title: Moderate variation of the oncogenic potential among high-risk human papillomavirus types in gynecologic patients with cervical abnormalities.
abstract: The oncogenic potential of human papillomavirus (HPV) infection was assessed by following the disease course in 455 patients who had had a routine diagnostic Hybrid Capture HPV test due to squamous cell abnormalities of the uterine cervix as detected by cytology and/or colposcopy. At entry, 308 patients had cytologic atypia classified as P3 by the Papanicolau classification, 168 had a positive high-risk HPV test, and 23 were infected only with low-risk HPV. The patients were followed-up using the patient registry until the endpoint of histologically diagnosed cervical intraepithelial neoplasia (CIN). High-grade CIN was diagnosed in 75 surgical biopsies. High-risk HPV infection (relative risk: 76.8 CI(95): 23.7-249.5), cytologic atypia (RR: 16.2 CI(95): 3.9-66.6), and age above 35 (RR: 1.99 CI(95): 1.26-3.16) were independent risk factors for high-grade CIN, while the viral load did not predict oncogenic progression (P = 0.47). After PCR-RFLP typing, the high-risk types were classified into groups as follows: (1) types 16 and 18, (2) types 45, 52, and 56, (3) types 31, 33, 35, 51, and 58. The relative risks of high-grade CIN were 119.1 (CI(95): 36.2-390.9) for group 1, 44.4 (CI(95): 9.8-201) for group 2, and 39.7 (CI(95): 10.9-144.8) for group 3, respectively. The risk ratios between the groups of high-risk types were found to differ at most by a factor of 2.98 (corrected P value: 0.007) indicating that the oncogenic potential varies moderately within the high-risk group of HPVs.
authors.affiliation: Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Szoke
authors.forename: Tamás
authors.initials: T
authors.lastname: Sápy
authors.forename: Zoárd
authors.initials: Z
authors.lastname: Krasznai
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Hernádi
authors.forename: Györgyi
authors.initials: G
authors.lastname: Szládek
authors.forename: György
authors.initials: G
authors.lastname: Veress
authors.forename: Joakim
authors.initials: J
authors.lastname: Dillner
authors.forename: Lajos
authors.initials: L
authors.lastname: Gergely
authors.forename: József
authors.initials: J
authors.lastname: Kónya
mesh_terms: D002584:Cervix Uteri / Q000473:pathology; D005260:Female; D014644:Genetic Variation; D006801:Humans; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000150:complications* / Q000473:pathology / Q000821:virology; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D012307:Risk Factors; D002575:Uterine Cervicitis / Q000150:complications / Q000473:pathology / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000209:etiology* / Q000821:virology