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在中国宫颈癌及癌前病变女性中,人乳头瘤病毒58型的高流行率。

High prevalence of human papillomavirus type 58 in Chinese women with cervical cancer and precancerous lesions.

作者信息

Chan P K, Li W H, Chan M Y, Ma W L, Cheung J L, Cheng A F

机构信息

Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.

出版信息

J Med Virol. 1999 Oct;59(2):232-8.

Abstract

The prevalence of human papillomavirus (HPV) among 332 Hong Kong Chinese women with abnormal Papanicolaou smears were determined by polymerase chain reaction and restriction fragment length polymorphism analysis. The overall HPV positive rate was 44.3% with 18.6% (16/86) for normal/inflamed cervices, 36.4% (32/88) for condyloma, 64.7% (33/51) for cervical intraepithelial neoplasia grade 1 (CIN 1), 37.9% (11/29) for CIN 2, 68.3 (41/60) for CIN 3, and 77.8% (14/18) for carcinoma. Double HPV infection was detected in 17 of the 147 positive samples, with a significantly higher proportion in patients with normal or inflamed cervices than those with CIN or carcinoma (31.3% vs 10.5%, P =.029). The six most commonly identified genotypes were HPV 16 (33.3%), HPV 58 (23.8%), HPV 11, 18, 31 (8.8% each), and HPV 33 (6.8%). The worldwide uncommon genotype HPV 58 was found to be the second most common genotype detected in patients with cervical carcinoma (6 of 18 patients). HPV 58 infection showed a significant association with CIN/carcinoma (odds ratio [OR] = 3.98; 95% confidence interval [CI] = 1.22-14.35) and a significant trend of increase in prevalence with increasing severity of cervical lesion (chi(2) = 5.84; P =.016). Among Hong Kong Chinese women with abnormal cervical cytology, the detection of HPV 58 carried a positive predictive value of 68.6% for a cervical lesion of CIN 1 or higher severity. The high prevalence of HPV 58 among Chinese women, particularly in patients with carcinoma, has an implication on the design of HPV detection methods and the development of vaccines.

摘要

通过聚合酶链反应和限制性片段长度多态性分析,确定了332名巴氏涂片异常的中国香港女性中人乳头瘤病毒(HPV)的感染率。HPV总体阳性率为44.3%,其中正常/炎症宫颈为18.6%(16/86),尖锐湿疣为36.4%(32/88),宫颈上皮内瘤变1级(CIN 1)为64.7%(33/51),CIN 2为37.9%(11/29),CIN 3为68.3%(41/60),癌为77.8%(14/18)。在147份阳性样本中,有17份检测到双重HPV感染,正常或炎症宫颈患者中的比例显著高于CIN或癌患者(31.3%对10.5%,P = 0.029)。六种最常见的基因型为HPV 16(33.3%)、HPV 58(23.8%)、HPV 11、18、31(各8.8%)和HPV 33(6.8%)。发现全球罕见的基因型HPV 58是宫颈癌患者中检测到的第二常见基因型(18例患者中有6例)。HPV 58感染与CIN/癌显著相关(优势比[OR]=3.98;95%置信区间[CI]=1.22 - 14.35),且随着宫颈病变严重程度增加,感染率有显著上升趋势(χ²=5.84;P = 0.016)。在中国香港宫颈细胞学异常的女性中,检测到HPV 58对CIN 1或更高严重程度宫颈病变的阳性预测值为68.6%。中国女性中HPV 58的高感染率,尤其是在癌患者中,对HPV检测方法的设计和疫苗的研发具有启示意义。

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