Evolution of Cervical Lesions Associated with Human Papillomavirus Infection after the Introduction of Vaccination  

作　　者：Montserrat de la Torre Ana María Colino Lone Nielsen Alejandro Pascual Concepción Millana María Jesús González Patricia Barreiro Eva Rodríguez Dolores García Aranzazu Gómez Rosa Rodero María Jesús Fernández Montserrat de la Torre;Ana María Colino;Lone Nielsen;Alejandro Pascual;Concepción Millana;María Jesús González;Patricia Barreiro;Eva Rodríguez;Dolores García;Aranzazu Gómez;Rosa Rodero;María Jesús Fernández(Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain;Department of Surgical Pathology, Hospital Universitario del Sureste, Madrid, Spain;Grupo de Investigación en Anatomía Patológica, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain;Department of Legal Medicine, Psychiatry and Surgical Pathology, Complutense University of Madrid, Madrid, Spain)

机构地区：[1]Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain [2]Department of Surgical Pathology, Hospital Universitario del Sureste, Madrid, Spain [3]Grupo de Investigación en Anatomía Patológica, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain [4]Department of Legal Medicine, Psychiatry and Surgical Pathology, Complutense University of Madrid, Madrid, Spain

出　　处：《Open Journal of Obstetrics and Gynecology》2023年第8期1307-1323,共17页妇产科期刊（英文）

摘　　要：Background: The main objective of this study is to analyse the change in the type of lesions developed by HPV-infected patients after the introduction of the vaccine in three different periods;2002-2006 (years previous to the implementation of the vaccine in Spain), 2009-2011 (shortly after the vaccination) and 2020-2021 (years where the vaccine was well established) at a single hospital. Methods: This is an observational, descriptive, retrospective study based on the review of the results of the biopsies of patients with HPV lesions at a single large tertiary hospital, Hospital Clínico San Carlos, in Madrid, Spain. We have collected the data from three different time periods: 2002-2006, 2009-2011, 2020-2021 to try to understand the potential changes in these lesions after vaccine introduction. Results: In this time we have reviewed the data from 946 women. In these three periods, a decreasing trend in the rate of squamous cell carcinoma was noted, the rate of adenocarcinoma remains stable, and the rate of cervical intraepithelial neoplasia grades 2 - 3 (CIN 2-3) lesions shows an increasing trend. We have also found a change in the mean ages of the patients with these lesions, as this increased in the three lesions caused by HPV after the implementation of the vaccine. Our study indicates that the identification of other high risk serotypes, apart from 16 and 18, as well as those with indeterminate risk, has undergone a progressive increase, increasing from 24.24% and 14.11% respectively in 2002-2006 to 40.42% and 28.34% in 2020-2021. Conclusion: Our study confirms the effectiveness of the vaccines developed so far, against the HPV serotypes they contain. This is demonstrated by the evidence, in our population, of a decrease in the incidence of squamous cell carcinoma in uterine cervix. In parallel, an increase in the mean age of diagnosis has been verified, for both squamous cell carcinoma and its CIN 2-3 precursor lesions, as well as a change in the infective trend of HPV serotypes that are not included in theBackground: The main objective of this study is to analyse the change in the type of lesions developed by HPV-infected patients after the introduction of the vaccine in three different periods;2002-2006 (years previous to the implementation of the vaccine in Spain), 2009-2011 (shortly after the vaccination) and 2020-2021 (years where the vaccine was well established) at a single hospital. Methods: This is an observational, descriptive, retrospective study based on the review of the results of the biopsies of patients with HPV lesions at a single large tertiary hospital, Hospital Clínico San Carlos, in Madrid, Spain. We have collected the data from three different time periods: 2002-2006, 2009-2011, 2020-2021 to try to understand the potential changes in these lesions after vaccine introduction. Results: In this time we have reviewed the data from 946 women. In these three periods, a decreasing trend in the rate of squamous cell carcinoma was noted, the rate of adenocarcinoma remains stable, and the rate of cervical intraepithelial neoplasia grades 2 - 3 (CIN 2-3) lesions shows an increasing trend. We have also found a change in the mean ages of the patients with these lesions, as this increased in the three lesions caused by HPV after the implementation of the vaccine. Our study indicates that the identification of other high risk serotypes, apart from 16 and 18, as well as those with indeterminate risk, has undergone a progressive increase, increasing from 24.24% and 14.11% respectively in 2002-2006 to 40.42% and 28.34% in 2020-2021. Conclusion: Our study confirms the effectiveness of the vaccines developed so far, against the HPV serotypes they contain. This is demonstrated by the evidence, in our population, of a decrease in the incidence of squamous cell carcinoma in uterine cervix. In parallel, an increase in the mean age of diagnosis has been verified, for both squamous cell carcinoma and its CIN 2-3 precursor lesions, as well as a change in the infective trend of HPV serotypes that are not included in the

关 键 词：HPV SEROTYPES CERVIX VACCINE CIN 2 - 3 Squamous Cell Carcinoma Women’s Health 

分 类 号：R73[医药卫生—肿瘤]