Alexandre Natishvili Institute of Morphology, 2 Chiaureli St., Tbilisi 0159, Georgia.
Cancer Epidemiol. 2011 Oct;35(5):465-70. doi: 10.1016/j.canep.2010.12.006. Epub 2011 Feb 2.
No accurate estimates of cervical cancer incidence or mortality currently exist in Georgia. Nor are there any data on the population-based prevalence of high-risk (HR) human papillomavirus (HPV) infection, which, in the absence of good-quality screening, is known to correlate with cervical cancer incidence.
We obtained cervical cell specimens from 1309 women aged 18-59 years from the general population of Tbilisi, and also from 91 locally diagnosed invasive cervical cancers (ICC). DNA of 44 HPV types was tested for using a GP5+/6+-based PCR assay.
In the general population (of whom 2% reported a previous Pap smear) HPV prevalence was 13.5% (95% CI: 11.6-15.9), being highest in women aged 25-34 years (18.7%) and falling to between 8.6% and 9.5% for all age groups above 34 years. HR HPV prevalence was 8.6% overall, being 6.8% and 38.9% among women with normal and abnormal cytology, respectively. HPV45 (1.6%) was the most common type in women with normal cytology, whereas HPV16 predominated among women with cervical abnormalities (including 7 of 10 histologically confirmed cervical intraepithelial neoplasia 2/3) and among ICC (57.6%). The next most common types in ICC in Georgia were HPV45 and 18 (13.2 and 11.0%, respectively).
We report a relatively high burden of HPV infection in Tbilisi, Georgia. Improving cervical cancer prevention, through screening and/or HPV vaccination, is an important public health issue in Georgia, where 70% of ICC are theoretically preventable by HPV16/18 vaccines.
目前格鲁吉亚尚无关于宫颈癌发病率或死亡率的准确估计，也没有关于高危型（HR）人乳头瘤病毒（HPV）感染人群患病率的数据，而在缺乏高质量筛查的情况下，HPV 感染与宫颈癌发病率相关。
我们从第比利斯的一般人群中获得了 1309 名年龄在 18-59 岁的女性宫颈细胞标本，以及 91 例当地诊断为浸润性宫颈癌（ICC）的标本。使用基于 GP5+/6+的 PCR 检测方法检测 44 种 HPV 类型的 DNA。
在一般人群中（其中 2%的人报告之前做过巴氏涂片），HPV 患病率为 13.5%（95%CI：11.6-15.9），年龄在 25-34 岁的女性中最高（18.7%），而所有 34 岁以上年龄组的患病率均降至 8.6%-9.5%。总的 HR-HPV 患病率为 8.6%，细胞学正常和异常的女性分别为 6.8%和 38.9%。HPV45（1.6%）是细胞学正常女性中最常见的类型，而 HPV16 在宫颈异常（包括 10 例组织学确诊的宫颈上皮内瘤变 2/3 中的 7 例）和 ICC 中更为常见（57.6%）。在格鲁吉亚的 ICC 中，其次常见的类型是 HPV45 和 18（分别为 13.2%和 11.0%）。
我们报告了格鲁吉亚第比利斯 HPV 感染的负担相对较高。通过筛查和/或 HPV 疫苗接种来改善宫颈癌预防，是格鲁吉亚一个重要的公共卫生问题，在格鲁吉亚，70%的 ICC 理论上可以通过 HPV16/18 疫苗预防。
