401147 重庆,重庆市妇幼保健院宫颈疾病诊治中心
Received:25 March 2020,
Revised:2020-05-16,
Published:15 August 2020
移动端阅览
Xin LONG, Jun YANG, Deping ZHOU, et al. Synchronous HPV genotyping and quantification assay to predict the outcome of high risk HPV infection: report of 2 784 cases[J]. Journal of Third Military Medical University, 2020, 42(15): 1555-1561.
Xin LONG, Jun YANG, Deping ZHOU, et al. Synchronous HPV genotyping and quantification assay to predict the outcome of high risk HPV infection: report of 2 784 cases[J]. Journal of Third Military Medical University, 2020, 42(15): 1555-1561. DOI: 10.16016/j.1000-5404.202003322.
目的
2
探讨高危型人乳头瘤病毒感染(high risk human papillomavirus infection
HR-HPV)的自然转归规律,确立同步HPV分型及标准化定量检测预测HR-HPV感染转归的最佳阈值。
方法
2
采用同步HPV分型及标准化定量检测对初次检出单一型别HR-HPV感染的2 784例女性进行跟踪随访2年,分析HPV标准化定量与感染转归的关系,绘制ROC曲线确立HPV标准化定量预测HR-HPV持续感染的最佳阈值。
结果
2
2 784例女性HR-HPV自然消退率为73.71%,持续感染率为20.26%,进展率为6.03%。13种HR-HPV标准化定量在HPV感染自然消退组、持续感染组及进展组中相比差异有统计学意义(
H
=673.943,
P
<
0.001)。根据ROC曲线建立同步HPV分型及标准化定量检测预测高危型HPV感染转归的最佳阈值,Log10转化的病毒标准化定量预测HPV16、18、33、52、58、59、68型持续感染的最佳阈值为3.00拷贝数/10 000个细胞,预测HPV31、39、51、56型持续感染的最佳阈值为4.00拷贝数/10 000个细胞,预测13种HR-HPV持续感染的最佳阈值为3.00拷贝数/10 000个细胞,敏感度为88.66%,特异度为59.36%(
P
<
0.001)。
结论
2
HPV标准化定量可以作为一种生物学指标,用于预测女性生殖道HR-HPV感染的转归。
Objective
2
To explore the law of natural outcome of high-risk human papillomavirus (HR-HPV) infection and determine the optimal cutoff for prediction of the infection natural outcome based on the synchronous HPV genotyping and quantification.
Methods
2
A total of 2 784 women who underwent primary cervical screening with single type HPV infection for the first time by the synchronous HPV genotyping and quantification assay were enrolled and followed up for 2 years in this study. The correlation between standardized quantification and HR-HPV infection natural outcome was analyzed. Receiver operating characteristic (ROC) curve was plotted to determine the optimal cutoffs of individual HR-HPV standardized quantification in prediction of persistent infection.
Results
2
Among all the subjects
the natural clearance rate of HR-HPV infection was 73.71%
the persistent infection rate was 20.26% and the progression rate was 6.03%. Statistical differences were observed in the 13 HR-HPVs standardized quantifications among the natural clearance group
persistent infection group
and progression group (
H
=673.943
P
<
0.001). The best threshold of the synchronous HPV genotyping and quantification assay to predict the outcome of HR-HPV infection was established according to ROC curve
and the optimal cutoffs of the log10-transformed quantification for HPV16
18
33
52
58
59 and 68 in prediction of persistent infection were 3.00 copies per 10 000 cells
those for HPV31
39
51 and 56 were 4.00 copies per 10 000 cells. The optimal cutoff of the log10-transformed quantification for 13 HR-HPVs in prediction persistent infection was 3.00 copies per 10 000 cells
and the sensitivity was 88.66% and the specificity was 59.36% (
P
<
0.001).
Conclusion
2
HR-HPV standardized quantification can be used as a biological maker to predict the outcome of HR-HPV infection in the genital tract of female.
MOODY C A, LAIMINS L A. Human papillomavirus oncoproteins: pathways to transformation[J]. Nat Rev Cancer, 2010, 10(8): 550-560. DOI:10.1038/nrc2886.
CUZICK J, WHEELER C. Need for expanded HPV genotyping for cervical screening[J]. Papillomavirus Res, 2016, 2: 112-115. DOI:10.1016/j.pvr.2016.05.004.
