The Korean Journal of Cytopathology 15 (1) : 17-27, 2004

Transcription

1 5 The Korean Journal of Cytopathology 5 () : 7-7,

2 / 5 / / (human papillomavirus, HPV), 6%, 5% HPV. HPV HPV. HPV HPV,,5 HPV HPV. HPV, 6 HPV. HPV HPV International Agency for Research on Cancer (IARC) HPV DNA ( ) 5. S 6 ( ) ( ).,68, 8 (%), 6 (9.7%), 7 (.5%),,,, (.7%).,68.,6 (6.%).. 99, ml 5 ml. ml -7.. HPV DNA. HPV DNA HPV oligoprobe cocktail GP 5+/6+ primer-mediated PCR-EIA 87 HPV (HPV 6, 8,,, 5, 9, 5, 5, 5, 56, 58, 59, 66, 68) HPV (HPV 6,, 6,,,,,, 5, 5, 55, 57, 6, 7, 7 (CP86), 7, 7, 8 (CP8), 8/IS9, 8 (MM7), 8 (MM8), CP 68 6 HPV DNA Jacobs 7 PCR-EIA. HPV Combita 8 enzyme linked immunoassay HPV 6, 8,,, 58 5 L virus-like particles IgG ( VLPs). 7

3 : HPV Papanicolaou. The Bethesda System, (9.8%), 7 (5.%). (atypical squamous cells of undetermined significance, ASCUS) (atypical glandular cells of undetermined significance, AGUS) (.%), (low-grade squamous intraepithelial lesion, LSIL) 8 (.%), (high-grade squamous intraepithelial lesion, HSIL) (.%), (carcinoma in situ, CIS) (.%), (invasive cervical carcinoma, ICC) (.%) % (/88), 5 5.% (9/7), 5 (Table ). HPV DNA 87 9 (.%), 5, 5 7 (8.6%). 5 HPV DNA %, 6 % (Table ). HPV HPV 9 5 (6%) HPV. HPV 5 HPV, 5 HPV HPV, 5 HPV HPV.5. 5 HPV HPV 6 (Table ). HPV DNA Cytologic diagnosis Age ASCUS (year) Normal LSIL HSIL CIS ICC AGUS < (%) 86 (9.8) (.) 8 (.) (.) (.) (.) 99 () ASCUS; Atypical squamous cells of undetermined significance, AGUS; Atypical glandular cells of undetermined significance, LSIL; Low-grade squamous intraepithelial lesion, HSIL; High-grade squamous intraepithelial lesion, CIS; Carcinoma in situ, ICC; Invasive cervical carcinoma HPV 9 7 (8.9%), HPV,, (Table ). 6 HPV DNA HPV, 57, 6, 7, 7, 7, HPV HPV 7 (5.6%), HPV 6 (.%), HPV (.%) HPV 7, 6, (Table ). HPV DNA 8 7 (8.5%), (7.6%). HPV DNA ASCUS 8 (.%), LSIL 7 9 (5.9%), HSIL 7 (%) HPV DNA (Table ). HPV HPV 7 6 (5.%) ASCUS (5%), LSIL 9 HSIL 7 6 (%) (Table ). HPV 7 HPV 7 (7%), HPV 9 (.9%). 8 (9%) HPV, HPV

4 / 5 / / Age group (year) HPV type <5 (n=7) 5- (n=5) 5- (n=8) 5-5 (n=6) 55 (n=95) (n=87) No. of HPV (+) cases (%) High-risk HPV Low-risk HPV No. of multiple infection type types types types (8.6) (.) (8.9) 6 (.) 7 (8.7) 6 9 (.) Cytologic diagnosis* HPV type Normal (n=8) ASCUS (n=8) LSIL (n=7) HSIL or higher (n=7) (n=86) No. of HPV (+) cases (%) High-risk HPV Others Low-risk HPV 7 8 Others 7 (8.5) (.) 9 (5.9) 9 7 (.) 7 9 (.) * : ASCUS; Atypical squamous cells of undetermined significance, LSIL; Low-grade squamous intraepithelial lesion, HSIL; High-grade squamous intraepithelial lesion : High-risk HPV types other than HPV 6, 8,,, 58, 66 : Low-risk HPV types other than HPV 7, (5%), HPV 58, HPV 66 (Table ). 7 HPV HPV, LSIL HPV. VLPs 86 7 (9.7%), 7 (69%) HPV, 5 (%) 86. VLPs HPV 8 85 (9.7%), HPV 7 (5.9%), HPV 6 55 (9.%), HPV (5%), HPV 58 9 (.%) (Table ). 5, 5 5 % 55 % (Table ).

