Department of Gynecology and Obstetrics, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Germany.
Department of Health, Witten/Herdecke University, Witten, Germany.
BMC Infect Dis. 2024 Jun 4;24(1):558. doi: 10.1186/s12879-024-09449-z.
In January 2020, a different cervical cancer screening program started in Germany. Women above the age of 35 are recommended to have a combined HPV and cytology swab every three years. Showing persistent high-risk human papillomavirus (hrHPV), cytologic negative cervical samples at baseline and after 12 months, patients are referred to colposcopy. Entailing considerable additional workload due to the required colposcopies, we analyzed the risk of high-grade cervical intraepithelial neoplasia (CIN 3) in cytologic negative and persistent hrHPV women according to their hrHPV genotypes.Methods In this single center retrospective study, patients with persistent hrHPV, cytology negative cervical samples from our certified Colposcopy Unit in 2020 and 2021 were analyzed. Patient demographics, hrHPV types, biopsy rates and histological reports were collected.Results During the study, 69 patients were enrolled. Most frequent hrHPV genotypes were: hrHPV other 72.5%; HPV 16, 20.3% and HPV 18, 7.2%. Colposcopy showed no or minor changes in 92.7% and major changes in 7.2%. CIN 3 was found in 7 patients (10.1%). Prevalence of CIN 3 by hrHPV genotypes was 27.3% for HPV16, 20.0% for HPV18 and 7.1% for HPVO. A statistically significant dependency between hrHPV and cervical intraepithelial neoplasia was demonstrated (p = 0.048).Conclusion Within this single center study of persistent hrHPV, cytologic negative samples, patients with HPV 16 were more likely to have high-grade disease compared to other hrHPV subtypes. Larger prospective randomized trials are needed to substantiate our results and obtain adjusted cervical cancer screening time intervals according to the hrHPV genotypes.
2020 年 1 月，德国开始实施一种不同的宫颈癌筛查方案。建议年龄在 35 岁以上的女性每三年进行一次 HPV 和细胞学联合拭子检查。对于基线和 12 个月后持续存在高危型人乳头瘤病毒（hrHPV）、细胞学阴性的宫颈样本的患者，建议进行阴道镜检查。由于需要进行阴道镜检查，这会带来相当大的额外工作量，因此我们根据 HPV 基因型分析了细胞学阴性且持续存在 hrHPV 的女性中高级别宫颈上皮内瘤变（CIN3）的风险。
本单中心回顾性研究分析了我们认证的阴道镜检查科 2020 年和 2021 年持续存在 hrHPV、细胞学阴性的宫颈样本患者。收集了患者的人口统计学数据、hrHPV 类型、活检率和组织学报告。
研究期间，共纳入 69 例患者。最常见的 hrHPV 基因型为：hrHPV 其他型 72.5%；HPV16 占 20.3%，HPV18 占 7.2%。阴道镜检查显示无变化或轻微变化占 92.7%，明显变化占 7.2%。7 例（10.1%）发现 CIN3。HPV16 型、HPV18 型和 HPV0 型的 CIN3 患病率分别为 27.3%、20.0%和 7.1%。hrHPV 与宫颈上皮内瘤变之间存在显著的相关性（p=0.048）。
在本中心持续存在的 hrHPV、细胞学阴性样本的研究中，与其他 hrHPV 亚型相比，HPV16 型患者更有可能患有高级别疾病。需要更大规模的前瞻性随机试验来证实我们的结果，并根据 HPV 基因型确定调整后的宫颈癌筛查时间间隔。
