situ is underestimated, since its detection is difficult with the current cytology screening.

摘要

背景

本研究旨在展示奥地利在 2004 年至 2007 年期间于 13 个欧洲国家开展的一项观察性、横断面、多中心研究的结果。该研究旨在评估高危型人乳头瘤病毒(HPV)在高级别宫颈病变中的分布。

方法

通过组织病理学复查和聚合酶链反应(PCR)对 290 例高级别宫颈上皮内瘤变(CIN2、CIN3)或宫颈原位腺癌病例进行 HPV 分析。

结果

209 例病例“组织学上符合条件”,其中 206 例 HPV 阳性。中位年龄为 34 岁(19-76 岁)。CIN3 是最常见的诊断(64.6%),其次是 CIN2/3(19.4%)和 CIN2(13.6%)。原位腺癌仅在 2.4%的病例中与鳞状病变同时发现。大多数女性(75.2%)感染了单一 HPV 型,98.1%为高危 HPV 型:HPV 16(56.1%)、HPV 33(12.3%)、HPV 31(11.0%)、HPV 18(3.9%)、HPV 35(3.9%)、HPV 51(3.2%)和 HPV 52(2.6%)、HPV 58(1.9%)和 HPV 45(0.6%)。低危型 HPV 6 仅占 1.3%。46 例(22.3%)病变包含多重感染,其中 71.1%为 HPV 16 或 18 型,91.1%为 HPV 16、18、31、33 或 45 阳性。

结论

这些奥地利数据清楚地表明,HPV 16 是宫颈癌前病变高级别 CIN 的主要类型。超过 60%的病变与 HPV 16 和 18 相关,超过 85%的病变与 HPV 16、18、31、33 或 45 相关。由于当前的细胞学筛查难以检测到原位腺癌,因此其检出率被低估。

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