ABSTRACT
Objective To explore the role of humall papillomavims (HPV) type 16 E6 variants in the persistent infection and recurrence of the cervical high-grade squamous intraepithelial lesion (HSIL) after conization. Motheds During May to June 2012, 100 HSIL patients with HPV16 positive but negative at the margin after Loop electrosurgical excision procedure (LEEP) were selected from Shanghai People′s Hospital of Pudong District. The gene sequencing was done to the E6. The patients were followed up for 2 years. The E6 gene sequencing was done again to detect the HPV16 variants among those with persistent infections and recurrence. Results Among the 100 cases, E6 variants were detected, 81% of them HPV E6 variants Asian prototype, 14% European variant; 2% European prototype (EP) and 3% African variant 1. LEEP for Asian prototype was susceptible to the clearance of HPV16 (P < 0.001). The European variants of T350G, and A442C were correlated with persistent infection and recurrence (P < 0.001). Conclusion The HPV16 variant is closely related to the HSIL incidence. HSIL caused by HPV16 in Pudong New Area of Shanghai belong to the Asian type variant. The European variants of E6 , T350G/A442C were likely related to the recurrence of HPV16.
ABSTRACT
OBJECTIVE: To determine the clinical value of human papillomavirus deoxyribonucleic acid(HPV DNA) testing by polymerase chain reaction(PCR), specifically to examine whether HPV testing could identify the women with Pap smears read as mostly atypical squamous cells of undetermined significance(ASCUS) or more. METHODS: HPV DNA testing by PCR for 3 high-risk cancer associated genotypes(HPV 16, 18, 33), repeat Pap smears and colposcopically directed punch biopsies were performed concurrently on 169 women referred for cervical cancer screening test with a previous Pap smear read as ASCUS or more. RESULTS: HPV DNA testing positivity was significantly associated with abnormal cytology and high-grade squamous intraepithelial lesion(HSIL) and squamous cell carcinoma(SCC) in histology(P=0.034). The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) of Pap smear and HPV testing for identifying 38 cases of histologically confirmed HSIL and carcinoma by different triage protocols(HPV positive or HSIL or SCC) among 169 women were 65.8%(25/38), 85.5%(112/131), 56.8%(25/44) and 89.6%(112/125), respectively. Also sensitivity, specificity, PPV and NPV were varied by ages and more higher in older. CONCLUSION: HPV DNA testing by PCR appears to offer an effective means by which women whose cervical Pap smears have been read as ASCUS or more could be triaged for colposcopically directed biopsy. The sensitivity for HSIL could be maintained in high and specificity markedly improved by HPV genotypes 16, 18, 33.