Distéfano A L, Picconi M A, Alonio L V, Dalbert D, Mural J, Bartt O, Bazán G, Cervantes G, Lizano M, Carrancá A G, Teyssié A
Departamento Virología, Instituto Nacional de Enfermedades Infecciosas, Buenos Aires, Argentina.
Infect Dis Obstet Gynecol. 1998;6(5):214-9. doi: 10.1002/(SICI)1098-0997(1998)6:5<214::AID-IDOG5>3.0.CO;2-I.
The aim of this study was to identify human papillomavirus (HPV) in cervical intraepithelial neoplasia (CIN) lesions and to evaluate the persistence of viral DNA after diathermic large loop excision (DLLE) treatment.
Biopsies from 36 patients with low- and high-grade CIN lesions were studied before and after DLLE treatment looking for HPV sequences. DNA was extracted to perform a radioactive polymerase chain reaction (PCR) using GP 5,6 generic primers. PCR products were analyzed by the single-stranded conformational polymorphism (SSCP) which is a simultaneous detection and typing method. Dot-blot hybridization with generic and type-specific biotinylated oligonucleotide probes was applied in some cases.
HPV DNA was found in all pretreatment samples, and the viral type was identified in 80% of them, HPV 16 being the most prevalent. The viral type coincided with that detected in the first biopsy in all except one case. Seventy five percent of the patients (27 cases) were negative for CIN at follow up, but 50% of them remained HPV DNA positive.
DLLE treatment was effective in removing the CIN lesion but not the HPV. This fact points out the need to asses the presence of HPV in DNA during the follow-up, since viral persistence has been considered a high risk factor for recurrence and/or malignant transformation.
本研究旨在检测宫颈上皮内瘤变（CIN）病变中的人乳头瘤病毒（HPV），并评估透热大圈切除术（DLLE）治疗后病毒DNA的持续存在情况。
对36例低级别和高级别CIN病变患者在DLLE治疗前后的活检样本进行研究，以寻找HPV序列。提取DNA，使用通用引物GP 5,6进行放射性聚合酶链反应（PCR）。PCR产物通过单链构象多态性（SSCP）进行分析，这是一种同时检测和分型的方法。在某些情况下，应用与通用和型特异性生物素化寡核苷酸探针的点杂交。
在所有预处理样本中均发现HPV DNA，其中80%鉴定出病毒类型，HPV 16最为常见。除1例病例外，病毒类型与首次活检中检测到的一致。75%的患者（27例）在随访时CIN为阴性，但其中50%仍为HPV DNA阳性。
DLLE治疗有效地切除了CIN病变，但未清除HPV。这一事实表明在随访期间需要评估DNA中HPV的存在情况，因为病毒持续存在被认为是复发和/或恶性转化的高风险因素。
