Boonkate Sarocha, Karnchanabanyong Wathirada, Ruengkhachorn Irene, Kuljarusnont Sompop, Jareemit Nida, Horthongkham Navin, Pattama Archiraya, Athipanyasilp Sukanya, Hanamornroongruang Suchanan
Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Virol. 2025 Aug;97(8):e70561. doi: 10.1002/jmv.70561.
This study explored histopathological outcomes among women who tested positive for high-risk human papillomavirus (hrHPV), examined the significance of extended HPV genotyping, and identified predictors of cervical intraepithelial neoplasia grade 2 or worse (CIN2). This retrospective review assessed medical records of women who screened positive for hrHPV between January 1, 2020, and December 31, 2023. Genotyping results, diagnostic procedures, and histopathological findings were collected. Data were analyzed using SPSS, with p < 0.05 considered statistically significant. Among 1981 women, the median age was 40 years (IQR 32.0‒49.0), and the median parity was 1 (IQR 0‒2). Overall, 1223 women (61.7%) had prior screening, 1215 women (61.3%) had previous cytology, and 107 women (5.4%) had prior hrHPV testing. Single-genotype infection occurred in 1408 women (74.7%), with HPV52, HPV16, and HPV58 identified in 23.7%, 15.6%, and 15.4% of cases, respectively. CIN2 was detected in 152 women (7.7%), including 130 with CIN2/CIN3/AIS and 22 with cancer. Detection of HPV16 significantly increased the risk of CIN2 (odds ratio [OR] 4.534, 95% CI: 3.197‒6.430), as did multiparity (OR 1.497, 95% CI: 1.070‒2.094). The immediate risk of CIN2 for HPV31, HPV39, HPV56, HPV66, and HPV68 was below 4%. Among hrHPV-positive women, 7.7% had CIN2. Extended hrHPV genotyping may refine risk stratification by highlighting HPV16 and multiparity as significant predictors of CIN2 lesions.
本研究探讨了高危型人乳头瘤病毒（hrHPV）检测呈阳性的女性的组织病理学结果，研究了扩展HPV基因分型的意义，并确定了2级或更高级别宫颈上皮内瘤变（CIN2）的预测因素。这项回顾性研究评估了2020年1月1日至2023年12月31日期间hrHPV筛查呈阳性的女性的病历。收集了基因分型结果、诊断程序和组织病理学发现。使用SPSS进行数据分析，p<0.05被认为具有统计学意义。在1981名女性中，年龄中位数为40岁（四分位距32.0-49.0），产次中位数为1（四分位距0-2）。总体而言，1223名女性（61.7%）曾接受过筛查，1215名女性（61.3%）曾接受过细胞学检查，107名女性（5.4%）曾接受过hrHPV检测。1408名女性（74.7%）发生单基因型感染，HPV52、HPV16和HPV58分别在23.7%、15.6%和15.4%的病例中被检测到。152名女性（7.7%）检测到CIN2，其中130名患有CIN2/CIN3/AIS，22名患有癌症。检测到HPV16会显著增加CIN2的风险（比值比[OR]4.534，95%置信区间：3.197-6.430），多产也会增加风险（OR 1.497，95%置信区间：1.070-2.094）。HPV31、HPV39、HPV56、HPV66和HPV68导致CIN2的直接风险低于4%。在hrHPV阳性女性中，7.7%患有CIN2。扩展hrHPV基因分型可能通过突出HPV16和多产作为CIN2病变的重要预测因素来优化风险分层。
