Stuebs Frederik A, Gass Paul, Dietl Anna K, Schulmeyer Carla E, Adler Werner, Geppert Carol, Hartmann Arndt, Knöll Antje, Beckmann Matthias W, Koch Martin C
Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany.
Department of Medical Informatics, Biometry and Epidemiology, Friedrich Alexander University of Erlangen-Nuremberg, Waldstrasse 6, 91054, Erlangen, Germany.
Arch Gynecol Obstet. 2021 Sep;304(3):751-758. doi: 10.1007/s00404-021-05986-z. Epub 2021 Feb 4.
Cervical cancer is caused by persistent infection with high-risk human papillomavirus (hrHPV). Cytology-based national screening programs have reduced the incidence and mortality of cervical cancer. Different hrHPV subtypes have different carcinogenic potentials. This study evaluated the distribution of different types of hrHPV relative to age in cervical cancer and its precursor lesions.
HPV testing was performed between November 2018 and February 2020 using the Abbott RealTime high-risk HPV assay on an Abbott m2000sp instrument. This assay separately detects HPV-16, HPV-18, and a pool of 12 additional hrHPV types (HPV-31, -33, -35, -39, -45, -51, -52, -56, -58, -59, -66, and -68).
The study included 652 women with HPV samples and biopsies of the cervix or histology samples obtained during surgery. In all, 30.8% (95% CI, 27.3-34.6%) were HPV-negative. Among HPV-positive women, HPV-16, HPV-18, and "HPV other" types were found in 33.5, 4.4, and 49.4%, respectively. Cervical intraepithelial neoplasia (CIN) 3/high-grade squamous intraepithelial lesions (HSILs) in women ≤ 34 years were positive for HPV-16 in 54.5% of cases and in those ≥ 35 years in 45.4% of cases. Among women with cervical cancer, 75.8% were infected with HPV-16 or had coinfection with HPV-16 and "HPV other".
HPV-16 is the most common type of hrHPV in HSIL + lesions. It is more common in women diagnosed with CIN 3/HSIL who are aged ≤ 35 and is decreasing with age. Therefore, women age ≥ 35 with persistent infection with this type of hrHPV need careful surveillance, as they are at high risk of progression to cervical cancer.
宫颈癌由高危型人乳头瘤病毒（hrHPV）持续感染所致。基于细胞学的国家筛查项目已降低了宫颈癌的发病率和死亡率。不同的hrHPV亚型具有不同的致癌潜能。本研究评估了宫颈癌及其前驱病变中不同类型hrHPV相对于年龄的分布情况。
于2018年11月至2020年2月期间，使用雅培m2000sp仪器上的雅培实时高危型HPV检测法进行HPV检测。该检测法可分别检测HPV-16、HPV-18以及另外12种hrHPV类型（HPV-31、-33、-35、-39、-45、-51、-52、-56、-58、-59、-66和-68）的混合类型。
该研究纳入了652名有HPV样本以及宫颈活检或手术中获取的组织学样本的女性。总体而言，30.8%（95%可信区间，27.3 - 34.6%）为HPV阴性。在HPV阳性女性中，HPV-16、HPV-18和“其他HPV”类型分别占33.5%、4.4%和49.4%。年龄≤34岁女性的宫颈上皮内瘤变（CIN）3/高级别鳞状上皮内病变（HSIL）中，54.5%的病例HPV-16呈阳性，年龄≥35岁女性中该比例为45.4%。在宫颈癌女性中，75.8%感染了HPV-16或同时感染了HPV-16和“其他HPV”。
HPV-16是HSIL+病变中最常见的hrHPV类型。在诊断为CIN 3/HSIL且年龄≤35岁的女性中更常见，且随年龄增长而减少。因此，年龄≥35岁且持续感染此类hrHPV的女性需要仔细监测，因为她们进展为宫颈癌的风险很高。
