Multicentric Intraepithelial Lesion Risk Factors and Human Papillomavirus Genotypes

Paper with words HPV infection and glasses.
The researchers’ goal was to study the risk factors for multicentric intraepithelial lesions of the lower genital tract, including specific human papillomavirus genotypes.

Among women, multicentric lesions were associated with multiple human papillomavirus (HPV) infections and a history of malignant tumors, according to results of a retrospective case-control study published in BMC Infectious Diseases.

Data from women (N=1950) undergoing colonoscopy-guided biopsy at the Cervical Disease Clinic of Liaoning Cancer Hospital and Institute in China between January 1, 2018, and October 31, 2019, were retrospectively reviewed for this study. Lesions were assessed for genotype and HPV viral load, and demographic information, menopause status, and clinical history were obtained.

The patients had single cervical intraepithelial neoplasia (CIN; n=1643) or multicentric lesions (n=307). The median age of the cohort was 43 years (interquartile range [IQR], 36-50) and 50 years (IQR, 43-55.5), 28.0% and 51.5% were in menopause, and 0.7% and 3.3% had a history of malignant tumors outside of the lower genital tract, respectively.

Among patients with cytology results, 62.5% (n=833) and 68.9% (n=184) of the multicentric and single CIN groups had abnormal cytology, respectively. Patients with multicentric lesions were more likely to be HPV positive (odds ratio [OR], 2.07; 95% CI, 1.03-4.15).

Median relative light units were higher among the multicentric group (median, 272.165; IQR, 1118.17 RLU/CO) compared with the single CIN cohort (median, 10.13; IQR, 16.70 RLU/CO).

Multiple HPV infections were detected among 36.5% of patients, and these infections were associated with multicentric lesions (OR, 1.54; 95% CI, 1.09-2.17).

The most common high-risk genotypes in the multicentric and single cohorts were HPV16 (39.0% vs 41.5%), HPV53 (13.6% vs 6.3%), HPV58 (12.4% vs 14.1%), and HPV52 (10.7% vs 15.1%), respectively. All low-risk genotypes were detected among less than 5% of patients in either group.

Multicentric lesions were associated with nongenital malignant tumors (OR, 9.58; 95% CI, 1.02-89.84), menopause (OR, 3.14; 95% CI, 2.24-4.41), and multiple HPV infections (OR, 1.47; 95% CI, 1.03-2.10).

This study may have been limited by lack of access to some pertinent information such as number of sexual partners or oral contraceptive use.

The study authors concluded that multicentric lesions were associated with multiple HPV infections, malignant tumors outside the genital tract, and menopause. Frequently detected HPV genotypes were HPV16, HPV18, HPV51, HPV52, HPV53, HPV56, and HPV58.


Zhang J, Liu G, Cui X, Yu H, Wang D. Human papillomavirus genotypes and the risk factors associated with multicentric intraepithelial lesions of the lower genital tract: a retrospective study. BMC Infect Dis. 2021;21(1):554. doi:10.1186/s12879-021-06234-0