van der Weele Pascal, King Audrey J, Meijer Chris J L M, Steenbergen Renske D M
National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven, the Netherlands; Amsterdam UMC, Vrije Universiteit, Department of Pathology, Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.
National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven, the Netherlands.
Papillomavirus Res. 2019 Jun;7:168-172. doi: 10.1016/j.pvr.2019.04.008. Epub 2019 Apr 13.
Recurrent cervical intraepithelial lesions (rCIN2/3) after treatment of CIN2/3 occur in 5-15% of cases. rCIN2/3 can result from incomplete resection of CIN2/3, where the same HPV type and variant remains present. rCIN2/3 could also occur following a new infection with a different HPV variant of the same HPV type as the initial lesion. This study investigates HPV16 consensus variants in paired HPV16 positive scrapes from baseline CIN2/3 and rCIN2/3 lesions.
Paired HPV16 positive cervical scrapes of women with CIN2/3 at baseline and rCIN2/3 6 or 12 months after treatment were selected for whole-genome amplification and Illumina sequencing. Sequences were compared and nucleotide changes over time were characterized.
From 14 paired samples, 10 had identical consensus variants in baseline CIN2/3 and rCIN2/3. Four paired samples showed one to three nucleotide variations at recurrent disease compared to baseline.
Identical or nearly identical HPV16 consensus variants were found in scrapes of paired HPV16 positive baseline CIN2/3 and rCIN2/3 lesions after treatment, suggesting no need for HPV variant analysis when the same HPV type is found in both lesions. These results argue for either incomplete excision of baseline CIN2/3 or inability of clearance of the original HPV infection.
CIN2/3治疗后复发性宫颈上皮内病变（rCIN2/3）发生率为5%-15%。rCIN2/3可能源于CIN2/3切除不完全，同一人乳头瘤病毒（HPV）型别及变体依然存在。rCIN2/3也可能在初始病变为同一HPV型别的不同HPV变体新感染后发生。本研究调查了基线CIN2/3和rCIN2/3病变中配对的HPV16阳性刮片的HPV16共有变体。
选取基线时为CIN2/3且治疗后6或12个月为rCIN2/3的女性的配对HPV16阳性宫颈刮片，进行全基因组扩增和Illumina测序。比较序列并对随时间的核苷酸变化进行特征分析。
在14对样本中，10对在基线CIN2/3和rCIN2/3中有相同的共有变体。4对样本在复发疾病时与基线相比显示出1至3个核苷酸变异。
在治疗后配对的HPV16阳性基线CIN2/3和rCIN2/3病变的刮片中发现相同或几乎相同的HPV16共有变体，这表明当两个病变中发现相同HPV型别时无需进行HPV变体分析。这些结果表明基线CIN2/3切除不完全或无法清除原始HPV感染。
