Chua K L, Hjerpe A
Department of Pathology and Cytology, Huddinge University Hospital, Karolinska Institute, Sweden.
Cancer. 1996 Jan 1;77(1):121-7. doi: 10.1002/(SICI)1097-0142(19960101)77:1<121::AID-CNCR20>3.0.CO;2-6.
A persistent genital infection with an oncogene-type of human papillomavirus (HPV) is considered to be essential for the development of most cervical carcinomas. Therefore, HPV analysis has been proposed as a possible complementary cytological screening program. The authors have developed a technique to analyze archival Pap smears, which has enabled them to study the relation between persistent HPV infection and the development of cervical cancer.
Nested polymerase chain reaction was used to demonstrate the presence of HPV DNA, and sequencing of the obtained amplimer was performed to establish HPV type. The authors analyzed a series of 88 smears taken 1.5 to 7 years prior to the diagnosis of an HPV-containing cervical carcinoma (12 invasive adenocarcinomas, 18 invasive squamous carcinomas, and 58 squamous carcinoma in situ), which were compared with age-matched controls with no tumor development.
HPV DNA was present in a majority of the smears preceding a cancer, with an odds ratio of around 15 for all tumor groups. Infections with a persisting HPV type were demonstrated in most samples from a series of eight patients, from who multiple smears were available, covering the 7-year period preceding the cancer diagnosis.
Persisting infection can be demonstrated in exfoliated cells many years before cancer is diagnosed. The results are complementary to those obtained with cytology, that is, HPV is detected also in those at-risk patients whose Pap smears are morphologically normal. However, the results are still insufficient to justify a general recommendation to use HPV testing for health control purposes.
人乳头瘤病毒（HPV）致癌基因类型的持续性生殖器感染被认为是大多数宫颈癌发生的必要条件。因此，HPV分析已被提议作为一种可能的补充细胞学筛查方案。作者开发了一种分析存档巴氏涂片的技术，这使他们能够研究持续性HPV感染与宫颈癌发生之间的关系。
采用巢式聚合酶链反应来证明HPV DNA的存在，并对获得的扩增子进行测序以确定HPV类型。作者分析了一系列88份涂片，这些涂片是在诊断含HPV的宫颈癌之前1.5至7年采集的（12例浸润性腺癌、18例浸润性鳞状细胞癌和58例原位鳞状细胞癌），并与未发生肿瘤的年龄匹配对照进行比较。
在大多数癌症发生前的涂片中都存在HPV DNA，所有肿瘤组的优势比约为15。在一系列8名患者的大多数样本中都证明存在持续性HPV类型感染，这些患者有多次涂片，涵盖了癌症诊断前的7年时间。
在癌症诊断前许多年，就可以在脱落细胞中证明存在持续性感染。这些结果与细胞学检查结果互补，也就是说，在巴氏涂片形态正常的高危患者中也检测到了HPV。然而，这些结果仍不足以证明普遍推荐将HPV检测用于健康控制目的是合理的。
