肛门生殖器发育不良组织样本中 alpha 人乳头瘤病毒（HPV）型的回顾性分析 - RICH（HIV 患者 HPV 相关癌风险）评分的介绍。

Retrospective analysis of alpha-human papillomavirus (HPV) types in tissue samples from anogenital dysplasias - introduction of the RICH (Risk of HPV-related Carcinoma in HIV patients) score.

机构信息

Department of Dermatology and Allergology, University Hospital of Munich (LMU), Munich, Germany.

出版信息

J Eur Acad Dermatol Venereol. 2020 Feb;34(2):377-384. doi: 10.1111/jdv.15932. Epub 2019 Oct 17.

DOI:10.1111/jdv.15932

PMID:31494974

Abstract

BACKGROUND

Chronic viral infections caused by highly contagious human papillomaviruses (HPVs) from the alpha genus are a substantial risk factor for tumour diseases.

OBJECTIVES

The goal of this study was to compare the HPV infection pattern with histology in a patient group of immunocompromised HIV and non-immunocompromised patients with anal intraepithelial neoplasia.

MATERIALS AND METHODS

Tissue samples (n = 210) from the anogenital area of 121 patients underwent retrospective histological and molecular examination for HPV DNA prevalence by chip analysis. The study was part of a cancer screening from the Dermatology Department of the LMU Munich, Germany. All data were collected and processed anonymously.

RESULTS

HPV 6 or 11 are more abundant in tissue samples from histologically diagnosed condylomata acuminata (47.7%) compared to grade 1, 2, and 3 intraepithelial neoplasias (IN 1-3). Detection of high-risk (hr) alpha-HPV DNA was significantly higher in tissue samples from IN 3 (67.5%) compared to IN 1 and 2 (12.9%), and compared to condylomata acuminata (29.5%). No HPV types were detected in histologically unremarkable tissue samples. There was a significant association between the prevalence of HPV 16 and the classifications IN 1 to IN 3 (χ (2) = 13.62, P = 0.001). We identified a significant correlation between the prevalence of high-risk and low-risk (lr) HPV types and HIV, especially mixed infections of different HPV types correlated with high-grade IN. Based on the present data, we suggest the risk of carcinoma in HIV patients (RICH) score and test it in the 121 patients.

CONCLUSIONS

hr alpha-HPVs, mainly HPV 16, are associated with increased oncogenic potential of premalignant lesions (IN 1-3), especially in HIV patients. Based on the combination of HIV/HPV-testing and histological analysis, we identified correlations that could potentially forecast the risk of malignant transformation and summarized them in the form of RICH score.

摘要

背景

高度传染性的人乳头瘤病毒（HPV）属于α属，慢性病毒感染是肿瘤疾病的一个重要危险因素。

目的

本研究旨在比较免疫抑制的 HIV 患者和非免疫抑制的肛门上皮内瘤变患者的 HPV 感染模式与组织学。

材料和方法

对来自德国慕尼黑 LMU 皮肤学部癌症筛查的 121 名患者的 210 份肛生殖器组织样本进行回顾性组织学和 HPV DNA 芯片分析。所有数据均匿名收集和处理。

结果

组织学诊断为尖锐湿疣（CA）的标本中 HPV 6 或 11 更为丰富（47.7%），而 1 级、2 级和 3 级上皮内瘤变（IN 1-3）则较少（分别为 12.9%和 29.5%）。组织学未发现明显异常的标本中未检测到 HPV 类型。IN 3 组织样本中高危（hr）α-HPV DNA 的检出率明显高于 IN 1 和 2（12.9%），也明显高于 CA（29.5%）。组织学无明显异常的标本中未检测到 HPV 类型。HPV 16 的流行与 IN 1 至 IN 3 的分类呈显著相关（χ (2) = 13.62，P = 0.001）。我们发现高危和低危（lr）HPV 类型与 HIV 之间存在显著相关性，尤其是不同 HPV 类型的混合感染与高级别 IN 相关。根据目前的数据，我们建议使用 HIV 患者的癌前病变风险（RICH）评分，并在 121 名患者中进行测试。