Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Obstetrics and Gynecology, Ospedale di Circolo, Fondazione Macchi, University of Insubria, Varese, Italy.
Int J Gynaecol Obstet. 2019 Nov;147(2):233-237. doi: 10.1002/ijgo.12934. Epub 2019 Aug 8.
To investigate the characteristics of women developing cervical intraepithelial neoplasia who had had a vaccination against human papillomavirus (HPV).
A retrospective cohort study was carried out of women diagnosed with moderate or severe cervical dysplasia (CIN2+) in four Italian centers between 2015 and 2017. All women included had had previous bivalent or quadrivalent vaccination against HPV.
The present study included 43 patients affected by CIN2+. The median age was 28 (range, 21-41) years. Ten (23.3%) patients did not have a diagnosis of specific HPV type(s) involved: high-risk HPV was detected in 7 (16.3%) women while HPV testing was negative in 3 (6.9%) women. Lesions related to HPV16 were found in two patients. HPV types covered by nonavalent vaccination were diagnosed in 27/33 (81.8%) women. HPV types not covered by nonavalent vaccination were diagnosed in 6 (18.2%) women. Co-infections are most commonly detected in women with HPVs other than those included in the nonavalent vaccination (P=0.024).
Cervical dysplasia occurring after HPV vaccination is a rare condition. Theoretically, nonavalent vaccination should improve protection against more than 80% of HPV-related lesions compared to other vaccines.
研究接种人乳头瘤病毒（HPV）疫苗后发生宫颈上皮内瘤变的女性的特征。
本研究对 2015 年至 2017 年期间意大利四家中心诊断为中重度宫颈上皮内瘤变（CIN2+）的女性进行了回顾性队列研究。所有纳入的女性均曾接种过二价或四价 HPV 疫苗。
本研究共纳入 43 例 CIN2+患者。中位年龄为 28 岁（范围 21-41 岁）。10 例（23.3%）患者未诊断出特定 HPV 型别：7 例（16.3%）女性检测到高危型 HPV，3 例（6.9%）女性 HPV 检测阴性。2 例患者存在与 HPV16 相关的病变。33 例（81.8%）女性诊断出九价疫苗涵盖的 HPV 型别，6 例（18.2%）女性诊断出九价疫苗未涵盖的 HPV 型别。最常见的是检测到非九价疫苗涵盖的 HPV 型别与其他 HPV 型别的合并感染（P=0.024）。
HPV 疫苗接种后发生宫颈上皮内瘤变是一种罕见情况。理论上，与其他疫苗相比，九价疫苗接种应该能更好地预防超过 80%的 HPV 相关病变。
