Multiple HPV 16 infection with two strains: a possible marker of neoplastic progression
Multiple HPV 16 infection with two strains: a possible marker of neoplastic progression
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DOI：
10.1186/s12885-020-06946-7
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发表时间：
2020-05-19
期刊：
影响因子：
3.8
通讯作者：
Boemi, Sara
中科院分区：
文献类型：
--
作者：
Bruno, Maria Teresa;Scalia, Guido;Boemi, Sara
背景我们研究了单一和多重HPV感染的病例，并分析了与阴性病例、宫颈癌前病变和宫颈癌病变的相关性，旨在为讨论中的预后因素做出贡献。方法909例宫颈细胞学检查阳性的妇女接受第二级筛查。所有患者均行阴道镜检查和宫颈活检，并进行病毒基因分型。我们根据存在的基因型数量将mHPV感染分为：2株、3株、4株和5株或更多株感染。统计分析使用卡方检验进行数据分析。创建列联表以评价单次、多次和CIN2+感染之间的相关性。p <0.05的值被认为具有统计学显著性。结果HPV16基因型的存在与高级别病变的风险增加12倍相关，OR = 12.70。单次感染者CIN 2+的发生率最高（34.1%），而多次感染者为10.6%。在mHPV感染中，我们研究了不同基因型之间的组合情况，发现在mHPV16感染中，HPV 16，18和HPV 16，31的组合在CIN 3病变中最常见（55.5%）。结论：我们的研究结果表明，单一HPV感染有更大的风险发展为鳞状细胞癌相对于多重感染。多重HPV感染仅在病变的第一阶段（CIN1-CIN2）相关，而在癌中不存在，其中感染是单一基因型的。特别是，在多重感染中，具有2种HR基因型的HPV16感染与CIN2/CIN3显著相关（21/30），并且发展为高级别病变的风险高4倍。因此，很可能只有HPV的特定组合（HPV 16，18-HPV 16，31）可以与临床显著影响相关，而其他组合可以简单地相关，因为常见的感染或使用的诊断方法。因此，具有两种高危基因型的HPV16多重感染是CIN 2/CIN 3的主要风险。
Background We studied the cases of single and multiple HPV infection and analyzed the correlation with negative cases, and preneoplastic and neoplastic lesions of the uterine cervix with the aim of making a contribution to the prognostic factor under discussion. Methods Nine hundred nine women undergoing second level screening because they had been positive at cervical cytology were enrolled. All the patients underwent colposcopy and cervical biopsy with viral genotyping. We divided mHPV infection based on the number of genotypes present: infections with 2 strains, 3 strains, 4 strains and 5 or more strains. Statistical analysis The analysis of the data was made using the chi 2 test. Contingency tables were created to evaluate the correlation between single, multiple and CIN2+ infections. Values with p < 0.05 were considered statistically significant. Results The presence of genotype HPV16 in our study was associated with a 12 times greater risk of developing a high-grade lesion, OR = 12.70. The patients with single infections had the highest incidence of CIN2+ (34.1%) with respect to those with multiple infections (10.6%).When we studied in the mHPV infection the prevalence of the combinations between the genotypes, we found that in mHPV16 infections, the combinations HPV16, 18 and HPV16, 31 were the most frequent (55.5%) in CIN3 lesion. Conclusions Our results suggest that single HPV infections have a greater risk of developing SCC with respect to multiple infections. Multiple HPV infections are relevant only in the first phase of the lesion (CIN1-CIN2), while they are absent in carcinomas, where infections are of a single genotype. In particular, among multiple infections, HPV16 infection with 2 HR genotypes is associated significantly with CIN2 / CIN3 (21/30) and has 4 times greater risk of developing a high-grade lesion. Thus, it is probable that only specific combinations of HPV (HPV16,18 - HPV 16,31) can be associated with a clinically significant impact, while other combinations can simply be correlated because of a common infection or diagnostic method used. Therefore, multiple HPV16 infections with two high-risk genotypes is a major risk of CIN2/CIN3.