Abd El-Azim Shymaa, Lotfy Mohamed, Omr Ayman
Microbiology and Immunology Department, Faculty of Medicine, Molecular Genetics Laboratory, Zagazig University, Egypt.
Clin Lab. 2011;57(5-6):363-71.
Cervical cancer (CCA) is the 2nd most common cancer among women worldwide. For approximately 2 years now, CCA has been converted from an oncological disease to an infectious disease, almost certainly caused by Human papillomavirus (HPV). Development of effective vaccines against the virus has created considerable issue world-wide and has major implications for both primary and secondary prevention strategies. The objective of this study was to establish the prevalence and genotype distribution of HPV in preinvasive, cervical intraepithelial neoplasia (CIN II and III) and invasive CCA in Sharkia governorate, Egypt.
This study included 42 patients with CIN II and III, 30 patients with invasive CCA, and 45 controls who had undergone hysterectomy for any cause other than CCA. HPV detection and genotyping in cervical biopsies by Polymerase Chain Reaction (PCR) and Restriction Fragment Length Polymorphism (RFLP).
HPV DNA was detected in 85.7% (36/42) patients with CIN II and III. HPV genotypes were arranged in order of decreasing frequency as follows: HPV 16 being detected in 50.0% (21/42), HPV 45 in 143% (6/42) HPV 33 in 11.9% (5/42), HPV 18 in 9.5% (4/42) and HPV 31 in 7.1% (3/42) cases. In patients with invasive CCA, 93.3% (28/30) were positive for HPV DNA. In order of decreasing frequency, HPV genotypes were: HPV 16 being detected in 66.7% (20/30), HPV 18 in 16.7% (5/30), HPV 33 in 10.0% (3 /30) and both HPV 31 and HPV 45 in 6.7% (2/30) cases. About 13.3% invasive cervical cancer and 7.1% CIN II & III specimens exhibited multiple infections without significant difference (P > 0.05). HPV 16 and 33 infections show a higher risk for development of advanced stages of invasive CCA but without a statistically significant difference.
The high prevalence of HPV genotypes 16, 18, and 45 in Sharkia governorate, Egypt, deserves attention as it has important implications for the usefulness of vaccine in prevention of a significant proportion of CCA and the choice of diagnostic methods.
宫颈癌（CCA）是全球女性中第二常见的癌症。大约两年来，CCA已从一种肿瘤疾病转变为一种几乎可以肯定由人乳头瘤病毒（HPV）引起的传染病。针对该病毒的有效疫苗的研发在全球引发了诸多问题，并且对一级和二级预防策略都具有重要意义。本研究的目的是确定埃及谢赫村省宫颈上皮内瘤变（CIN II和III）及浸润性CCA的癌前病变中HPV的患病率和基因型分布。
本研究纳入了42例CIN II和III患者、30例浸润性CCA患者以及45例因CCA以外的任何原因接受子宫切除术的对照者。通过聚合酶链反应（PCR）和限制性片段长度多态性（RFLP）对宫颈活检组织进行HPV检测和基因分型。
在42例CIN II和III患者中，85.7%（36/42）检测到HPV DNA。HPV基因型按频率递减顺序排列如下：50.0%（21/42）检测到HPV 16，14.3%（6/42）检测到HPV 45，11.9%（5/42）检测到HPV 33，9.5%（4/42）检测到HPV 18，7.1%（3/42）检测到HPV 31。在浸润性CCA患者中，93.3%（28/30）HPV DNA呈阳性。HPV基因型按频率递减顺序为：66.7%（20/30）检测到HPV 16，16.7%（5/30）检测到HPV 18，10.0%（3/30）检测到HPV 33，6.7%（2/30）检测到HPV 31和HPV 45。约13.3%的浸润性宫颈癌和7.1%的CIN II和III标本显示多重感染，差异无统计学意义（P>0.05）。HPV 16和33感染显示浸润性CCA晚期发展风险较高，但无统计学显著差异。
埃及谢赫村省HPV 16、18和45基因型的高患病率值得关注，因为这对疫苗预防相当比例的CCA的有效性以及诊断方法的选择具有重要意义。