5 : HPV Age group Type of anti-vpls No. of antibody* No. of antibody (+) cases Age group (year) < Virgins < (9.) 85 (9.7) 6 7 (5.9) 5 (5.) 8 9 (.) ( ) 6 (.7) 9 (.) 9 (.) (.) 86 () 5 /7 ( ) /9 (.8) 57/78 (.5) 5/5 (.) 7/9 (.9) 7/86 (9.7) /7 (.) / ( 6.7) 5/ (.9) * ; The number includes multiple antibody-positive women, ( ) ; percent HPV DNA VLPs. VLPs 5 (.9%), 5 7 (.%) HPV 8,,, 5 (6.7%) HPV 8 (Table ). VLPs 96 VLPs, HPV (7.9%), HPV 65 (7.%), HPV 6 6 (5.%). HPV (9.%), HPV 6 HPV 6 (.8%). 8.% 57.% (Table 5). HPV DNA VLPs 86 HPV HPV DNA 9 9 (.%) 5 HPV, HPV HPV 6, 8,,, 58 (6.7%) HPV Cytologic diagnosis (%) anti-vlps No. HSIL type of cases Normal ASCUS LSIL or higher No. of cases Type of anti-vlps 6 5( 5.7) 6 ( 5.) (.) 5 ( 5.5) ( ) 8 8( 8.9) 7 ( 7.9) (.) (.) (.) 7( 7.8) 65 ( 7.) (.) (.) (.) 9(.) 6 (.) (.) (.) ( ) 58 6(.9) (.5) ( ) (.) (.) 69(9.7) (8.) 6 (7.) 6 (88.9) 5(7.) ASCUS; Atypical squamous cells of undetermined significance, LSIL; Low-grade squamous intraepithelial lesion, HSIL; Highgrade squamous intraepithelial lesion DNA. 5 HPV VLPs 7 5 HPV DNA 7 (8.%) (Table 6). HPV DNA HPV - (HPV type-specific anti-hpv antibody), HPV 6, HPV, HPV 58 7, HPV, HPV 8 HPV 8

6 / 5 / / HPV DNA Any of HPV types * No. of cases Serum anti-vlps Negative (%) Positive (%) Negative (8.) 5 (9.6) Positive 9 7 (78.9) 9 (.) Any of 5 HPV types Negative 8 67 (8.) 56 (8.8) Positive 6 (5.) (6.7) No. of cases (8.) 7 (9.8) * ; high-risk and low-risk HPV types ; High-risk HPV types : HPV 6, 8,,, 58 HPV DNA type Same type anti-vlps Negative Positive HPV 6 Negative 8 7 Positive 7 HPV 8 Negative Positive HPV Negative Positive HPV Negative 87 Positive 7 HPV 58 Negative 8 Positive 5 (Table 7). HPV DNA , %, HPV DNA.%, VLPs 9.8%. HPV.%, 5 (9.%) 9 (.9%), (6%) (.5%) HPV. HPV DNA 5. HPV Stoler 6 HPV DNA %, 9 %,. 5 5, 55 HPV U. HPV. HPV DNA 5 % 9 % HPV. HPV HPV DNA.%, HPV DNA %, ASCUS 5.7%, LSIL 6.%, HSIL 8%. 7 HPV DNA

