Duan L F, Du H, Xiao A M, Wang C, Huang X, Zhao M F, Men H J, Wu R F
Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen 518036, China.
Family PlanningService Center, Buji Street, Longgang District of Shenzhen, Shenzhen 518129, China.
Zhonghua Fu Chan Ke Za Zhi. 2019 Jul 25;54(7):458-463. doi: 10.3760/cma.j.issn.0529-567x.2019.07.005.
To explore the relationship between cervical lesions and high risk HPV (HR-HPV) viral load reflected by the cycle threshold (Ct) values of Cobas 4800 HPV (Cobas 4800) system. From August 2016 to September 2017, 7 000 women from Shenzhen, were recruited for cervical cancer screening with Cobas 4800 system and cytology co-test. Colposcope biopsies were performed on women who were positive of HPV 16, 18, and positive of HPV types other than 16,18 with cytology [≥ atypical squamous cell of undetermined signification (ASCUS)], or HPV negative but abnormal of cytology [≥ low grade squamous intraepithelial lesion (LSIL)]. The Ct values of HPV 16, 18 and all combined other types coming from Cobas 4800 system were used as an indicator of viral load to analyze the relationship between type-specific HPV load and the cervical lesions. (1) Among the 7 000 screening women, 370 cases were positive for cervical cancer screening, 325 of them underwent colposcope biopsies, and coloposcopy referred rate was 87.8% (325/370). Among 325 women undergoing cervical biopsy, pathological diagnosis was 119 cases of normal cervical cervix, 151 cases of LSIL, and 55 cases of high-grade squamous intraepithelial lesion (HSIL) and above (HSIL(+); including 53 cases of HSIL, 1 case of cervical adenocarcinoma, and 1 case of cervical squamous cell carcinoma). (2) The Ct value of HPV 16 was inversely correlated with the upgrading of the lesions (=-0.617, =0.000), and significant different among normal cervix,LSIL and HSIL(+) (35.4±4.5 vs 31.0±6.0 vs 26.5±4.0; =25.537, =0.000). There was no correlation between Ct value of HPV 18 and cervical lesions (=-0.021, =0.902). The Ct value of other 12 HPV types was statistically difference among normal normal cervix, HSIL(+) and cervicitis (33.0±5.3 vs 29.9±7.2 vs 29.8±5.8; =5.087, =0.007). Among them, LSIL and HSIL(+) were significantly lower than normal cervix (<0.05), but there was no significant difference between LSIL and HSIL(+) (>0.05). The Ct value of HPV 16 detecting in Cobas 4800 system as an indicator of virus load obviously correlates with different grades of cervical lesions, therefore could be a reference of cervical lesion existence and an indicator of lesion prognosis.
探讨Cobas 4800 HPV(Cobas 4800)系统的循环阈值(Ct)值所反映的宫颈病变与高危型人乳头瘤病毒(HR-HPV)病毒载量之间的关系。2016年8月至2017年9月,招募了来自深圳的7000名女性,采用Cobas 4800系统和细胞学联合检测进行宫颈癌筛查。对HPV 16、18阳性,以及HPV 16、18以外其他型别且细胞学检查[≥意义不明确的非典型鳞状细胞(ASCUS)]阳性,或HPV阴性但细胞学检查异常[≥低级别鳞状上皮内病变(LSIL)]的女性进行阴道镜活检。将来自Cobas 4800系统的HPV 16、18及所有其他合并型别的Ct值作为病毒载量指标,分析型特异性HPV载量与宫颈病变之间的关系。(1)在7000名筛查女性中,370例宫颈癌筛查阳性,其中325例接受了阴道镜活检,阴道镜转诊率为87.8%(325/370)。在325例接受宫颈活检的女性中,病理诊断为正常宫颈119例,LSIL 151例,高级别鳞状上皮内病变(HSIL)及以上(HSIL(+);包括53例HSIL、1例宫颈腺癌和1例宫颈鳞状细胞癌)。(2)HPV 16的Ct值与病变升级呈负相关(r=-0.617,P=0.000),在正常宫颈、LSIL和HSIL(+)之间差异有统计学意义(35.4±4.5 vs 31.0±6.0 vs 26.5±4.0;F=25.537,P=0.000)。HPV 18的Ct值与宫颈病变无相关性(r=-0.021,P=0.902)。其他12种HPV型别的Ct值在正常宫颈、HSIL(+)和宫颈炎之间差异有统计学意义(33.0±5.3 vs 29.9±7.2 vs 29.8±5.8;F=5.087,P=0.007)。其中,LSIL和HSIL(+)明显低于正常宫颈(P<0.05),但LSIL与HSIL(+)之间差异无统计学意义(P>0.05)。以Cobas 4800系统检测的HPV 16的Ct值作为病毒载量指标,与不同级别的宫颈病变明显相关,因此可作为宫颈病变存在的参考及病变预后的指标。