Clin Lab. 2020 Dec 1;66(12). doi: 10.7754/Clin.Lab.2020.200406.
Human papillomavirus (HPV) is a major risk factor for cervical dysplasia and invasive cervical cancer; therefore, regular screening by cervical smear cytology or HPV testing is recommended. We aimed to determine the overall and risk group-specific HPV prevalence, age distribution, and temporal trends and to appraise the correlation of HPV positivity with abnormal cervical cytological findings.
This retrospective, single-center study involved a total of 751 women (aged 18 - 67) concurrently subjected to HPV DNA testing and cervical cytology evaluation over a 10-year period in Zagreb, Croatia. Digene HC2 HPV DNA test (Qiagen Corporation, USA) was employed in screening specimens for both low-risk and high-risk HPV risk groups. The cytology was reported using the Bethesda system and in accordance with uniform classification of uterine cervix cytological findings in Croatia "Zagreb 2002". Statistical significance was set at p < 0.05.
The overall HPV prevalence in our study population was 48.6%, and the 18 - 30 age group presented with the highest infection burden (p = 0.046). A decrease in low-risk and high-risk mono-positivity has been observed over the 10-year period; conversely, there was a significant increase in low-risk/high-risk co-positivity (p = 0.007). Low-risk/high-risk HPV co-infection resulted in a compounding effect which increased the occurrence of abnormal cells, HPV-associated changes and low grade squamous intraepithelial lesions (LSIL/cervical intraepithelial neoplasia grade I) in cervical cytology when compared to mono-infection with either low-risk or high-risk HPV. On the other hand, such effect has not been demonstrated for high grade squamous intraepithelial lesions (HSIL/ cervical intraepithelial neoplasia grades II and III).
The overall HPV prevalence in female outpatients was high, underscored with rising co-positivity rates. Such co-infection with both low-risk and high-risk HPV (predominantly seen in women younger than 30) can exhibit a compounding effect in the occurrence of cytological abnormalities and low grade squamous intra-epithelial lesions (LSIL), which has to be considered in future diagnostic and screening algorithms.
人乳头瘤病毒（HPV）是宫颈发育不良和宫颈癌的主要危险因素；因此，建议定期进行宫颈涂片细胞学检查或 HPV 检测筛查。我们旨在确定 HPV 的总体流行率和风险组特异性流行率、年龄分布和时间趋势，并评估 HPV 阳性与异常宫颈细胞学发现的相关性。
这是一项回顾性单中心研究，共纳入 751 名（18-67 岁）女性，在克罗地亚萨格勒布进行了 10 年的 HPV DNA 检测和宫颈细胞学评估。Digene HC2 HPV DNA 检测（美国 Qiagen 公司）用于筛查低危和高危 HPV 风险组的标本。细胞学报告采用巴氏系统，并按照克罗地亚“萨格勒布 2002 年”的子宫颈细胞学检查结果统一分类。统计学意义设定为 p < 0.05。
在我们的研究人群中，HPV 总流行率为 48.6%，18-30 岁年龄组的感染负担最高（p = 0.046）。在 10 年期间，低危和高危单阳性的比例有所下降；相反，低危/高危双重感染的比例显著增加（p = 0.007）。低危/高危 HPV 合并感染导致异常细胞、HPV 相关改变和低级别鳞状上皮内病变（LSIL/宫颈上皮内瘤变 I 级）的发生率增加，与单独感染低危或高危 HPV 相比。另一方面，高危鳞状上皮内病变（HSIL/宫颈上皮内瘤变 II 级和 III 级）并未显示出这种效果。
女性门诊患者的 HPV 总流行率较高，且合并感染率呈上升趋势。这种低危和高危 HPV 的合并感染（主要发生在 30 岁以下的女性）可能会对细胞学异常和低级别鳞状上皮内病变（LSIL）的发生产生复合作用，这在未来的诊断和筛查算法中需要考虑。
