Non-16/18 high-risk HPV infection predicts disease persistence and progression in women with an initial interpretation of LSIL.
初诊为LSIL女性中非16/18高危型HPV感染预示病变的持续存在以及进展
Abstract
The current management strategy for women with low-grade squamous intraepithelial lesions (LSILs) is inefficient and expensive because of the inability to identify patients at high risk for disease progression. The current study was designed to determine the genotypic patterns of human papillomavirus (HPV) associated with the persistence and progression of cervical lesions in women with an initial interpretation of LSIL.
One hundred sixty-seven women with LSIL on Papanicolaou tests collected between December 1, 2009 and March 30, 2011 were studied. HPV DNA was extracted from residual SurePath specimens, genotypes were determined with a DNA microarray containing 40 HPV genotype probes, and microarray data were confirmed by sequencing. Follow-up Papanicolaou tests and/or biopsies were performed within a 20- to 46-month period after the initial diagnosis.
Ninety-seven of the 167 cases with follow-up results were included in the study. Compared with the women with a regressed cervical lesion, those with a persistent cervical lesion (PCL) were significantly more commonly infected with high-risk human papillomavirus (HR-HPV) genotypes (P < .01) and particularly with non-16/18 HR-HPV genotypes (P < .05). The PCL group also had a significantly higher average number of HR-HPV genotypes and non-16/18 HPV genotypes per specimen (P < .01). Infection with HPV-16/18 genotypes was not significantly associated with the persistence or progression of cervical lesions.
Infection with non-16/18 HR-HPV genotypes but not with HPV-16/18 genotypes was a strong predictor of the persistence and progression of cervical disease upon follow-up. Genotyping solely for HPV-16/18 would miss the majority of patients with LSIL who progress to high-grade squamous intraepithelial lesions. Pooled HR-HPV tests provide a better predictive value than HPV-16/18 genotyping alone in guiding the clinical management of patients with LSIL. Cancer (Cancer Cytopathol) 2015;123:435-42. © 2015 American Cancer Society.
One hundred sixty-seven women with LSIL on Papanicolaou tests collected between December 1, 2009 and March 30, 2011 were studied. HPV DNA was extracted from residual SurePath specimens, genotypes were determined with a DNA microarray containing 40 HPV genotype probes, and microarray data were confirmed by sequencing. Follow-up Papanicolaou tests and/or biopsies were performed within a 20- to 46-month period after the initial diagnosis.
Ninety-seven of the 167 cases with follow-up results were included in the study. Compared with the women with a regressed cervical lesion, those with a persistent cervical lesion (PCL) were significantly more commonly infected with high-risk human papillomavirus (HR-HPV) genotypes (P < .01) and particularly with non-16/18 HR-HPV genotypes (P < .05). The PCL group also had a significantly higher average number of HR-HPV genotypes and non-16/18 HPV genotypes per specimen (P < .01). Infection with HPV-16/18 genotypes was not significantly associated with the persistence or progression of cervical lesions.
Infection with non-16/18 HR-HPV genotypes but not with HPV-16/18 genotypes was a strong predictor of the persistence and progression of cervical disease upon follow-up. Genotyping solely for HPV-16/18 would miss the majority of patients with LSIL who progress to high-grade squamous intraepithelial lesions. Pooled HR-HPV tests provide a better predictive value than HPV-16/18 genotyping alone in guiding the clinical management of patients with LSIL. Cancer (Cancer Cytopathol) 2015;123:435-42. © 2015 American Cancer Society.
摘要
由于不能确定低级别鳞状上皮内病变（LSIL）中高风险患者病变的进展，所以目前对于LSIL的治疗策略无效且昂贵。本研究的目的，就是确定最初判读为LSIL的女性中与宫颈病变持续存在及进展相关的人乳头瘤病毒（HPV）基因类型。 我们研究了2009年12月1日至2011年3月30日期间所搜集的167例巴氏检测结果为LSIL的女性患者。从残留的SurePath样本中提取HPV DNA，采用含有40种HPV基因型探针的DNA微阵列技术确定基因型，同时采用测序法证实微阵列数据。最初诊断后，对这些患者进行巴氏检测和/或活体组织检查随访20-46个月。 我们研究了167例患者中具有随访结果的97例。与发生退变性宫颈病变的女性相比，那些伴有持续性宫颈病变（PCL）的女性显著且更常见感染有高危型人乳头瘤病毒（HR-HPV）基因型（P<0.01），特别是非16/18HR-HPV基因型（P<0.05）。PCL组中每个样本所检测到的HR-HPV基因型以及非16/18 HPV基因型的平均数量都显著增高（P<0.01）。HPV16/18基因型与宫颈病变的持续存在或进展无显著相关性。 非16/18HR- HPV基因型但无HPV16/18基因型感染是随访过程中预测宫颈病变持续存在及进展的一种强有力因素。绝大多数进展为高级别鳞状上皮内病变（HSIL）的LSIL患者没有单独存在的HPV16/18基因型。在指导LSIL患者的临床治疗方面，混合型HR-HPV检测较HPV16/18单独基因型检测具有更好的预测价值。
我要评论
共0条评论