Abstract

BackgroundThe significance of HPV viral load in the detection of cervical lesions is still controversial. This study analyzed the correlation between the high-risk HPV viral load and different cervical lesion degrees.MethodsThis retrospective study included women positive for high-risk HPV DNA and screened for cervical lesions between 01/2015 and 06/2018. The high-risk HPV DNA load was measured by the second-generation Hybrid Capture technology and classified as low, moderate, and high. Colposcopy and biopsy were performed in all patients. The patients were grouped as normal, cervical intraepithelial neoplasia (CIN) grade 1, CIN grade 2, CIN grade 3, and cervical cancer. Multivariable logistic regression was performed to explore the association between high-risk HPV DNA load and cervical lesions. The odds ratios (ORs) represent the odds for increasing from low to high viral load.ResultsFinally, 265 patients were grouped as normal (n = 125), CIN 1 (n = 51), CIN 2 (n = 23), CIN 3 (n = 46), and cervical cancer (n = 20). Among them, 139 (52.5%) had a low viral load, 90 (34.0) had a moderate viral load, and 36 (13.4%) had a high viral load. Taking the normal control group as a reference, a high viral load was an independent factor for CIN 1 (OR = 3.568, 95% CI: 1.164–10.941, P = 0.026), CIN 2 (OR = 6.939, 95% CI: 1.793–26.852, P = 0.005), CIN 3 (OR = 7.052, 95% CI: 2.304–21.586, P = 0.001), and cervical cancer (OR = 8.266, 95% CI: 2.120–32.233, P = 0.002).ConclusionsAmong women who underwent cervical biopsy, higher high-risk HPV viral load in cervical lesions was associated with a higher risk of high-grade cervical lesions.

Highlights

  • The significance of Human papillomavirus (HPV) viral load in the detection of cervical lesions is still controversial

  • Persistent HPV infection results in squamous intraepithelial lesions graded as cervical intraepithelial neoplasia (CIN) 1, CIN 2, and CIN 3 according to how much epithelium is impacted [8]

  • The viral load of patients in the CIN grade 3 and cervical cancer groups was higher than that of patients in the normal group, but there were no significant differences among the other groups (Table 2)

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Summary

Introduction

The significance of HPV viral load in the detection of cervical lesions is still controversial. This study analyzed the correlation between the high-risk HPV viral load and different cervical lesion degrees. Cervical cancer is the fourth major malignant tumor in women worldwide [1]. In 2018, there were an estimated 570,000 new cases of cervical cancer in the world and 311,000 deaths, with 85% of the new cases being in developing countries [2]. Human papillomavirus (HPV) infection can lead to cervical precancerous lesions and cervical cancer [7]. Persistent HPV infection results in squamous intraepithelial lesions graded as cervical intraepithelial neoplasia (CIN) 1, CIN 2, and CIN 3 according to how much epithelium is impacted [8]. Different types of HPV have different potentials of causing cervical cancer. High-risk HPV is the main cause of

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