7 : HPV 8.5%, 7.6% HPV, HSIL %. HPV Castle % ASCUS, 6.% LSIL,.% HSIL, HPV.% ASCUS, Rosendaal 9 HPV CIN III HPV 6. HPV DNA, HPV 6 6 6%, HPV 8 -%, HPV 5-8%, HPV -7%, HPV -5%, HPV 8-95% HPV 6, 8,,, 5 5. HPV 58 HPV 5. HPV HPV HSIL HPV. HPV HPV 6,,,,,, HPV 6,, 5, 5, 7, 7, 7. HPV 6%, LSIL 6 HPV. HPV HPV 6, 7 6, 5. HPV DNA 6 HPV 6 6.6%. HPV DNA 7.5%, %, %,. HPV HPV,,,. HPV DNA 9 HPV 7, 6,, HPV 7 (5.6%). HPV 85 Clifford HPV 7,,.%,.7%,.5%,.%,,. HPV 7.6% (/86), HPV 7 ASCUS, HPV 7 HPV,. 6 HPV 7 HPV, HPV 7 HPV 6,. HPV DNA HPV. HPV HPV.7, 9%. HPV, HPV HPV,, HPV. HPV HPV 8, HPV.8 HPV, HPV 6., Woodman HPV HPV, HPV %, HPV HSIL 6 (-69 ). HPV HSIL 6, HPV HPV DNA 6

8 / 5 / / Schlecht SIL HPV HPV HPV 6.7, HPV 6 8 % SIL. HPV HPV HPV SIL, HPV HPV DNA HPV. Ho HPV 6. HPV HPV 7%, 9%. HPV HSIL HPV., HPV DNA VLPs. VLPs 9.7% HPV DNA.%,.%. HPV Carter %, HPV 6 HPV 6 8. HPV -5% - HPV (type-specific anti-hpv antibody) HPV HPV. HPV HPV. HPV, HPV. 8, HPV. HPV Combita 8 HPV, HPV 8 HPV HPV, HPV 6, HPV 6, 58, HPV 8, 5, 59. HPV HPV -. 5% VLPs, VLPs HPV DNA, 5 HPV DNA HPV. HPV, HPV. 7 HPV 56%, 8%,. 8 Carter HPV 6 HPV 8 HSIL % (/9), HSIL 7% (/7) HPV HSIL. HPV DNA, HPV HPV. HPV DNA HPV HPV. HPV 6 de Gruijl 6 HPV 6 HSIL, HPV 6 HPV 6 HSIL, HPV 6 LSIL

9 : HPV. HSIL HPV 6 HPV 6 8.% HPV 6 69.%, HPV 6. - HPV HPV DNA HPV % (9/9), 5 HPV 6, 8,,, 58 DNA 7% (/). HPV DNA 7 Combita 8 HPV DNA 56% 8%, HPV -. HPV DNA HPV 6,,, HPV - HPV DNA HPV 6 HPV 5 HPV HPV 5 HPV HPV -. HPV -. 8 HPV HPV, HPV HPV DNA - HPV DNA HPV -, HPV -, HPV HPV HPV DNA. HPV DNA 9% HPV DNA 9.6% % 7. VLPs %, % 9.8%. 8 HPV DNA probe, HPV DNA., HPV HPV, AIDS HPV HPV HPV. 5 HPV,,5 HPV. HPV HPV DNA HPV HPV PCR-EIA 6 HPV DNA, ELISA HPV 6, 8,,, 58 5 L virus-like particle IgG ( VLPs), 5.%, ASCUS AGUS.%, LSIL.%, HSIL

