Kotloff K L, Wasserman S S, Russ K, Shapiro S, Daniel R, Brown W, Frost A, Tabara S O, Shah K
Department of Pediatrics, University of Maryland School of Medicine, Baltimore 21201, USA.
Sex Transm Dis. 1998 May;25(5):243-50. doi: 10.1097/00007435-199805000-00005.
Human papillomavirus (HPV) is strongly implicated in the etiology of cervical neoplasia; however, the frequency, rate, and predictors of neoplastic progression are unknown.
To measure the type-specific prevalence of cervical HPV and the rate of development of cytological abnormalities among a cohort of college women and to elucidate factors associated with acquisition of HPV DNA and progression to cytological abnormalities.
Women 18 to 40 years of age seeking routine gynecologic care at a university health center were enrolled in a cross-sectional study with prospective, longitudinal follow-up of a subset of women. Demographic and behavioral data were collected using a written questionnaire. HPV DNA was detected in cervical scrapes by polymerase chain reaction using L1 consensus primers and a generic and 25 type-specific probes, and cervical cytological abnormalities were identified by Papanicolaou's (Pap) smear.
HPV DNA was detected in 35% of the 414 women in the cross-sectional study; 66% of infections were with intermediate or high cancer risk HPV types. Multiple lifetime sex partners was an independent predictor of prevalent infection. Longitudinal analysis of 205 women showed that detection was transient (HPV DNA absent at follow-up) in 38% of the 84 women who were HPV-positive at enrollment. Persistent detection of the same HPV type at > or = 2 visits occurred in 14% of women and was significantly more common when intermediate or high cancer risk types were present. After 16 months of observation, 9% of HPV-infected women developed low-grade squamous intraepithelial lesions (SIL) and 5% developed high-grade SIL; the risk of incident SIL was 7.8-fold higher among women who had persistent HPV detection with the same type.
It was concluded that cervical HPV infection is highly prevalent among college women. Although most infections are caused by intermediate of high cancer risk types, few women (5%) developed high-grade SIL during 16 months of observation.
人乳头瘤病毒（HPV）与宫颈癌变的病因密切相关；然而，肿瘤进展的频率、速率及预测因素尚不清楚。
测定一组大学女生中宫颈HPV的型特异性流行率及细胞学异常的发生率，并阐明与HPV DNA感染及进展为细胞学异常相关的因素。
在大学健康中心寻求常规妇科护理的18至40岁女性参与了一项横断面研究，并对部分女性进行前瞻性纵向随访。通过书面问卷收集人口统计学和行为学数据。使用L1共有引物及通用和25种型特异性探针，通过聚合酶链反应在宫颈刮片中检测HPV DNA，并用巴氏涂片法识别宫颈细胞学异常。
在横断面研究的414名女性中，35%检测到HPV DNA；66%的感染为中或高癌风险HPV型。多个性伴侣是感染流行的独立预测因素。对205名女性的纵向分析显示，在入组时HPV阳性的84名女性中，38%的检测为短暂性（随访时无HPV DNA）。14%的女性在≥2次就诊时持续检测到同一HPV型，当中或高癌风险型存在时更为常见。观察16个月后，9%的HPV感染女性发生了低级别鳞状上皮内病变（SIL），5%发生了高级别SIL；持续检测到同一型HPV的女性发生SIL的风险高7.8倍。
得出结论，宫颈HPV感染在大学女生中非常普遍。尽管大多数感染由中或高癌风险型引起，但在16个月的观察期内，很少有女性（5%）发生高级别SIL。
