Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Catania, Italy.
Department of Biomedical and Biotechnological Sciences, Clinical Virology, University of Catania, Catania, Italy.
BMC Cancer. 2020 May 19;20(1):444. doi: 10.1186/s12885-020-06946-7.
We studied the cases of single and multiple HPV infection and analyzed the correlation with negative cases, and preneoplastic and neoplastic lesions of the uterine cervix with the aim of making a contribution to the prognostic factor under discussion.
Nine hundred nine women undergoing second level screening because they had been positive at cervical cytology were enrolled. All the patients underwent colposcopy and cervical biopsy with viral genotyping. We divided mHPV infection based on the number of genotypes present: infections with 2 strains, 3 strains, 4 strains and 5 or more strains.
The analysis of the data was made using the χ2 test. Contingency tables were created to evaluate the correlation between single, multiple and CIN2+ infections. Values with p < 0.05 were considered statistically significant.
The presence of genotype HPV16 in our study was associated with a 12 times greater risk of developing a high-grade lesion, OR = 12.70. The patients with single infections had the highest incidence of CIN2+ (34.1%) with respect to those with multiple infections (10.6%).When we studied in the mHPV infection the prevalence of the combinations between the genotypes, we found that in mHPV16 infections, the combinations HPV16, 18 and HPV16, 31 were the most frequent (55.5%) in CIN3 lesion.
Our results suggest that single HPV infections have a greater risk of developing SCC with respect to multiple infections. Multiple HPV infections are relevant only in the first phase of the lesion (CIN1-CIN2), while they are absent in carcinomas, where infections are of a single genotype. In particular, among multiple infections, HPV16 infection with 2 HR genotypes is associated significantly with CIN2 / CIN3 (21/30) and has 4 times greater risk of developing a high-grade lesion. Thus, it is probable that only specific combinations of HPV (HPV16,18 - HPV 16,31) can be associated with a clinically significant impact, while other combinations can simply be correlated because of a common infection or diagnostic method used. Therefore, multiple HPV16 infections with two high-risk genotypes is a major risk of CIN2/CIN3.
我们研究了单一和多重 HPV 感染的病例，并分析了它们与阴性病例以及子宫颈的癌前和肿瘤病变之间的相关性，旨在为正在讨论的预后因素做出贡献。
纳入了 909 名因宫颈细胞学检查阳性而接受二级筛查的女性。所有患者均行阴道镜检查和宫颈活检，并进行病毒基因分型。我们根据存在的基因型数量对 mHPV 感染进行分类：感染 2 种、3 种、4 种和 5 种或更多种。
采用 χ2 检验进行数据分析。制作列联表以评估单一、多重和 CIN2+感染之间的相关性。p 值<0.05 被认为具有统计学意义。
本研究中 HPV16 基因型的存在与发生高级别病变的风险增加 12 倍相关，OR=12.70。与多重感染相比，单一感染患者的 CIN2+发生率最高（34.1%）。当我们研究 mHPV 感染中基因型组合的流行情况时，我们发现 mHPV16 感染中，HPV16、18 和 HPV16、31 的组合最常见（55.5%），与 CIN3 病变相关。
我们的结果表明，单一 HPV 感染发生 SCC 的风险高于多重感染。多重 HPV 感染仅与病变的早期阶段（CIN1-CIN2）相关，而在宫颈癌中不存在，宫颈癌中的感染是单一基因型的。特别是，在多重感染中，HPV16 感染与两种 HR 基因型（HPV16、18-HPV16、31）显著相关，发生高级别病变的风险增加 4 倍。因此，只有特定的 HPV 组合（HPV16、18-HPV16、31）可能与临床显著影响相关，而其他组合可能仅仅是由于共同感染或使用的诊断方法而相关。因此，HPV16 感染与两种高危基因型的多重感染是 CIN2/CIN3 的主要危险因素。
