Background: Both cervical cancer and cervical intraepithelial neoplasia (CIN) are associated with human papillomavirus (HPV) infection at different anogenital sites, but the infection features of high-risk (HR) HPVs at these sites and their association with cervical lesions have not been well characterized. Given the limitation of cervical HPV 16/18 test in screening patients with high-grade CIN (CIN 2+), studies on whether non-16/18 HR-HPV subtype(s) have potential as additional indicator(s) to improve CIN 2+ screening are needed. Methods: The infection of 15 HR-HPVs in vulva, anus, vagina, and cervix of 499 Chinese women was analyzed, and CIN lesion-associated HR-HPV subtypes were revealed. Results: In addition to the well-known cervical-cancer-associated HPV 16, 52, and 58, HPV 51, 53, and 56 were also identified as high-frequency detected subtypes prevalently and consistently present at the anogenital sites studied, preferentially in multi-infection patterns. HPV 16, 52, 58, 56, and 53 were the top five prevalent subtypes in patients with CIN 2+. In addition, we found that cervical HPV 33/35/52/53/56/58 co-testing with HPV 16/18 might improve CIN 2+ screening performance. Conclusion: This study provided a new insight into HR-HPV screening strategy based on different subtype combinations, which might be used in risk stratification clinically.
背景：宫颈癌及宫颈上皮内瘤变（CIN）均与肛门生殖器不同部位的人乳头瘤病毒（HPV）感染相关，但高危型HPV在这些部位的感染特征及其与宫颈病变的关联尚未明确。鉴于宫颈HPV 16/18检测在高级别CIN（CIN 2+）筛查中的局限性，需进一步研究非16/18型高危HPV亚型是否具备作为补充指标提升CIN 2+筛查效能的潜力。方法：本研究对499名中国女性外阴、肛门、阴道及宫颈部位的15种高危HPV感染情况进行分析，揭示了与CIN病变相关的HR-HPV亚型特征。结果：除已知的宫颈癌相关HPV 16、52、58型外，HPV 51、53、56型也被确定为在肛门生殖器部位普遍且持续存在的高频检出亚型，且更倾向于以多重感染模式存在。在CIN 2+患者中，HPV 16、52、58、56、53为前五位流行亚型。此外，研究发现将宫颈HPV 33/35/52/53/56/58与HPV 16/18联合检测可能提升CIN 2+筛查效能。结论：本研究基于不同亚型组合的高危HPV筛查策略提供了新视角，该策略或可应用于临床风险分层管理。
肿瘤(癌症)患者之家