内蒙中部地区妇科门诊就诊患者宫颈HPV感染及与宫颈病变相关性的研究

目的:分析内蒙中部地区HPV感染的临床特征以及HPV感染与宫颈病变的相关性,为内蒙中部地区宫颈病变的筛查、治疗及预防提供参考依据。方法:2015年12月至2016年12月对在内蒙古医科大学附属医院妇科及内蒙古自治区人民医院妇科就诊的56406例患者常规行HPV分型检测,8533例高危亚型HPV感染患者行阴道镜检查,其中2511例行阴道镜下宫颈活检。按宫颈组织病理诊断结果分为5组:慢性炎症组(1063例),CINI组(865例),CINII组(197例),CINIII组(256例),宫颈癌组(130例)。结果:56406例患者中HPV阳性者9558例,感染率为16.95%,其中高危亚型HPV感染率为15.13%,低危亚型感染率为1.82%。HPV亚型感染率居前五位的依次为HPV16、52、58、53、81。56406例患者中,18~29岁、30~39岁、40~49岁、50~59岁、60~70岁年龄段的HPV阳性率分别为28.99%、22.94%、19.64%、10.66%、8.17%,随着年龄增高,HPV感染率逐渐降低,差异有统计学意义(P0.05)。2511例宫颈活检患者中,随着年龄升高,宫颈癌所占比例逐渐增高,以60~70岁组所占比例最高,达22.06%(P0.05)。2511例宫颈活检患者中,HPV感染以单一亚型为主,且随宫颈病变严重程度增加,多重感染率逐渐下降(P0.05);多重感染中,以二重感染所占比例最高63.60%(545/857),并随HPV型别数增加,所占比例降低,各级宫颈病变中,均有这样的分布特征。慢性炎症组中感染的亚型居前5位分别是HPV16、52、58、53、51;CINI级中感染的亚型主要为HPV16、52、53、58、51型;CINII级中感染的亚型主要为HPV16、58、52、51、18、59型;CINIII级中感染的亚型主要为HPV16、58、52、33、31;宫颈癌中感染的亚型主要以HPV16型(86.15%)为主,其次为HPV18型(4.62%)。HPV16型感染率从宫颈慢性炎到宫颈癌分别为16.75%、19.19%、35.03%、65.63%、86.15%,随着宫颈病变级别增高,HPV16型感染率逐渐递增,差异有统计学意义(P0.05)。结论:内蒙古中部地区妇科门诊就诊患者以HPV16型最常见,其次为52及58型。年龄是HPV感染和宫颈病变的相关因素,随着年龄增加,HPV感染率逐渐降低,但宫颈癌所占比例逐渐升高。各级宫颈病变均以单一HPV感染为主,且宫颈病变的严重程度与HPV感染数目无关,而与HPV种类有关。内蒙中部地区应重视对HPV16、52及58型别的检测、筛查,以及疫苗的研制,并加强对60岁以上人群宫颈病变的筛查力度。     

人乳头瘤病毒基因亚型分布及与宫颈病变关系分析

目的:探讨女性HPV感染率和基因亚型分布,分析其与宫颈病变的关系.方法:收集四川大学华西第二医院2011年9月至2012年8月妇科就诊29832例女性患者的宫颈脱落细胞进行HPV基因分型检测.对2398例同时具有宫颈活检组织病理诊断结果的患者进行分组,包括慢性宫颈炎症组599例;CIN Ⅰ组437例;CINⅡ/Ⅲ组906例(CINⅡ338例,CINⅢ568例);宫颈癌组456例.结果:HPV感染率为25.20％(7518/29832),其中高危型HPV、低危型HPV、HPV多重感染率分别为21.03％(6275/29832)、4.17％(1243/29832)、5.94％(1772/29832).常见的高危型HPV为HPV16、58、33、52、18.随着年龄增加,HPV感染率呈现增高趋势.随着宫颈病变的严重程度增加,HPV感染率增高.所有宫颈病变中,常见的高危型HPV由高至低依次为HPV16、58、33、18、52;在宫颈癌组中为HPV16、18、58、33、52;在CINⅡ/Ⅲ组为16、58、33、52、18.在HPV阳性的不同程度宫颈病变中均以单一感染为主,除慢性宫颈炎组外,单一感染的比例随宫颈病变程度增加而增加.结论:本研究最常见的高危型HPV为16、58、33、52、18,与其他地区相比存在一定的地区差异.HPV感染率随年龄增加呈现增高趋势.在不同宫颈病变中,HPV的型别分布有所不同,单一感染可能更易导致宫颈癌的发生.     

