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首页> 美国卫生研究院文献>Journal of Clinical Microbiology >Multiple Human Papillomavirus Infections with High Viral Loads Are Associated with Cervical Lesions but Do Not Differentiate Grades of Cervical Abnormalities
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Multiple Human Papillomavirus Infections with High Viral Loads Are Associated with Cervical Lesions but Do Not Differentiate Grades of Cervical Abnormalities

机译：高病毒载量的多种人乳头瘤病毒感染与宫颈病变有关但不能区分不同程度的宫颈异常

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Multiple human papillomavirus (HPV) genotypes often coexist within cervical epithelia and are frequently detected together in smears of different grades of cervical neoplasia. Describing the association between multiple infections and cervical disease is important in generating hypotheses regarding its pathogenesis. We analyzed the prevalence of multiple HPV infections and their attribution to cervical disease in a screening population of 999 consecutive BD SurePath liquid-based cervical cytology samples enriched with atypical squamous cells of undetermined significance (ASCUS) (n = 100), low-grade squamous intraepithelial lesions (LSIL) (n = 100), and high-grade squamous intraepithelial lesions (HSIL) (n = 97). HPV genotyping was performed only on cytology specimens using a broad-spectrum GP5+/6+-PCR/multiplex HPV genotyping (BSGP5+/6+-PCR/MPG) assay that detects and quantifies 51 HPV genotypes and 3 subtypes. Using a recently defined high viral load cutoff, the quantitative data were scored as high or low viral load. In the 36-month follow-up, 79 histologically confirmed cervical intraepithelial neoplasia grade 2 or greater (CIN2+) cases were identified. In the screening population, there was a trend of having more multiple infections at a younger age. Multiple HPV infections were common. Multiple HPV types were most prevalent in LSIL (75.9% of HPV positives), followed by HSIL (65.5%), ASCUS (64.6%), and negative for intraepithelial lesion or malignancy (NILM) (36.8%). On average, 3.2 and 2.5 HPV types were detected per LSIL and HSIL sample, respectively. Multiple HPV types with high viral loads were most prevalent in LSIL (62.6% of high viral load positives), followed by HSIL (51.9%), ASCUS (40.7%), and NILM (19.3%). Patients with multiple high viral loads showed a 4- to 6-fold-higher risk of having cervical precancerous cytological lesions than did patients with single high viral loads. Compared to NILM, multiple infections, especially with multiple high viral loads, were significantly associated with cytological precancerous lesions. However, the presence of multiple infections did not distinguish low-grade from high-grade cytological lesions.
机译：多种人类乳头瘤病毒（HPV）基因型通常在宫颈上皮细胞中共存，并且经常在不同等级的宫颈肿瘤形成的涂片中一起检测到。描述多种感染与宫颈疾病之间的关联对于产生有关其发病机理的假设很重要。我们分析了999个连续BD SurePath液基宫颈细胞学样本的筛查人群中多种HPV感染的患病率及其对宫颈疾病的归因，这些样本富含未定意义的非典型鳞状细胞（ASCUS）（n = 100），低度鳞状鳞状细胞上皮内病变（LSIL）（n = 100）和高级别鳞状上皮内病变（HSIL）（n = 97）。仅使用广谱GP5 + / 6 + -PCR /多重HPV基因分型（BSGP5 + / 6）对细胞学标本进行HPV基因分型 + -PCR / MPG）检测，可检测和定量51种HPV基因型和3种亚型。使用最近定义的高病毒载量临界值，将定量数据记为高或低病毒载量。在36个月的随访中，确定了79例经组织学证实为2级以上的宫颈上皮内瘤变（CIN2 +）的病例。在筛查人群中，有一种趋势，即在年轻时发生多种感染。多次HPV感染是常见的。多种HPV类型在LSIL中最为普遍（占HPV阳性的75.9％），其次是HSIL（65.5％），ASCUS（64.6％），以及上皮内病变或恶性肿瘤（NILM）阴性（36.8％）。平均每个LSIL和HSIL样本检测到3.2和2.5 HPV类型。在LSIL中，多种具有高病毒载量的HPV类型最为普遍（占高病毒载量阳性的62.6％），其次是HSIL（51.9％），ASCUS（40.7％）和NILM（19.3％）。具有多个高病毒载量的患者显示出宫颈癌前细胞病变的风险比具有单个高病毒载量的患者高4至6倍。与NILM相比，多种感染，尤其是多种高病毒载量，与细胞学癌前病变显着相关。但是，多种感染的存在不能区分低度和高度细胞学病变。

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