Gu Liying, Hong Zubei, Gao Hua, Qiu Lihua, Di Wen
Department of Obstetrics and Gynecology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.
Shanghai Key Laboratory of Gynecologic Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.
Cytopathology. 2019 Jul;30(4):419-425. doi: 10.1111/cyt.12717.
To retrospectively analyse the incidence of high-grade squamous intraepithelial lesions (HSILs) and squamous cell carcinoma (SCC) in women of different ages with high-risk (HR) human papillomavirus (HPV) but with normal cytology test results stratified by age and HPV genotype.
In total, 1858 women with HR-HPV infection but with a normal smear who received a colposcopy and biopsy between 2015 and 2016 at our institution were included. The pathological results were retrospectively analysed after stratifying by age and HPV genotype.
Among the 1858 cases, the HSIL% in women aged 21-29 years (10.54%) was significantly different from that in women aged 40-49 years (19.85%; P < 0.05), whereas there was no significant difference in the HSIL% among women aged 21-29 years and those in the other age groups (P > 0.05). In total, 295 cases had single HPV16 infection. The HSIL% in patients with HPV16/18 infection was >15%, and the 40-49-year age group had the highest percentage at 48.48%. For other HR-HPV infections, the HSIL and SCC incidence rate was 10.41%, and there was no significant difference among the age groups; thus, women with other types of viral infections, regardless of age, should be referred to colposcopy.
Although HPV16 is the HPV with the highest risk, other HR-HPV infections can also cause a high percentage of HSILs and SCC in women with normal cytology. Therefore, it is necessary to refer HR-HPV-infected women aged ≥21 years for colposcopy in a timely manner to exclude potential cervical intraepithelial neoplasia and cervical cancer.
回顾性分析不同年龄、高危（HR）人乳头瘤病毒（HPV）感染但细胞学检查结果正常的女性中高级别鳞状上皮内病变（HSIL）和鳞状细胞癌（SCC）的发生率，并按年龄和HPV基因型进行分层。
纳入2015年至2016年在我院接受阴道镜检查和活检的1858例HR-HPV感染但涂片正常的女性。对病理结果按年龄和HPV基因型进行分层后进行回顾性分析。
在1858例病例中，21-29岁女性的HSIL%（10.54%）与40-49岁女性（19.85%；P<0.05）有显著差异，而21-29岁女性与其他年龄组的HSIL%无显著差异（P>0.05）。共有295例为单一HPV16感染。HPV16/18感染患者的HSIL%>15%，40-49岁年龄组最高，为48.48%。对于其他HR-HPV感染，HSIL和SCC发生率为10.41%，各年龄组之间无显著差异；因此，其他类型病毒感染的女性，无论年龄大小，均应转诊至阴道镜检查。
虽然HPV16是风险最高的HPV，但其他HR-HPV感染在细胞学正常的女性中也可导致较高比例的HSIL和SCC。因此，有必要及时将年龄≥21岁的HR-HPV感染女性转诊至阴道镜检查，以排除潜在的宫颈上皮内瘤变和宫颈癌。
