Human papillomavirus is a necessary cause of invasive cervical cancer worldwide
Human papillomavirus is a necessary cause of invasive cervical cancer worldwide
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DOI：
10.1002/(sici)1096-9896(199909)189:1
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发表时间：
1999-09-01
影响因子：
7.3
通讯作者：
Munoz, N
中科院分区：
文献类型：
--
作者：
Walboomers, JMM;Jacobs, MV;Munoz, N
最近的一份报告称，全世界93%的浸润性宫颈癌含有人乳头瘤病毒（HPV），这可能是一个低估;由于样本不足或整合事件影响HPV L1基因，这是聚合酶链反应（PCR）为基础的测试的目标。因此，重新分析了本研究中以前HPV阴性病例的HPV血清抗体和HPV DNA，对66例HPV阴性病例中的49例和866例HPV阳性病例中的48例进行了HPV 16 VLP、E6和E7抗体的血清学检查。此外，还通过夹心程序重新分析了66份以前HPV阴性活检中的55份，其中一系列切片中的外部切片用于组织学检查，而内部切片通过针对不同开放阅读框（ORF）的三种不同的NPV PCR测定进行测定，HPV 16蛋白在HPV PCR阴性和阳性病例之间的血清学无显著差异，对14种高危NPV类型进行的类型特异性E7 PCR在55份原始HPV阴性和可扩增标本中的38份（69%）中检测到HPV DNA。HPV分型为16、18、31、33、39、45、52和58型，另有2例（4%）仅E1和/或L1一致PCR阳性。在所有PCR检测中，34个合格样本中只有2个HPV阴性，而21个不合格样本中有13个HPV阴性（p < 0.001）。结合本研究和先前研究的数据并排除不充分的标本，宫颈癌中HPV的全球患病率为99.7%，几乎所有宫颈癌中HPV的存在意味着迄今为止报告的任何主要人类癌症的特定原因的全球可归因比例最高。HPV阴性癌症的极端罕见性加强了HPV检测的理由，除了，甚至代替，在常规宫颈筛查宫颈细胞学。版权所有（C）1999约翰威利父子有限公司。
A recent report that 93 per cent of invasive cervical cancers worldwide contain human papillomavirus (HPV) may be an underestimate; due to sample inadequacy or integration events affecting the HPV L1 gene, which is the target of the polymerase chain reaction (PCR)-based test which was used. The formerly HPV-negative cases from this study have therefore been reanalysed for HPV serum antibodies and HPV DNA, Serology for HPV 16 VLPs, E6, and E7 antibodies was performed on 49 of the 66 cases which were HPV-negative and a sample of 48 of the 866 cases which were HPV-positive in the original study. Moreover, 55 of the 66 formerly HPV-negative biopsies were also reanalysed by a sandwich procedure in which the outer sections in a series of sections are used for histological review, while the inner sections are assayed by three different NPV PCR assays targeting different open reading frames (ORFs), No significant difference was found in serology for HPV 16 proteins between the cases that were originally HPV PCR-negative and -positive, Type-specific E7 PCR for 14 high-risk NPV types detected HPV DNA in 38 (69 per cent) of the 55 originally HPV-negative and amplifiable specimens. The HPV types detected were 16, 18, 31, 33, 39, 45, 52, and 58, Two (4 per cent) additional cases were only HPV DNA-positive by E1 and/or L1 consensus PCR, Histological analysis of the 55 specimens revealed that 21 were qualitatively inadequate. Only two of the 34 adequate samples were HPV-negative on all PCR tests, as against 13 of the 21 that were inadequate (p < 0.001). Combining the data from this and the previous study and excluding inadequate specimens, the worldwide HPV prevalence in cervical carcinomas is 99.7 per cent, The presence of HPV in virtually all cervical cancers implies the highest worldwide attributable fraction so far reported for a specific cause of any major human cancer. The extreme rarity of HPV-negative cancers reinforces the rationale for HPV testing in addition to, or even instead of, cervical cytology in routine cervical screening. Copyright (C) 1999 John Wiley & Sons, Ltd.