J Gynecol Oncol.  2016 Nov;27(6):e56. 10.3802/jgo.2016.27.e56.

Can human papillomavirus (HPV) genotyping classify non-16/18 high-risk HPV infection by risk stratification?

• Sung YE
• Ki EY
• Lee YS
• Hur SY
• Lee A
• Park JS

• KMID: 2374258
• DOI: http://doi.org/10.3802/jgo.2016.27.e56

Abstract

OBJECTIVE
Infection with high-risk genotypes of human papillomavirus (HR-HPV) is the major cause of invasive cervical cancers. HPV-16 and HPV-18 are known to be responsible for two-thirds of all invasive cervical carcinomas, followed by HPV-45, -31, and -33. Current guidelines only differentiate HPV-16/18 (+) by recommending direct colposcopy for treatment. We tried to evaluate whether there are differences in risk among 12 non-16/18 HR-HPV genotypes in this study.
METHODS
The pathology archive database records of 1,102 consecutive gynecologic patients, who had results for cervical cytology and histology and for HPV testing, as determined by HPV 9G DNA chip, were reviewed.
RESULTS
Among the 1,102 patients, 346 were non-16/18 HR-HPV (+) and 231 were HPV-16/18 (+). We calculated the odds ratios for ≥cervical intraepithelial neoplasia 2 (CIN 2) of 14 groups of each HR-HPV genotype compared with a group of HR-HPV (-) patients. Based on the odds ratio of each genotype, we divided patients with non-16/18 HR-HPV genotypes (+) into two groups: HPV-31/33/35/45/52/58 (+) and HPV-39/51/56/59/66/68 (+). The age-adjusted odds ratios for ≥CIN 2 of the HPV-31/33/35/45/52/58 (+) and HPV-39/51/56/59/66/68 (+) groups compared with a HR-HPV (-) group were 11.9 (95% CI, 7.6 to 18.8; p<0.001) and 2.4 (95% CI, 1.4 to 4.3; p<0.001), respectively, while that of the HPV-16/18 (+) group was 18.1 (95% CI, 11.6 to 28.3; p=0.003).
CONCLUSION
The 12 non-16/18 HR-HPV genotypes can be further categorized (HPV-31/33/35/45/52/58 vs. HPV-39/51/56/59/66/68) by risk stratification. The HPV-31/33/35/45/52/58 genotypes might need more aggressive action. Large scale clinical trials or cohort studies are necessary to confirm our suggestion.

Keyword

Cervical Intraepithelial Neoplasia; Human Papillomavirus DNA Tests; Papillomavirus Infections; Uterine Cervical Neoplasms

MeSH Terms

Adult
Cervical Intraepithelial Neoplasia/*virology
Colposcopy
DNA, Viral/analysis
Female
*Genotype
Human papillomavirus 16/genetics
Human papillomavirus 18/genetics
Humans
Middle Aged
Papanicolaou Test
Papillomaviridae/*genetics
Papillomavirus Infections/*virology
Risk Factors
Uterine Cervical Neoplasms/virology
Vaginal Smears
DNA, Viral