HRHPV DNA载量 分型和e6蛋白对宫颈癌前病变进展的预测作用*

Objective: To explore biomarkers of predicting the progression of cervical intraepithelial neoplasia grade 1 (CIN1) in women with positive human papillomavirus (hrHPV). Methods: From October 2010 to August 2012 in Shanxi, Henan, Jiangxi province, 7,543 women underwent hrHPV DNA and E6 protein (OncoE6) screening tests. Women with either positive results were referred to colposcopy for biopsy and followed up after one year. Women with hrHPV positivity or CIN1 were included in the analysis. Results: A total of 794 eligible women were included in the final analysis; among them, 88 women progressed histologically in one year. The relative risk of progression for women with intermediate/high hrHPV viral load compared to low hrHPV viral load was 2.9 (95%CI: 1.8-4.8); correspondingly, the figures in women with positive HPV16/18/45 and OncoE6 were 2.4 (95%CI: 1.5-3.9) and 2.9 (95%CI: 1.5-5.9), respectively. The corresponding absolute risks for progression to CIN2+ were 4.9% (95%CI: 3.2-7.4), 9.0% (95%CI: 5.5-14.3), and 18.8% (95% CI: 10.2-31.9), respectively. The absolute risk of progression for women with intermediate/high hrHPV 16/18/45 viral load and positive OncoE6 was as high as 32.4%. Conclusions: The hrHPV intermediate/high viral load, HPV16/18/45 genotyping, and E6 protein (On-coE6) showed promising predictive value for cervical precancer. In particular, women with intermediate/high hrHPV viral load and On-coE6 positivity should be followed up closely.