埼玉医科大学雑誌

埼玉医科大学雑誌第30巻第2号 (2003年4月) 147-153頁 ◇論文(図表を含む全文)は，PDFファイルとなっています．

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原　著
HPV感染による子宮頚部病変の長期予後について

王　驤
埼玉医科大学産婦人科学教室〔平成15年2月14日受付〕

The Prognosis of the HPV Infected Cervical Lesions after Followed-up for a Long Term
O Jou (Department of Gynecology and Obstetrics, Saitama Medical School, Moroyama, Iruma-gun, Saitama 350-0495, Japan)

Objective: HPV infections are very common in women, only very few develop clinically relevant dysplastic lesions or even cancer. Some infected cases experienced spontaneous regression, and some showed persistent infection. On the other hand, cervical dysplasia that displays a certain persistent process from the normal to tumorigenic state in the tissues, is a precancerous lesion on the histopathological viewpoint. Unfortunately, long-term follow-up cases on HPV-infected uterocervixes are limited. In this study, patients with cervical dysplasia were monitored with the attempt of detecting the continuous changes in cervical lesions. Furthermore, treatments for the HPV-infected cases in progression group were attempted and progresses in these cases were observed. Materials and methods: We examined 573 women aged 16-81 who visited our Department of OB/Gyn between April 1992 and October 2002 for Papanicolaou Smear Testing and HPV examination. All the patients were divided into 3 groups. Progression group includes patients with developed process of cervical lesions, which were from smear ≦ Class II to mild dysplasia, or from mild to severe dysplasia, or from dysplasia to carcinoma in situ. Regression group consisted of patients with regression, or reducing from dysplasia to smear ≦ Class II or from severe to mild dysplasia. In the dysplasia cases, patients whose lesions persisted in one stage were classified in persistence group. Results: Of 206 women who were followed-up for 2 years, 118(57.3%) were HPV-positive. Among these, the numbers of the three groups were 56(47.5%) in regression group, 35(29.6%) in persistence group, and 27(22.8%) in progression group. Among 29 women infected with HPV-16, their distribution in the three groups were 5(17.2%), 12(41.4%) and 12(41.4%) respectively. Eighty-eight (42.7%) cases of 206 women were HPV-negative and their distribution in the three groups were 57(64.7%), 26(29.5%), and 5(5.7%), respectively. Of the post-operation cases, 16 were followed-up and their HPV persistencies were reevaluated. Within these 16 cases, 14 were turned out to be HPV-negative and got a smear ≦ Class II. Conclusion: The results confirm an important pathogenic role of high-risk-types HPV infections in cervical dysplasia as well as in cervical cancers. After an effective treatment, HPV-positive cases have a strong tendency of negative conversion, and most of them have an HPV-negative report and normal histologycal findings finally.
Keywords: HPV types, high-risk-type HPV, progression group, cervical dysplasia, carcinoma in situ
J Saitama Med School 2003;30:147-153
(Received February 14, 2003)

HPV: human papilloma virus, PCR: polymerase chain reaction

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