JZUS - Journal of Zhejiang University SCIENCE

Journal of Zhejiang University SCIENCE B 2017 Vol.18 No.3 P.249-255

Prognostic value of human papillomavirus 16/18 genotyping in low-grade cervical lesions preceded by mildly abnormal cytology

Author(s): Jing Ye, Bei Cheng, Yi-fan Cheng, Ye-li Yao, Xing Xie, Wei-guo Lu, Xiao-dong Cheng
Affiliation(s): Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
Corresponding email(s): attwentyone@163.com, chengxd@zju.edu.cn
Key Words: Low-grade squamous intraepithelial lesion (LSIL), Cervical intraepithelial neoplasia grade 1 (CIN1), Human papillomavirus (HPV), HPV16/18 genotyping, Prognostic value, Prospective study

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Abstract: Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 (LSIL/CIN1) preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus (HPV) 16/18 genotyping in 273 patients with LSIL/CIN1. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV (hrHPV) were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases (69.6%) regressed, 37 (13.6%) persisted, and 46 (16.8%) progressed. HPV16/18 positivity (hazard ratio (HR), 2.708; 95% confidence interval (CI), 1.432–5.121; P=0.002) is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured.

人乳头瘤病毒16/18分型在细胞学轻度异常的低度宫颈病变中的预测价值

目的：评估人乳头瘤病毒（HPV）16/18分型在细胞学正常或轻度异常的低度宫颈病变中的预测价值，为临床分流决策提供依据。
创新点：目前对于细胞学正常或轻度异常的低度宫颈病变患者缺乏有效分流策略。本研究首次探索HPV16/18分型对这部分患者疾病转归的预测价值。
方法：新招募细胞学正常或轻度异常的低度宫颈病变患者，以6个月为间隔随访2年，采用Cox回归模型对入组HPV16/18分型结果与疾病转归进行关联分析。
结论：对于HPV16/18阳性，细胞学轻度异常，且30岁及以上的低度宫颈病变患者，可以考虑比保守随访更积极的诊疗方案。

关键词：低度鳞状上皮内病变；宫颈上皮内瘤变1级；人乳头瘤病毒（HPV）；HPV16/18分型；预测价值；前瞻性研究

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人乳头瘤病毒16/18分型在细胞学轻度异常的低度宫颈病变中的预测价值

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