Wang Zhiling, Liu Ting, Wang Yunjian, Gu Ying, Wang Hui, Liu Jingkang, Cui Baoxia, Yang Xingsheng
1Department of Gynecology, Qilu Hospital of Shandong University, Jinan, China.
2West China School of Medicine, Sichuan University, Chengdu, China.
Infect Agent Cancer. 2020 May 21;15:34. doi: 10.1186/s13027-020-00291-x. eCollection 2020.
To investigate high-risk HPV (hr-HPV) genotype distributions and the association between hr-HPV infection with severity of the cervical lesions in women with normal cytology.
In this cross-sectional study, the result of the hr-HPV test and biopsy of colposcopy of women with normal cytology from January 2012 to January 2019 were analyzed. The detection rate of high-grade squamous intraepithelial lesion (HSIL) and cervical cancer were calculated among different hr-HPV genotypes, viral load group, and age groups.
Five thousand eight hundred eighty women were enrolled in this study. Overall, 59.97% had normal histological results, 19.32% had HSIL, and 1.07% had cervical cancer. The detection rate of HSIL or worse (HSIL+) in women with single HPV16(34.00%), HPV31(27.50%), HPV33(25.58%), and HPV52(20.88%) infection were higher significantly than single HPV18 (15.59%) infection, respectively. The HSIL+ detection rate between HPV16 single infection and multiple infections (excluding HPV18) was no significant difference (34% vs 35.47%, = 0.638), contrary to HPV18(12.59% vs 21.67%, = 0.022). In women without HPV16/18 infections, HSIL+ detection rates for single, double, and triple or more hr-HPV infections were 12.28, 20.31, and 37.50%, the risk of detection of HSIL+ significantly increasing. With the hr-HPV DNA load increases, the risk of detection of HSIL+ (χ2 = 91.01, < 0.0001) and invasive cervical cancer (χ2 = 5.757, = 0.016) increase. In age < 30, 31-40, 41-50, 51-60, > 60 group, HSIL+ detection rate were 24.80%、22.10%、19.59%、14.29, and 12.61%, respectively.
Women who have normal cytology with HPV 16/18/31/33/52/58 infections, multiple HPV infections and high viral load, have a higher detection rate of HSIL+.
探讨细胞学正常女性中高危型人乳头瘤病毒（hr-HPV）基因型分布以及hr-HPV感染与宫颈病变严重程度之间的关联。
在这项横断面研究中，分析了2012年1月至2019年1月细胞学正常女性的hr-HPV检测结果和阴道镜活检结果。计算了不同hr-HPV基因型、病毒载量组和年龄组中高级别鳞状上皮内病变（HSIL）和宫颈癌的检出率。
本研究共纳入5880名女性。总体而言，59.97%组织学结果正常，19.32%为HSIL，1.07%为宫颈癌。单一HPV16（34.00%）、HPV31（27.50%）、HPV33（25.58%）和HPV52（20.88%）感染的女性中HSIL或更严重病变（HSIL+）的检出率分别显著高于单一HPV18（15.59%）感染。HPV16单一感染与多重感染（不包括HPV18）之间的HSIL+检出率无显著差异（34%对35.47%，P = 0.638），而HPV18则相反（12.59%对21.67%，P = 0.022）。在未感染HPV16/18的女性中，单一、双重以及三重或更多hr-HPV感染的HSIL+检出率分别为12.28%、20.31%和37.50%，HSIL+的检出风险显著增加。随着hr-HPV DNA载量增加，HSIL+（χ2 = 91.01，P < 0.0001）和浸润性宫颈癌（χ2 = 5.757，P = 0.016）的检出风险增加。在年龄<30岁、31 - 40岁、41 - 50岁、51 - 60岁、>60岁组中，HSIL+检出率分别为24.80%、22.10%、19.59%、14.29%和12.61%。
细胞学正常但感染HPV 16/18/31/33/52/58、多重HPV感染且病毒载量高的女性，HSIL+检出率较高。
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