Sadeghi Zahra, Aboofazeli Amir, Sarrafzadeh Sheida, Tayebi Naeimeh, Tajdini Roxana, Yarandi Fariba, Jazayeri Seyed Mohammad
Department of Pathobiology, Division of Microbiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
Virol J. 2025 Jul 31;22(1):264. doi: 10.1186/s12985-025-02858-9.
Cervical cancer (CC) is a serious health issue, especially in low- and middle-income countries, primarily caused by human papillomavirus (HPV) infection, particularly genotypes 16 and 18. Other risk factors include smoking, early sexual activity, and long-term oral contraceptive use. Early detection through cervical cytology and HPV testing is vital for effective prevention.
This study aimed to analyze the clinical and epidemiological characteristics of cervical intraepithelial neoplasia (CIN) in HPV-positive women at a Tehran teaching hospital, focusing on HPV genotypes and their association with CIN.
We conducted a cross-sectional study of HPV-positive women who underwent Pap smear testing, HPV genotyping via real-time PCR, and colposcopy with biopsies of suspected lesions. Risk factors like smoking and alcohol consumption were evaluated, and statistical analyses were performed, including ordinal logistic regression.
Among participants, 52.4% had abnormal CIN: CIN I (31.1%), CIN II (11.4%), and CIN III (10.0%). HPV-16 was the most prevalent genotype (43.7%), significantly associated with severe CIN outcomes (odds ratio [OR] = 2.88, 95% CI), followed by HPV-18 (OR = 1.87, 95% CI). Smoking increased the risk of severe CIN (OR = 1.53, 95% CI), while older age and later age at sexual debut correlated with better CIN outcomes.
HPV-16 and smoking are major predictors of severe CIN, highlighting the need for targeted interventions such as HPV vaccination and smoking cessation, along with regular screenings to lower cervical cancer risks. Additional research is required to evaluate the persistence of different HPV genotypes and their progression to CIN and cervical cancer."
宫颈癌是一个严重的健康问题，在低收入和中等收入国家尤为突出，主要由人乳头瘤病毒（HPV）感染引起，特别是16型和18型。其他风险因素包括吸烟、过早开始性行为和长期使用口服避孕药。通过宫颈细胞学检查和HPV检测进行早期检测对于有效预防至关重要。
本研究旨在分析德黑兰一家教学医院HPV阳性女性宫颈上皮内瘤变（CIN）的临床和流行病学特征，重点关注HPV基因型及其与CIN的关联。
我们对接受巴氏涂片检查、通过实时PCR进行HPV基因分型以及对疑似病变进行活检的HPV阳性女性进行了横断面研究。评估了吸烟和饮酒等风险因素，并进行了包括有序逻辑回归在内的统计分析。
在参与者中，52.4%患有异常CIN：CIN I（31.1%）、CIN II（11.4%）和CIN III（10.0%）。HPV-16是最常见的基因型（43.7%），与严重CIN结果显著相关（优势比[OR]=2.88，95%可信区间），其次是HPV-18（OR=1.87，95%可信区间）。吸烟增加了严重CIN的风险（OR=1.53，95%可信区间），而年龄较大和初次性行为年龄较晚与较好的CIN结果相关。
HPV-16和吸烟是严重CIN的主要预测因素，这凸显了有针对性干预措施的必要性，如HPV疫苗接种和戒烟，以及定期筛查以降低宫颈癌风险。需要进一步研究来评估不同HPV基因型的持续性及其向CIN和宫颈癌的进展情况。