多重人乳头瘤病毒感染检测在宫颈病变诊断中的价值

目的探讨人乳头瘤病毒（human papillomavirus,HPV）检测在宫颈病变筛查中的意义,以及多型别HPV感染与宫颈病变的关系。方法2005年8月至2006年10月应用HPV基因分型技术对北京市垂杨柳医院967例门诊患者进行检测,阳性者进行细胞学检测,两者均阳性者行阴道镜检测;并与同期门诊行细胞学检测的512例患者对比。结果967例中筛查出360例HPV感染患者,感染率为37.23%,单一型别感染率为61.11%,多型别感染率为38.89%。在多型别感染中2种型别感染比例最多（57.86%）。从正常组织到宫颈上皮内瘤样病变（CIN）Ⅱ的不同病变中,多重感染的比例随病变级别上升逐渐增加,与正常者相比差异有显著性意义（P〈0.05）。在CINⅢ和宫颈癌中,多重感染的比例有所下降,但明显高于正常者。HPV联合宫颈薄层液基细胞学（TCT）检测与单纯TCT检测比较,两者中低度鳞状上皮内病变（LSIL）分别为13.33%和5.27%,高度鳞状上皮内病变（HSIL）为4.17%和0.78%,癌为0.56%和0.20%,两者比较差异有显著性意义,P〈0.01。结论结合HPV检测可提高TCT检测的敏感性,多重HPV感染及型别与宫颈病变级别相关。     

HPV多重感染与宫颈病变关系的初步研究

目的探讨人乳头状瘤病毒(HPV)多重感染在不同级别宫颈病变中的分布情况及多重感染亚型间的相互作用。方法采用PCR-反向点杂交人乳头状瘤基因分型技术对300例(慢性宫颈炎症组121例、CIN158例、CIN2 42例、CIN3 20例、宫颈鳞癌组SCC 8例、正常对照组51例)就诊患者进行HPV分型检测。运用?2趋势检验比较HPV在不同病变中的总感染率、多重感染率,分析HPV亚型在多重感染中的分布及变化。结果正常对照组、慢性宫颈炎、CIN1、CIN2、CIN3、SCC组的HPV多重感染率分别为3.92%、9.92%、15.52%、19.05%、15.00%、12.50%。不同宫颈病变相对于正常对照组,多重感染率明显升高(P0.05),宫颈癌组多重感染率与正常对照组比较差异无统计学意义(P0.05);多重感染中以二重感染最常见,二重感染最常见的HPV亚型组合是HPV16+51型。结论 CIN1、CIN2、CIN3及宫颈癌中HPV的感染率均高于正常和宫颈慢性炎症组,高危型HPV多重感染(高危与高危)增加宫颈上皮内病变风险,但与宫颈癌的发生无明显相关性。     

HPV单一感染与多重感染对宫颈病变影响的比较

目的：探讨单一高危HPV亚型与多重高危HPV亚型感染对宫颈病变的影响。方法：选取2010年1月—12月在天津医科大学总医院妇科门诊就诊的有性生活史并出现临床症状的患者137例,比较患者细胞学、病理学结果出现的概率;比较单一高危HPV亚型与多重高危HPV亚型感染对宫颈病变影响的差别。结果：①在全部感染病例中,以20～49岁者居多,并且随着年龄的增长,感染率呈现下降趋势。②感染病例中,高危型别以HPV16感染率最高。③在宫颈高级别病变中,以HPV16感染率最高。④单一高危与多重高危HPV感染相比较,宫颈细胞学和病理学结果差异无统计学意义。⑤高低危混合HPV感染中低级别病变概率高于单纯高危HPV感染,而高级别病变则相反。结论：①与单一高危HPV亚型相比,多重高危HPV亚型感染对宫颈病变严重程度的影响不明显。②与单纯高危HPV亚型感染相比,高低危HPV亚型混合感染更多表现为低级别宫颈病变。     

