Abstract：
OBJECTIVE: To stratify the risk of cervical precancers (high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS)) and cancers (squamous cell carcinoma (SCC) and adenocarcinoma) based on distinct high-risk human papillomavirus (hrHPV) genotypes as well as age groups among women with atypical squamous cells of undetermined significance (ASC-US) and hrHPV+results.
METHODS: In total, 2292 cases of ASC-US/hrHPV+ with immediate follow-up biopsy results were included in the study for prevalence analysis.
RESULTS: Overall, 12.2% women with ASC-US /hrHPV+ had HSIL+ while 0.22% had AIS+ lesions. The HPV-16+ group (31.6%) showed significantly higher prevalence of HSIL+ squamous lesions than other genotype groups (p<0.0001). The prevalence of SCC is significantly higher in HPV-16+ (1.8%) or HPV-18/45+ (1.1%) group than women in other genotype groups (0.1%) (p<0.0001). The HPV-18/45+ group (1.7%) showed significantly higher prevalence of AIS+ glandular lesions than other genotype groups (p=0.003). In addition, SCC prevalence was significantly higher in age over 50 group than that in age under 50 group (1.2% vs 0.2%, p=0.012).
CONCLUSIONS: Women with ASC-US/hrHPV+ are at significant risk of cervical precancers and cancers; notably, HPV-16+ group has a higher risk of HSIL squamous lesions and SCC while HPV-18/45+ group has a higher risk of AIS+ glandular lesions. In addition, the older patient group (>50 years) has a significantly higher risk of SCC. Therefore, HPV genotyping as well as patient age need to be considered in the clinical management of patient.
METHODS: In total, 2292 cases of ASC-US/hrHPV+ with immediate follow-up biopsy results were included in the study for prevalence analysis.
RESULTS: Overall, 12.2% women with ASC-US /hrHPV+ had HSIL+ while 0.22% had AIS+ lesions. The HPV-16+ group (31.6%) showed significantly higher prevalence of HSIL+ squamous lesions than other genotype groups (p<0.0001). The prevalence of SCC is significantly higher in HPV-16+ (1.8%) or HPV-18/45+ (1.1%) group than women in other genotype groups (0.1%) (p<0.0001). The HPV-18/45+ group (1.7%) showed significantly higher prevalence of AIS+ glandular lesions than other genotype groups (p=0.003). In addition, SCC prevalence was significantly higher in age over 50 group than that in age under 50 group (1.2% vs 0.2%, p=0.012).
CONCLUSIONS: Women with ASC-US/hrHPV+ are at significant risk of cervical precancers and cancers; notably, HPV-16+ group has a higher risk of HSIL squamous lesions and SCC while HPV-18/45+ group has a higher risk of AIS+ glandular lesions. In addition, the older patient group (>50 years) has a significantly higher risk of SCC. Therefore, HPV genotyping as well as patient age need to be considered in the clinical management of patient.
摘要：
目的：根据不同的高危型人乳头瘤病毒（hrHPV）基因型以及年龄范围，对宫颈癌前病变（高度鳞状上皮内病变（HSIL）和原位腺癌（AIS））和癌症（鳞状细胞癌（SCC）和腺癌）的风险进行分层。
方法：总共，研究中纳入了2292例ASC-US/hrHPV+，并立即随访活检结果，以进行患病率分析。
结果：总体而言，12.2%的ASC-US/hrHPV+患者有HSIL+，0.22%有AIS+病变。HPV-16+组(31.6%)显示HSIL+鳞状病变的患病率明显高于其他基因型组(p<0.0001)。HPV-16+(1.8%)或HPV-18/45+(1.1%)组的SCC患病率明显高于其他基因型组(0.1%)的女性(p<0.0001)。HPV-18/45+组(1.7%)显示AIS+腺体病变的患病率明显高于其他基因型组(p=0.003)。此外,50岁以上组的SCC患病率明显高于50岁以下组（1.2％vs0.2％，p=0.012)。
结论：患有ASC-US/hrHPV+的女性患子宫颈癌前病变和癌症的风险很大；HPV-16+组发生HSIL鳞状病变和SCC的风险较高,而HPV-18/45+组发生AIS+腺体病变的风险较高。此外,老年患者组(>50岁)患SCC的风险明显较高.因此,在患者的临床管理中需要考虑HPV基因分型以及患者年龄。
方法：总共，研究中纳入了2292例ASC-US/hrHPV+，并立即随访活检结果，以进行患病率分析。
结果：总体而言，12.2%的ASC-US/hrHPV+患者有HSIL+，0.22%有AIS+病变。HPV-16+组(31.6%)显示HSIL+鳞状病变的患病率明显高于其他基因型组(p<0.0001)。HPV-16+(1.8%)或HPV-18/45+(1.1%)组的SCC患病率明显高于其他基因型组(0.1%)的女性(p<0.0001)。HPV-18/45+组(1.7%)显示AIS+腺体病变的患病率明显高于其他基因型组(p=0.003)。此外,50岁以上组的SCC患病率明显高于50岁以下组（1.2％vs0.2％，p=0.012)。
结论：患有ASC-US/hrHPV+的女性患子宫颈癌前病变和癌症的风险很大；HPV-16+组发生HSIL鳞状病变和SCC的风险较高,而HPV-18/45+组发生AIS+腺体病变的风险较高。此外,老年患者组(>50岁)患SCC的风险明显较高.因此,在患者的临床管理中需要考虑HPV基因分型以及患者年龄。
