Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel.
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
J Low Genit Tract Dis. 2019 Oct;23(4):248-252. doi: 10.1097/LGT.0000000000000486.
A total of 95% to 99% of patients with invasive cervical cancer (CC) are infected with human papillomavirus (HPV). The aim of the study was to evaluate the incidence of low-risk HPV (LR-HPV) types among women with cervical intraepithelial neoplasia (CIN 2-3) and CC.
We conducted a nested cohort study of patients diagnosed with CIN 2-3 or CC. Inclusion criteria were diagnosis of CIN 2-3 or CC and HPV-DNA testing from the cervix.
During the study period, we collected clinical data on 608 women of whom 402 were with CIN 2-3 and 206 with diagnosis of CC. When examining 14 high-risk HPV (HR-HPV) types, patients with CIN 2-3, 90.3% were found positive to at least one type of HR-HPV, 89.8% from CC patients were found positive to at least one type of HR-HPV. A total of 4.5% of patients with CIN 2-3 and 3.9% of those with CC were positive to only one LR-HPV or to some of a few LR-HPV types. Among 5.2% with CIN 2-3 and 6.3% of those with CC, no HPV types were detected.
The prevalence of the LR-HPV in high-grade squamous intraepithelial lesion cervical lesions is low but is expected to increase in the future because of the expected decrease in CC caused by HPV types that are included in the bi-, quadri-, and nanovalent vaccine. The CIN 2-3 and CC patients with LR-HPV types and with negative HPV, challenge HPV screening sensitivity, which is based on a limited number of HR-HPV types.
浸润性宫颈癌（CC）患者中 95%至 99%感染人乳头瘤病毒（HPV）。本研究旨在评估宫颈上皮内瘤变（CIN 2-3）和 CC 患者中低危型 HPV（LR-HPV）的发生率。
我们对诊断为 CIN 2-3 或 CC 的患者进行了巢式队列研究。纳入标准为诊断为 CIN 2-3 或 CC 且 HPV-DNA 检测来自宫颈。
在研究期间，我们收集了 608 名女性的临床数据，其中 402 名患有 CIN 2-3，206 名患有 CC。在检查 14 种高危 HPV（HR-HPV）类型时，CIN 2-3 患者中 90.3%至少有一种 HR-HPV 阳性，89.8%的 CC 患者至少有一种 HR-HPV 阳性。CIN 2-3 患者中有 4.5%和 CC 患者中有 3.9%仅对一种 LR-HPV 或少数几种 LR-HPV 类型呈阳性。在 5.2%的 CIN 2-3 患者和 6.3%的 CC 患者中，未检测到 HPV 类型。
高级别鳞状上皮内病变宫颈病变中 LR-HPV 的患病率较低，但由于包含在双价、四价和九价疫苗中的 HPV 类型预计会降低 CC 的发病率，LR-HPV 的患病率预计会增加。CIN 2-3 和 CC 患者中存在 LR-HPV 类型和 HPV 阴性的情况，这对基于有限数量 HR-HPV 类型的 HPV 筛查敏感性提出了挑战。