人乳头瘤状病毒感染型别及多重感染与宫颈癌发病风险的关系研究

目的分析研究人乳头瘤状病毒(HPV)感染型别与宫颈癌发病风险的关系。方法回顾性分析2015年1月—12月液基薄层细胞学检查(TCT)联合HPV DNA检查进行宫颈癌筛查后,再进行阴道镜下宫颈组织病理检查的患者临床资料。结合患者的人口学信息,分析比较单一HPV感染及多重HPV感染型别分别与宫颈癌发病风险,其中以阴道镜下宫颈组织病理检查结果为金标准。结果 2 195名患者的检查结果显示,年龄是宫颈癌发病风险之一,TCT检测结果为低度鳞状上皮内病变(LSIL)或高度鳞状上皮内病变(HSIL),易发高级别宫颈上皮内病变和浸润癌,单一感染与多重感染患者间宫颈癌发病风险没有统计学差异(P0.05),HPV16型的感染率较高,无论患者是否为单一与多重感染,HPV16型都为宫颈癌发病风险,其OR值为6.27。结论需要重视38岁以上妇女的宫颈癌筛查,随着宫颈病变级别增加,HPV单一感染率与多重感染率无统计学差异,且宫颈鳞癌HPV感染倾向于单一高危型HPV16型。     

HPV感染与宫颈鳞癌临床病理因素的相关性分析

目的:分析HPV感染与宫颈鳞癌临床病理因素的相关性。方法:回顾分析中南大学湘雅三医院因宫颈鳞癌行广泛子宫全切及盆腔淋巴结清扫的184例患者的HPV感染情况、TCT结果、肿瘤分期(IA~IIB)、分化程度、肿瘤直径、淋巴结转移情况、间质浸润深度等临床资料,探讨宫颈鳞癌患者HPV感染情况及其与临床病理因素的相关性。结果:184例宫颈鳞癌患者的HPV阳性率为92.9%,其中单一感染占63.6%,多重感染占29.3%,单一感染中前四位HPV感染类型依次为HPV16、18、58、45,多重感染中前四位HPV感染类型依次为HPV16、33、52、18。HPV单一感染的宫颈鳞癌患者较多重感染者的FIGO分期更晚且更易发展为巨块型宫颈癌;HPV感染类型与宫颈鳞癌的临床病理因素之间无相关性。结论:HPV感染模式可影响宫颈鳞癌的临床表现及复发相关因素。     

人乳头瘤病毒的DNA检测在宫颈病变诊断的临床应用

目的:探讨女性生殖道感染人乳头瘤病毒(HPV)和不同宫颈病变的关系。方法:采用PCRDNA反向斑点杂交技术,对520例门诊首诊患者的宫颈脱落细胞标本进行HPV基因诊断和分型,用统计软件SPSS17.0进行统计分析。结果:520例患者标本中HPV的整体感染率为32.1%,其中单重感染占阳性标本的75.4%,双重感染和多重感染分别占阳性标本的17.7%和6.9%。HPV感染在小于30岁时感染率最高,随着年龄的增加,感染率逐渐降低。HPV感染率还随着宫颈病变级别的增加逐渐上升(P<0.001),HPV16亚型随着宫颈病变级别的增加感染率逐渐上升(P<0.001)。不同年龄段HPV多重感染率的差异有统计学意义(P<0.05)。结论:DNA杂交技术可以一次性检测23中HPV型别,而且特异性好、敏感度高、操作简便、结果容易判断,所以DNA杂交技术适用于临床应用,HPV分型检测有助于筛选和诊断宫颈病变,值得推广。     