10 / 5 / /.%, CIS.%,.%. HPV DNA.%, 5. HPV DNA HPV 7, HPV 6, HPV. HPV 5, HPV DNA HPV 6, 58, 66. HPV 6, 8,,, 58 5 HPV VLPs 9.7%,. VLPs HPV 8,, 6. 5 HPV DNA VLPs (6.7%), HPV DNA -, HPV 6. HPV DNA 8.9%, VLPs %. VLPs.9%. HPV, HPV DNA VLPs HPV.. Ho GYF, Bierman R, Beardsley L, Chang CJ, Burk RD. Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med 998;8:-8.. Koutsky L. Epidemiology of genital human papillomavirus infection. Am J Med 977;:-8.. Bosch FX, Lorincz A, Munoz N, Meijier CJLM, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol ;55:-65.. Harro CD, Pang YY, Roden RB, et al. Safety and immunogenicity trial in adult volunteers of a human papillomavirus 6 L virus-like particles vaccine. J Natl Cancer Inst ;9: Evans TG, Bonnez W, Rose RC, et al. Phase I study of a recombinant viruslike particle vaccine against human papillomavirus type in healthy adult volunteers. J Infect Dis ;8: Hwang T. Detection and typing of human papillomavirus DNA by PCR using consensus primers in various cervical lesions of Korean women. J Korean Med Sci 999;: Jacobs MV, Roda Husman AM, van den Brule AJ, Snijders PJ, Meijer CJ, Walboomers JM. Group-specific differentiation between high- and low-risk human papillomavirus genotypes by general primer-mediated PCR and two cocktails of oligonucleotide probes. J Clin Microbiol 995;: Combita AL, Bravo MM, Touze A, Orozco O, Coursaget P. Serologic response to human oncogenic papillomavirus types 6, 8,,, 9, 58 and 59 viruslike particles in Colombian women with invasive cervical cancer. Int J Cancer ;97: Sukvirach S, Smith JS, Kesararat W, et al. Population-based human papillomavirus prevalence in Lampang and Songkla, Thailand. 9th International Papillomavirus Conference ;P-:9.. Pham TH, Nguyen TH, Herrero R, et al. Human papillomavirus infection among women in South and North Vietnam. Br J Cancer ;:-.. Herrero R, Hildesheim A, Bratti C, et al. Population-based study of human papillomavirus infection and cervical neoplasia in rural Costa Rica. J Natl Cancer Inst ; 9:6-7.. Lazcano-Ponce E, Herrero R, Mu oz N, et al. Epidemiology of HPV infection among Mexican women with normal cervical cytology. Int J Cancer ;9:-.. Jacobs MV, Walboomers JM, Snijders PJ, et al. Distribution of 7 mucosotropic HPV types in women with cytologically normal cervical smears: the age-related patterns for high-risk and low-risk types. Int J Cancer ;87:-7.. Molano M, Posso H, Weiderpass E, van den Brule AJ, Ronderos M, Franceschi S. Prevalence and determinants of HPV infection among Colombian women with normal cytology. Br J Cancer ;87:-. 5. Shin HR, Lee DH. Cancer incidence in Busan, Korea, Busan: Association of Busan Cancer Registry,. 6. Stoler MH. Advances in cervical screening technology. Mod Pathol ;: Kulasingam SK, Hughes JP, Kiviat NB, et al. Evaluation of human papillomavirus testing in primary screening for cervical abnormalities. Comparison of sensitivity, specificity, and frequency of referral. JAMA ;88: Castle PE, Wacholder S, Sherman ME, et al. Absolute risk of a subsequent abnormal pap among oncogenic human papillomavirus DNA-positive, cytologically negative women.

11 : HPV Cancer ;95: Rosendaal L, Walboomers JMM, van der Linden JC, et al. PCR-based high-risk HPV test in cervical cancer screening gives objective risk assessment of women with cytomorphologically normal cervical smears. Int J Cancer 996;68: Clifford GM, Smith JS, Plummer M, Munoz N, Franceschi S. Human papillomavirus types in invasive cancer worldwide: a meta-analysis. Br J Cancer ;88:6-7.. Schlecht NF, Kulaga S, Robitaille J, et al. Persistent human papillomavirus infection as a predictor of cervical intraepithelial neoplasia. JAMA ;86:6-.. Woodman CB, Collins S, Winter H, et al. Natural history of cervical papillomavirus infection in young women: a longitudinal cohort study. Lancet ;57:8-6.. Touzè A, de Sanjose S, Coursaget P, et al. Prevalence of anti-human papillomavirus type 6, 8,, and 58 virus-like particles in women in the general population and in prostitutes. J Clin Microbiol ;9:-8.. Carter JJ, Koutsky LA, Hughes JP, et al. Comparison of human papillomavirus types 6, 8, and 6 capsid antibody response following incident infection. J Infect Dis ; 8: Bosch FX, Rohan T, Schneider A, et al. Papillomavirus research update: highlights of the Barcelona HPV international papillomavirus conference. J Clin Pathol ; 5: de Gruijl TD, Bontkes HJ, Walboomers JMM, et al. Immunoglobulin G responses against human papillomavirus type 6 virus-like particles in a prospective nonintervention cohort study of women with cervical intraepithelial neoplasia. J Natl Cancer Inst 997;89:6-8.