Background. The objective of the present study is to investigate the age-specific distribution of HPV genotypes in CIN3 lesions in screened unvaccinated women. These data are essential to optimize current and future screening programs. Methods. A multicenter retrospective study was conducted. A total of 408 unvaccinated women with positive histology and a high-risk HPV genotype were enrolled. Each woman at baseline had HPV DNA testing and HPV genotyping, and all women underwent targeted biopsy and/or treatment with a loop electrosurgical excision procedure (LEEP) before entering the study. We divided the genotypes into HPV16/18 and HPV non-16/18 (HPV31/33/45/35/39/51/52/58/59/66/68). Women were divided into increasing age categories: <30, 30–44, and ≥45. Results. The percentage of CIN3 associated with HPV16/18 is maximum in women under 30 years of age (85.1%), drops to 75.6% in women aged between 30 and 44 years, and up to 47.2% in women over 45 years. CIN3 in women younger than 30 years was significantly associated with HPV16/18 genotypes (p= 0). Discussion. The data from the present study suggest that the risk of CIN3 is related to the woman’s age and hr HPV genotype. The data highlight two different types of CIN3: a more frequent type, related to HPV16/18, which develops rapidly and in young women, and another, relating to non-16/18 HPV, which develops later at an advanced age and slowly, through low-grade lesions.
背景：本研究旨在探讨未接种疫苗的筛查女性中，宫颈上皮内瘤变3级（CIN3）病变的HPV基因型年龄特异性分布。这些数据对于优化当前及未来的筛查方案至关重要。方法：开展了一项多中心回顾性研究。共纳入408例组织学阳性且携带高危HPV基因型的未接种疫苗女性。所有受试者在入组前均接受HPV DNA检测及基因分型，并通过靶向活检和/或环形电切术（LEEP）进行治疗。将HPV基因型分为HPV16/18型与非16/18型（包括HPV31/33/45/35/39/51/52/58/59/66/68）。按年龄将受试者分为三组：<30岁、30-44岁及≥45岁。结果：在30岁以下女性中，HPV16/18型相关的CIN3占比最高（85.1%），30-44岁女性中降至75.6%，45岁以上女性中进一步降至47.2%。30岁以下女性的CIN3与HPV16/18基因型显著相关（p=0）。讨论：本研究数据表明，CIN3的发生风险与女性年龄及高危HPV基因型相关。数据揭示了两类不同的CIN3发展模式：一类更常见于年轻女性，与HPV16/18型相关，进展迅速；另一类与非16/18型HPV相关，多发生于高龄女性，通常经低级别病变缓慢进展形成。
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