人乳头瘤病毒的DNA检测在宫颈病变诊断的临床应用

目的:探讨女性生殖道感染人乳头瘤病毒(HPV)和不同宫颈病变的关系。方法:采用PCRDNA反向斑点杂交技术,对520例门诊首诊患者的宫颈脱落细胞标本进行HPV基因诊断和分型,用统计软件SPSS17.0进行统计分析。结果:520例患者标本中HPV的整体感染率为32.1%,其中单重感染占阳性标本的75.4%,双重感染和多重感染分别占阳性标本的17.7%和6.9%。HPV感染在小于30岁时感染率最高,随着年龄的增加,感染率逐渐降低。HPV感染率还随着宫颈病变级别的增加逐渐上升(P<0.001),HPV16亚型随着宫颈病变级别的增加感染率逐渐上升(P<0.001)。不同年龄段HPV多重感染率的差异有统计学意义(P<0.05)。结论:DNA杂交技术可以一次性检测23中HPV型别,而且特异性好、敏感度高、操作简便、结果容易判断,所以DNA杂交技术适用于临床应用,HPV分型检测有助于筛选和诊断宫颈病变,值得推广。     

HPV病毒检测在宫颈病变诊断中的临床观察及价值

目的：探讨高危型人乳头状病毒宫颈细胞学异常病例中诊断宫颈上皮内瘤变的价值。方法：对2010年至2012年妇科门诊经宫颈细胞学筛查提示异常的患者200例,采用HPV病毒检测,并对所有病人进行阴道镜下活检,分析HPV病毒感染与HPV亚型与宫颈病变的相关性。结果：200例宫颈细胞学筛查异常的患者中,HPV感染患者86例,其中高危型感染59例,低危型感染27例,单一亚型感染26例,多重亚型感染36例,宫颈病变者74例。结论：在宫颈细胞学筛查异常的患者中,宫颈上皮内瘤变患者中高危型HPV感染率较高,且HPV重复感染在宫颈高度上皮内瘤变的患者中的几率较高。     

Increased frequency of genital human papillomavirus infection in human immunodeficiency virus-seropositive Taiwanese women.

BACKGROUND AND PURPOSE: Human papillomavirus (HPV) infection is associated with increased incidence and severity of HPV-related cervical dysplasia and cervical cancer in women with human immunodeficiency virus (HIV) infection. This study examined the incidence of genital HPV infection in HIV-infected Taiwanese women and its relationship with cervical neoplasia. METHODS: This hospital-based, case-control study enrolled 31 consecutive HIV-seropositive women and 124 age-matched women who were free from HIV infection. Polymerase chain reaction (PCR) was used to distinguish high-risk (types 16, 18, 31, 33, 52 and 58) and low-risk HPV (types 6 and 11). The occurrence of genital HPV infection was compared between women with and without HIV infection. In addition, CD4 lymphocyte counts were determined by flow cytometry and Papanicolaou test was done in women with HIV infection. RESULTS: HPV and Papanicolaou test were done soon after the diagnosis of HIV infection. HIV seropositive women had a significantly greater high-risk HPV infection rate (48.4%; 15/31) than women without HIV infection (20.2%; 25/124; odds ratio, 3.71; p = 0.001). However, the prevalence of cervical intraepithelial neoplasia was similar between women with and without HIV infection. The CD4 lymphocyte counts in HIV-seropositive women were similar between those with and without genital HPV infection. CONCLUSIONS: The risk of genital HPV infection was significantly increased in HIV-infected women. Due to the association between high-risk HPV infection and the development of cervical dysplasia and cervical cancer, regular follow-up of Papanicolaou test is necessary in these women.     

Cervical schistosomiasis,human papilloma virus (HPV), and human immunodeficiency virus (HIV): a dangerous coexistence or coincidence?

