Mitamura Takashi, Konno Yosuke, Kikawa Satomi, Iwaki Yutaka, Iwaki Kurumi, Tanuma Fumie, Kataoka Soromon
Department of Obstetrics and Gynecology, Hakodate Central General Hospital, 33-2, Honcho, Hakodate, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Japan.
J Cytol. 2019 Jul-Sep;36(3):180-183. doi: 10.4103/JOC.JOC_148_17.
The mortality due to uterine cervical cancer has been gradually increasing in women under 40 years of age (U40) in Japan. We investigated the effect of high-risk papillomavirus (HR-HPV) on U40 subjects without any overt cytological abnormalities.
We retrospectively examined the clinical data, including the findings of a cobas 4800 HPV test that was approved in Japan in 2013 to triage women with atypical squamous cells of undetermined significance (ASC-US) and a histological examination in 589 Japanese women.
The overall prevalence rate of HR-HPV was 34.5%. Biopsy-confirmed cervical intraepithelial neoplasia (CIN) 2, or worse (CIN2+) was identified in 45.1% (23/51) of HR-HPV-positive women with ASC-US, who underwent colposcopy immediately. The mean period from the HPV test to the diagnosis of CIN2+ was 3.7 months. CIN2+ was more common (69.6%) in U40 patients. The rates of single or multiple infections of HPV-16, HPV-18, and 12 other HR-HPV (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) in CIN2+ U40 patients were 31.3%, 0%, and 81.3%, respectively. The relative risk for CIN 2+ among U40 women with HPV-16 was not significantly different from that of the patients with infection of any of the 12 other HR-HPVs.
The results of this study suggest that the 12 other HR-HPVs have a potential to generate high-grade cervical lesions among young women, and the examination rate of colposcopy should be increased.
在日本,40岁以下女性(U40)因子宫颈癌导致的死亡率一直在逐渐上升。我们调查了高危型人乳头瘤病毒(HR-HPV)对无明显细胞学异常的U40受试者的影响。
我们回顾性检查了589名日本女性的临床数据,包括2013年在日本获批用于对意义不明确的非典型鳞状细胞(ASC-US)女性进行分流的cobas 4800 HPV检测结果以及组织学检查结果。
HR-HPV的总体患病率为34.5%。在立即接受阴道镜检查的ASC-US且HR-HPV阳性的女性中,45.1%(23/51)经活检确诊为宫颈上皮内瘤变(CIN)2级或更严重(CIN2+)。从HPV检测到诊断为CIN2+的平均时间为3.7个月。CIN2+在U40患者中更为常见(69.6%)。CIN2+的U40患者中HPV-16、HPV-18和其他12种HR-HPV(31、33、35、39、45、51、52、56、58、59、66和68)单一或多重感染率分别为31.3%、0%和81.3%。HPV-16感染的U40女性中CIN 2+的相对风险与其他12种HR-HPV感染患者的相对风险无显著差异。
本研究结果表明,其他12种HR-HPV有可能在年轻女性中引发高级别宫颈病变,应提高阴道镜检查率。