US Preventive Services Task Force, CURRY S J, KRIST A H, et al . Screening for cervical cancer: US preventive services task force recommendation statement[J ] . JAMA, 2018, 320(7):674-686. DOI: 10.1001/jama.2018.10897.
王轶英, 王悦, 孔北华, 等. HPV定量检测的临床意义与研究进展[J].中华妇产科杂志, 2017, 52(8): 569-572. DOI: 10.3760/cma.j.issn.0529-567X.2017.08.015.
WANG Y Y, WANG Y, KONG B H, et al . Clinical significance and research progress of quantitative detection of HPV[J ] . Chin J Obstet Gynecol, 2017, 52(8):569-572. DOI:10.3760/cma.j.issn.0529-567x.2017.08.015.
王晴, 张蓓, 印泽远, 等. HPV分型定量检测对宫颈病变的预测价值[J].现代妇产科进展, 2018, 27(5): 351-354, 358.
WANG Q, ZHANG B, YIN Z Y, et al . The value of HPV genotyping and quantitative PCR testing in the prediction of cervical lesions[J ] . Curr Adv Obstet Gynecol, 2018, 27(5): 351-354, 358.
SEGONDY M, NGOU J, KELLY H, et al . Diagnostic value of human papillomavirus (HPV) 16 and HPV18 viral loads for the detection of high-grade cervical intraepithelial neoplasia (CIN2+) in a cohort of African women living with HIV[J ] . J Clin Virol, 2018, 99/100: 79-83. DOI:10.1016/j.jcv.2018.01.006.
MANAWAPAT-KLOPFER A, WANG L, HAEDICKE-JARBOUI J, et al .HPV16 viral load and physical state measurement as a potential immediate triage strategy for HR-HPV-infected women: a study in 644 women with single HPV16 infections[J ] . Am J Cancer Res, 2018, 8(4):715-722.
SUN Z, ZHANG R, LIU Z, et al . Development of a fluorescence-based multiplex genotyping method for simultaneous determination of human papillomavirus infections and viral loads[J ] . BMC Cancer, 2015, 15:860. DOI: 10.1186/s12885-015-1874-9.
WRIGHT T C Jr. The new ASCCP colposcopy standards[J]. J Low Genit Tract Dis, 2017, 21(4):215.DOI: 10.1097/LGT.0000000000000337.
WENTZENSEN N, MASSAD L S, MAYEAUX E J Jr, et al . Evidence-Based consensus recommendations for colposcopy practice for cervical cancer prevention in the united states[J ] . J Low Genit Tract Dis, 2017, 21(4):216-222. DOI: 10.1097/LGT.0000000000000322.
BORNSTEIN J, BENTLEY J, BÖSZE P, et al .2011 colposcopic terminology of the international federation for cervical pathology and colposcopy[J ] . Obstet Gynecol, 2012, 120(1):166-172.
中华预防医学会妇女保健分会.子宫颈癌综合防控指南[M].北京:人民卫生出版社, 2017:8.
Chinese Preventive Medicine Association. Guidelines for comprehensive prevention and control of cervical cancer[M]. Beijing: People's Medical Publishing House, 2017:8.
魏丽惠, 赵昀, 沈丹华, 等.中国子宫颈癌筛查及异常管理相关问题专家共识(一)[J].中国妇产科临床杂志, 2017, 18(2): 190-192. DOI:10.13390/j.issn.1672-1861.2017.02.032.
WEI L H, ZHAO Y, SHEN D H, et al . Expert consensus on cervical cancer screening and abnormal management in China(1)[J ] . Chin J Clin Obstet Gynecol, 2017, 18(2): 190-192. DOI:10.13390/j.issn.1672-1861.2017.02.032.
魏丽惠, 沈丹华, 赵方辉, 等.中国子宫颈癌筛查及异常管理相关问题专家共识(二)[J].中国妇产科临床杂志, 2017, 18(3): 286-288. DOI:10.13390/j.issn.1672-1861.2017.03.041.
WEI L H, SHEN D H, ZHAO F H, et al . Expert consensus on cervical cancer screening and abnormal management in China(2)[J ] . Chin J Clin Obstet Gynecol, 2017, 18(3): 286-288. DOI:10.13390/j.issn.1672-1861.2017.03.041.