BACKGROUND: Female genitourinary schistosomiasis (FGS) is widespread in endemic areas causing significant morbidity and mortality. Recent data suggest that FGS of the cervix not only is considered a risk factor for contracting different sexually transmitted diseases (STD), but also plays a significant role in modifying the natural history and immunological response to those infections, in particular HIV and HPV. CASE REPORT: A 32-year-old female from Zambia, who was recently diagnosed with HIV and high-grade dysplasia with koilocytosis on cervical Pap smear, underwent cervical conization which confirmed moderate cervical dysplasia and also revealed the presence of viable and nonviable schistosoma eggs in cervical stroma. Four different HPV types were isolated by PCR, including one "low-risk" (type 6) and three "high-risk" types (types 45,56, and 58). CONCLUSION: The presence of HPV, HIV infection, and cervical schistosomiasis in our patient is likely more than coexistence of multiple agents in the same milieu as cervical schistosomiasis increase susceptibility for other STDs including HIV and HPV. Therefore, in patients with schistosomiasis, immediate treatment for schistosomiasis and additional testing for HIV and HPV is warranted.     

In situ hybridization study on the localization of HPV DNA in the precancerous lesions of uterine cervix

Human papillomavirus (HPV) types 16 and 18 have been found closely associated with cervical cancer. In order to investigate the relationship between HPV DNA and cervical precancerous lesions, we examined the formalin fixed specimens obtained from 22 cases of mild dysplasia, 33 cases of moderate dysplasia and 31 cases of severe dysplasia of the uterine cervix for the presence of HPV 6/11, 16 and 18 DNAs by in situ hybridization using the biotinylated HPV DNA probes. We also followed some HPV DNA positive cases of cervical dysplasia for more than 6 months prospectively. The results of in situ hybridization analysis revealed that HPV DNA was detected in the nuclei of koilocytosis, dysplastic cells and metaplastic cells. HPV 6/11 was positive in 27.3% (6/22) of mild dysplasia and 21.2% (7/33) of moderate dysplasia. On the other hand, HPV 16 positive rate increased with the grade of dysplasia and 36.4% (12/33) of moderate dysplasia, 61.3% (19/31) of severe dysplasia were positive for HPV 16 DNA. Some of the follow-up cases which were positive for HPV 16 DNA were later found to have carcinoma in situ. Our results suggest that HPV type 16 might play an important role in cervical carcinogenesis.     

HPV oligonucleotide microarray-based detection of HPV genotypes in cervical neoplastic lesions

BACKGROUND: In this study we examined the use of a new-human papillomavirus (HPV) detection method, the HPV oligonucleotide microarray system (Biomedlab Co., Korea), which we compared with the well-established HPV DNA detection system (Hybrid Capture II; HC-II, Digene Co.). This new method prompted us to develop a new HPV genotyping technique, using the oligonucleotide microarray, to detect the generic and type-specific sequence of HPV types. In particular, we undertook the evaluation of the clinical efficacy of the HPV oligonucleotide microarray for detecting HPV in cervical neoplastic lesions. METHODS: One hundred forty patients were involved and classified into three groups according to their histopathologic diagnoses: Group I (nonspecific chronic cervicitis; n = 61), Group II (low-grade squamous intraepithelial lesion (SIL); koilocytosis, and mild dysplasia; n = 39), and Group III (high-grade SIL; moderate, severe dysplasia and in situ carcinoma; n = 40). Cytological diagnoses were based on the Bethesda System and cervical samples were analyzed by the two methods. The HPV oligonucleotide microarray detected 15 types of high-risk HPV (HPV-16/-18/-31/-33/-35/-39/-45/-51/-52/-56/-58/-59/-66/-68/-69) and 7 types of low-risk HPV (HPV-6/-11/-34/-40/-42/-43/-44). RESULTS: In 105 of the 140 cervical samples (75%), HPV DNAs were examined using the HC-II method. HPV detection rates using the HPV microarray agreed with those of HC-II. One HC-II-positive, but HPV microarray-negative, case occurred in the low-grade SIL (Group II) and was later confirmed negative for HPV. The other HPV microarray-positive but HC-II-negative case was found to be HPV-18 by PCR. Low-risk types of HPV were detected in 3 of 39 low-grade SIL cases (Group II) using the HPV microarray. HPV-16 was the most frequent type (32.1%) in all specimens tested, and was significantly more frequent in low-grade or high-grade intraepithelial lesions (Groups II or III) than in normal controls (Group I) (P < 0.05). HPV-58 was the second most common type (17.5%) in Group III. The HPV microarray was found to have advantages in terms of identifying the HPV genotypes and cases of multiple HPV infection. Double HPV infections were detected in 12 cases and triple HPV infections in 7 cases. Two cases were positive for four types of HPV (HPV-16/18/33/35, HPV-16/18/58/68). The sensitivity of HPV testing (HC-II; 94.9%, HPV microarray; 93.7%) for identifying patients with squamous intraepithelial lesion was significantly better than the sensitivity of cytology (77.1%, P < 0.05). On using multiple logistic regression analysis to estimate the relative risk of SIL versus HPV type, HPV-16-positive cases were found to have a 7.5-fold risk of SIL (95% CI = 3.28-16.51; P < 0.01). HPV-33 and HPV-58 were found to be significantly related to high-grade SILs (P < 0.01). CONCLUSIONS: Our results suggest that the HPV oligonucleotide microarray is highly comparable to HC-II for detecting HPV in cervical specimens. The HPV oligonucleotide microarray provides useful information on viral genotype and multiple HPV infections in HPV-related cervical lesions. Genetic information on HPV in cervical specimens might be a particular benefit of the new procedure in the management of cervical neoplastic lesions     

