Department of Pathology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
Department of Gynecology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
Cancer Cytopathol. 2017 Feb;125(2):138-143. doi: 10.1002/cncy.21789. Epub 2016 Nov 21.
Infections with multiple human papillomavirus (HPV) types (mHPV) in Papanicolaou tests have been reported but the histologic correlation and clinical meaning remains debatable.
The authors prospectively tested 37 HPV types using the Linear Array HPV Genotyping Test and correlated the results to cytology and histology findings in 260 women evaluated from June 2009 to October 2011 and followed for up to 60 months.
HPV was detected in 148 of 235 samples (63%) and high-risk HPV was detected in 132 samples (56%). mHPV infection was found to be twice as common as single HPV (sHPV) infection and was detected more frequently in low-grade squamous intraepithelial lesion (LSIL) (48 of 83 samples [58%]) and high-grade squamous intraepithelial lesion or invasive carcinoma (HSIL + (26 of 47 samples [55%]) compared with other categories (P<.001). Of 34 LSIL/cervical intraepithelial neoplasia 1 (CIN1) index cases, 13 of 21 patients with mHPV (61.9%) persisted on CIN1, whereas no histologic abnormality was detected during follow-up in all 12 patients with sHPV infection (high risk or low risk) (P<.001). Eighteen of 20 patients with HSIL/cervical intraepithelial neoplasia 2 (CIN2) (90%) and high-risk mHPV persisted on HSIL+/CIN2 + whereas 6 of 11 patients with sHPV infection did not demonstrate HSIL+/CIN2 + on follow-up (54.5%) (P = .066). Approximately 40% of women with HSIL were infected by high-risk HPV types other than types 16 or 18.
High-risk mHPV infection identified patients with persistent LSIL/CIN1 and may to help identify patients at higher risk of disease progression to HSIL+/CIN2+. Longer follow-up will clarify the role of mHPV testing in patient care. Cancer Cytopathol 2017;125:138-143. © 2016 American Cancer Society.
巴氏涂片检查中已报告了多种人乳头瘤病毒（HPV）类型（mHPV）的感染，但组织学相关性和临床意义仍存在争议。
作者前瞻性地使用线性阵列 HPV 基因分型试验检测了 37 种 HPV 类型，并将结果与 2009 年 6 月至 2011 年 10 月期间评估的 260 名女性的细胞学和组织学检查结果进行了相关性分析，并随访了长达 60 个月。
235 个样本中有 148 个（63%）检测到 HPV，132 个样本（56%）检测到高危型 HPV。mHPV 感染比单 HPV（sHPV）感染更为常见，在低度鳞状上皮内病变（LSIL）（83 个样本中的 48 个[58%]）和高级别鳞状上皮内病变或浸润性癌（HSIL+CIN2+）（47 个样本中的 26 个[55%]）中比其他类别更为常见（P<.001）。在 34 例 LSIL/宫颈上皮内瘤变 1（CIN1）指数病例中，21 例 mHPV 患者中有 13 例（61.9%）持续存在 CIN1，而所有 12 例 sHPV 感染（高危型或低危型）患者在随访期间均未发现组织学异常（P<.001）。20 例 HSIL/CIN2 患者中有 18 例（90%）和高危 mHPV 持续存在 HSIL+/CIN2+，而 11 例 sHPV 感染患者中有 6 例（54.5%）未出现 HSIL+/CIN2+（P=.066）。大约 40%的 HSIL 患者感染了除 16 型或 18 型以外的高危型 HPV。
高危型 mHPV 感染可确定持续存在 LSIL/CIN1 的患者，并且可能有助于识别疾病进展为 HSIL+/CIN2+的风险更高的患者。更长时间的随访将阐明 mHPV 检测在患者治疗中的作用。癌症细胞学杂志 2017；125：138-143。© 2016 美国癌症协会。