张倩, 曹頔, 马茜, 等. 760名女性生殖道高危型人乳头瘤病毒感染自然转归规律及影响因素[J].中国医学科学院学报, 2015, 37(5):534-540. DOI:10.3881/j.issn.1000-503X.2015.05.008.
ZHANG Q, CAO D, MA Q, et al . Natural outcome of genital tract high-risk human papillomavirus infection and associated factors among 760 women[J ] . Acta Acad Med Sin, 2015, 37(5): 534-540. DOI:10.3881/j.issn.1000-503X.2015.05.008.
TREVISAN A, SCHLECHT N F, RAMANAKUMAR A V, et al . Human papillomavirus type 16 viral load measurement as a predictor of infection clearance[J ] . J Gen Virol, 2013, 94(Pt 8): 1850-1857. DOI:10.1099/vir.0.051722-0.
CARCOPINO X, HENRY M, MANCINI J, et al . Two years outcome of women infected with high risk HPV having normal colposcopy following low-grade or equivocal cytological abnormalities: are HPV16 and 18 viral load clinically useful predictive markers?[J ] . J Med Virol, 2012, 84(6): 964-972. DOI:10.1002/jmv.23276.
DEL RÍO-OSPINA L, SOTO-DE L EÓN S C, CAMARGO M, et al . The DNA load of six high-risk human papillomavirus types and its association with cervical lesions[J ] . BMC Cancer, 2015, 15: 100. DOI:10.1186/s12885-015-1126-z.
SOTO-DE LEÓN S C, DEL RÍO-OSPINA L, CAMARGO M, et al . Persistence, clearance and reinfection regarding six high risk human papillomavirus types in Colombian women: a follow-up study[J ] . BMC Infect Dis, 2014, 14: 395. DOI:10.1186/1471-2334-14-395.
SHEN G Q, CHENG J X, WANG Y, et al . Viral DNA load of high-risk human papilloma virus is closely associated with the grade of cervical lesions[J ] . Int J Clin Exp Med, 2014, 7(12): 5826-5831.
XI L F, SCHIFFMAN M, KE Y, et al . Type-dependent association between risk of cervical intraepithelial neoplasia and viral load of oncogenic human papillomavirus types other than types 16 and 18[J ] . Int J Cancer, 2017, 140(8): 1747-1756. DOI:10.1002/ijc.30594.
WU Z N, QIN Y, YU L L, et al . Association between human papillomavirus (HPV) 16, HPV18, and other HR-HPV viral load and the histological classification of cervical lesions: Results from a large-scale cross-sectional study[J ] . J Med Virol, 2017, 89(3): 535-541. DOI:10.1002/jmv.24645.
BROCCOLO F, CHIARI S, PIANA A, et al . Prevalence and viral load of oncogenic human papillomavirus types associated with cervical carcinoma in a population of North Italy[J ] . J Med Virol, 2009, 81(2): 278-287. DOI:10.1002/jmv.21395.
DONG B H, SUN P M, RUAN G Y, et al . Type-specific high-risk human papillomavirus viral load as a viable triage Indicator for high-grade squamous intraepithelial lesion: a nested case- control study[J ] . Cancer Manag Res, 2018, 10: 4839-4851. DOI:10.2147/CMAR.S179724.
LUO H X, BELINSON J L, DU H, et al . Evaluation of viral load as a triage strategy with primary high-risk human papillomavirus cervical cancer screening[J ] . J Low Genit Tract Dis, 2017, 21(1): 12-16. DOI:10.1097/LGT.0000000000000277.
龙馨, 周德平, 杨君, 等.重庆地区29580例女性人乳头瘤病毒感染分布特点分析[J].实用妇产科杂志, 2016, 32(6): 464-467.
LONG X, ZHOU D P, YANG J, et al . Analysis of the distribution characteristics of human papilloma virus infection among 29580 females in Chongqing area[J ] . J Pract Obstet Gynecol, 2016, 32(6): 464-467.
HAJIA M, SOHRABI A. Possible synergistic interactions among multiple HPV genotypes in women suffering from genital neoplasia[J]. Asian Pac J Cancer Prev, 2018, 19(3): 785-789. DOI:10.22034/APJCP.2018.19.3.785.
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