传统宫颈细胞学检查与薄层细胞学检测的分析比较与评价

目的　对子宫颈癌和癌前病变的检查方法进行综合分析比较与评价。方法　对 2 10 0例患者分别采用传统宫颈细胞涂片 (10 4 9例 )和新柏氏薄层细胞学检测系统 (Thinprepcytologictest,TCT 10 5 1例 )进行宫颈病变的早期筛查 ,对 2 0 6例细胞学阳性或临床可疑的患者行阴道镜下活组织检查。结果　TCT标本的不满意率(0 .4 8% )明显低于传统宫颈细胞涂片 (1 4 3% ) ,明显提高了子宫颈癌及癌前病变的阳性诊断率 ,降低了对AS CUS的诊断率。传统细胞学和TCT检查与阴道镜下活检病理结果符合率分别为LSIL :5 6 82 % (2 5 4 4 )和 74 36 %(2 9 39) ,HIS :4 5 4 5 % (5 11)和 85 71% (18 2 1) ,HPV感染的符合率分别为 5 3 5 7% (15 2 8)和 75 6 8% (2 8 37)。HPV感染和CIN的高发年龄分别为 2 0～ 30岁和 30～ 5 0岁。结论　宫颈细胞学筛查是子宫颈癌及癌前病变早期诊断的重要手段 ,TCT独特的取材与制片方法 ,更有利于宫颈阳性病变的检出 ;细胞学筛查异常或临床可疑的患者 ,应在阴道镜下多点活检 ;细胞学提示HPV感染者 ,应行病理和HPV -DNA检测证实。     

Association between HLA-DQB1 and cervical dysplasia in Vietnamese women

Host genetic background seems to play a key role in cervical carcinogenesis as only a small subset of women infected with high-risk human papillomaviruses (HPVs) develop cervical cancer. The rate of cervical cancer in Vietnamese women is notably high. To explore the association of human leukocyte antigen (HLA)-DQB1 alleles, HPV infection, and cervical dysplasia in this population, cervical smears were obtained from 101 women attending the obstetrics and gynecology clinic of Da Nang General Hospital in Vietnam. Besides the Papanicolaou test, HPV and HLA-DQB1 genotyping were performed using cervical smear DNA. Additionally, a subset of 30 blood samples was used as the gold standard for HLA genotyping. HLA-DQB1 alleles showed no association with HPV infection status. However, a positive association with cervical dysplasia was found for HLA-DQB1*0302 (P= 0.0229, relative risk (RR) = 4.737) and HLA-DQB1*0601 (P= 0.0370, RR = 4.038), whereas HLA-DQB1*0301 (P= 0.0152, RR = 0.221) was found negatively associated. The low diversity of HLA-DQB1 alleles, wide spectrum of HPV genotypes, and high prevalence of HPV 16 and HPV 18 observed in the study population suggest a permissive/susceptible genetic background that deserves further research. Total concordance of HLA-DQB1 genotyping results between blood and cervical cells confirms the potential value of cervical smears as an effective tool for the development of cervical cancer biomarkers.     

