자궁경부 감염에서 고위험 인간 유두종 바이러스 유전자형의 음성 전환율 및 재발률
Rates of Negative Conversion and Relapse of High-risk Human Papillomavirus Genotypes in Cervical Infection
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초록
자궁경부암은 전 세계적으로 중요한 건강 문제이다. 고위험인유두종 바이러스(high-risk human papillomavirus, HPV) 감염은 HPV-16, HPV-18과 같이 자궁경부암의 원인에 중요한 역할을 하는 것으로 밝혀졌다. HPV 감염의 90%는 바이러스에 노출된 후 12∼24개월 내에 자연스럽게 제거되거나 비활성화되지만, 자궁경부암으로 진행될 위험을 증가시키는 유전자형에 따른 고위험 HPV의 지속성에 대한 보고는 많지 않다. 본 논문은 고위험 HPV 자궁경부 감염에서 고위험 HPV 유전자형에 따른 음성 전환율과 재발률을 분석했다. 5년 동안 고위험 HPV의 음성 전환율은 평균 53.0%였으며, 감염된 HPV 유전자형의 수가 많을수록 음성 전환율이 감소했다. 음성 전환까지 걸리는 시간은 감염된 HPV 유전자형 수가 많을수록 증가했으며, 단일감염 환자에서는 연령과 유전자형에 따라 상이한 결과를 보였다. 5년 동안 재발률은 평균 10.7%였으며, 감염된 HPV 유전자형의 수가 많을수록 재발률이 감소하고, 재발까지 걸리는 시간도 줄어들었다. 동일 유전자형에서의 재발률은 유전자형에 따라 달랐다. 이러한 결과는 HPV 감염 환자의 치료효과 판정과 재발률에 대한 예후 추정의 보조 수단으로 사용할 수 있을 것으로 생각된다.
Abstract
Cervical cancer is a major health issue globally. High-risk human papillomavirus (Hr HPV) infections, such as HPV16/18, play a crucial role in the cause of cervical cancer. Ninety percent of HPV infections are cleared or become inactive within 12 to 24 months of exposure to the virus. On the other hand, there are a few reports about the persistence of Hr HPV according to each genotype, which increases the risk of progression to cervical cancer. Therefore, this study analyzed the negative conversion rates and the relapse rates according to each Hr HPV genotype in Hr-HPV cervical infections. The negative conversion rate of Hr HPV averaged 53.0% for five years and decreased with the number of infected HPV genotypes. The time to negative conversion increased with the number of infected HPV genotypes and varied with age and genotypes in single-infected patients. The relapse rates averaged 10.7% for five years, decreased with the number of infected HPV genotypes, and the time to relapse decreased with the number of infected HPV genotypes. The rates of relapse with the same genotype varied according to the genotype. These results can be used as an adjunct to prognostic estimates of the cure and recurrence rates in HPV-infected individuals.
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