在中国，ASC-US 阳性的高危型 HPV（hr-HPV）阳性妇女的宫颈病变分布：一项回顾性单中心研究。
Distribution of cervical lesions in high-risk HPV (hr-HPV) positive women with ASC-US: a retrospective single-center study in China.
机构信息
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Wenhua West Road 44, Jinan, China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China.
出版信息
Virol J. 2020 Nov 23;17(1):185. doi: 10.1186/s12985-020-01455-2.
BACKGROUND
To investigate distributions of cervical lesions and factors associated with the severity of the cervical lesions in high-risk HPV (hr-HPV) positive women with atypical squamous cells of undetermined significance (ASC-US) cytology.
METHODS
Clinical information of 250,000 women who underwent HPV and cytological test was collected from January 2012 to January 2019. The association between the severity of the cervical lesions and hr-HPV genotypes, hr-HPV viral load, and ages, were analyzed in hr-HPV-positive/ASC-US women.
RESULTS
3459 hr-HPV-positive/ASC-US women were enrolled in this study. Overall, 43.51% of women with ASC-US had normal histological results, 34.35% had high-grade squamous intraepithelial lesion (HSIL), and 1.30% had cervical cancer. The rate of HSIL or worse (HSIL+) in women with single HPV16 infection (63.09%) was the highest, followed by HPV33 (57.50%), HPV51 (36.11%), HPV58 (36.11%), HPV52 (28.28%), HPV18 (26.37%), HPV66 (19.35%), HPV39 (18.92%), HPV53 (15.00%), and HPV56 (8.51%). Detection rate of HSIL+ in low, intermediate and high viral-load groups were 15.87% (n = 30), 34.91% (n = 74) and 40.68% (n = 214) (Cochran-Armitage Trend test χ = 35.03, p < 0.0001). Compared with the 51-60-year-old group (21.65%), the women in ≤ 30 (40.52%), 31-40 (39.67%), and 41-50 (34.22%) year-old groups had significantly higher risk of HSIL+. The women in ≤ 51-60 (2.68%) and > 60 (3.41%) year-old groups were at increased risk for cervical cancer, compared with the ≤ 30-year-old group (0.61%).
CONCLUSIONS
ASC-US women with HPV 16/18/33/51/52/58 single infection and multiple infections, as well as high HPV viral loads, have high risk of HSIL+.
背景
本研究旨在探讨 HPV 阳性（hr-HPV）、意义不明的非典型鳞状细胞（ASC-US）细胞学检查的女性中，宫颈病变的分布情况及与宫颈病变严重程度相关的因素。
方法
收集 2012 年 1 月至 2019 年 1 月间 25 万名女性的 HPV 和细胞学检测临床资料。分析 HPV 阳性/ASC-US 女性中，hr-HPV 基因型、hr-HPV 病毒载量与宫颈病变严重程度的关系。
结果
共纳入 3459 例 HPV 阳性/ASC-US 女性。ASC-US 患者中，组织学正常者占 43.51%，高级别鳞状上皮内病变（HSIL）者占 34.35%，宫颈癌者占 1.30%。单纯 HPV16 感染患者的 HSIL 或更高级别病变（HSIL+）发生率最高（63.09%），其次为 HPV33（57.50%）、HPV51（36.11%）、HPV58（36.11%）、HPV52（28.28%）、HPV18（26.37%）、HPV66（19.35%）、HPV39（18.92%）、HPV53（15.00%）、HPV56（8.51%）。低、中、高病毒载量组 HSIL+检出率分别为 15.87%（n=30）、34.91%（n=74）和 40.68%（n=214）（Cochran-Armitage 趋势检验 χ2=35.03，p<0.0001）。与≤30 岁年龄组（21.65%）相比，≤50 岁（40.52%）、31-40 岁（39.67%）和 41-50 岁（34.22%）年龄组发生 HSIL+的风险更高。与≤30 岁年龄组（0.61%）相比，≤51-60 岁（2.68%）和>60 岁（3.41%）年龄组女性发生宫颈癌的风险更高。
结论
HPV16/18/33/51/52/58 单一感染及多重感染、HPV 病毒载量高的 ASC-US 患者发生 HSIL+的风险较高。
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