Prevalence of human papillomavirus infection and its correlation with cervical lesions in commercial-sex workers in Japan

OBJECTIVE: To investigate the prevalence of the human papillomavirus (HPV) infection and its correlation with cervical lesions in commercial-sex workers (CSWs) who attended a sexually transmitted disease (STD) clinic in an entertainment area in Tokyo. METHODS: Surveys were conducted on 546 prostitutes and 233 control subjects. In all subjects, HPV detection was performed by the hybrid capture method. A cervical cytological examination was performed on 247 prostitutes and 233 control subjects. RESULTS: The HPV-positive rates in the two periods of study were higher (p < 0.01) in CSWs than in the control subjects. When the cytological grades were examined according to HPV-positive rates, the proportion of cytologic Class IIIa to Class IV was significantly higher (p < 0.01) in the HPV-positive CSWs than in the HPV-negative CSWs or in the normal subjects. CONCLUSION: The high frequencies of HPV infection and cervical dysplasia in the CSWs in the present series might predict a higher risk of cervical cancer in this group of subjects.     

Evaluation of urinary cytology of male sexual partners of women with cervical intraepithelial neoplasia and human papilloma virus infection

Condylomas of the genital tract can be found in 70% of patients who have cytologic evidence of human papilloma virus (HPV) infection or mild epithelial dysplasia (CIN I). Most male sexual partners of women with overt or subclinical HPV infections have no visible condylomas. Presently, there is no therapy for subclinically infected male partners. A screening test capable of detecting such HPV infections in males would be of value should effective therapy be discovered. Fifty-four men who were the current sexual partners of women with visible condylomata acuminata or with cytologic evidence of subclinical HPV infection or cervical neoplasia were asked to give a urine specimen for cytologic examination. The cytologist had no knowledge of the cytologic or histopathologic findings in the female partners. Of the 54 women, 39 (72%) had either visible genital condylomas or cytologic evidence of mild dysplasia or of HPV infection with or without mild dysplasia (CIN I). Twenty-five (63%) had histologic evidence of HPV infection with or without mild dysplasia. With one exception, urinary cytologic preparations from the study and from the control males were negative. No correlation could be found between cervical cytology and histology in the females and urinary cytologic findings in their current male partners. At the present time there is no screening test that can be utilized to detect male carriers with subclinical disease.     

HPV 11, 16 and 18 DNA sequences in cervical swabs from women with cervical dysplasia: prevalence and associated risk of progression.

Cervical swabs obtained from 164 women with histologically proven preinvasive and invasive cervical neoplasia were analysed for HPV type 11, 16 and 18 DNA by filter in situ hybridisation. HPV 16 or 18 was detected in 8 of 24 swabs from patients with invasive squamous cell carcinoma (33%), in 59 of 100 patients with carcinoma in situ or severe dysplasia (59%) and in 16 of 40 patients with mild or moderate dysplasia (40%). HPV 6 or 11 was found in only 2% of all swabs. Thirty-eight of the patients participated in a prospective follow-up study and were monitored non-invasively by cytology and colposcopy for 8 to 36 months. 25 patients had persisting or progressive lesions, 13 of which harboured HPV 16 or 18. Of 13 patients who had complete resolution of the dysplasia, only 2 were HPV-positive. The study indicates a significantly higher risk of malignant progression when the cervical dysplasia is associated with HPV 16 or 18 infection.