Suthipintawong Cheepsumon, Siriaunkgul Sumalee, Tungsinmunkong Kobkul, Pientong Chamsai, Ekalaksananan Tipaya, Karalak Anant, Kleebkaow Pilaiwan, Vinyuvat Songkhun, Triratanachat Surang, Khunamornpong Surapan, Chongsuwanich Tuenjai
Institute of Pathology, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand.
Asian Pac J Cancer Prev. 2011;12(4):853-6.
The pattern of infection in cervical lesions with respect to HPV subtype has not been systematically studied in Thai women. The aim here was to determine HPV prevalence, genotype, and infection pattern in cervical lesions and to estimate the potential efficacy of an HPV prophylactic vaccine.
Formalin-fixed paraffin-embedded cervical tissue blocks of 410 Thai patients from 8 institutes in 4 regions of Thailand (northern, southern, north-eastern, and central) were studied. The samples included 169 low grade squamous intraepithelial lesions (LSILs), 121 high grade squamous intraepithelial lesions (HSILs), and 120 squamous cell carcinomas (SCCs). HPV-DNA was amplified by PCR using consensus primers GP5+ and GP6+. The HPV genotype was then determined by reverse linear blot assay that included 37 HPV-specific 5'-amino-linked oligonucleotide probes. Patterns of infection were classified as single infection (one HPV type), double infection (two HPV types), and multiple infection (three or more HPV types).
The mean age of the subjects was 42 years. The prevalence of HPV infection was 88.8%. The highest HPV prevalence was found in the southern region (97.1%) and the lowest in the central region (78.6%). HPV-DNA was detected in 84.6% of LSILs, 90.1% of HSILs, and 93.3% of SCCs. A total of 20 HPV genotypes were identified. The five most common high risk HPV were HPV16 (83.2%), HPV18 (59.3%), HPV58 (9.3%), HPV52 (4.1%), and HPV45 (3.8%). In double and multiple infection patterns, the most common genotypes were HPV16/18 (27.8%) and HPV11/16/18 (54.9%). HPV6 was found only in LSIL and never in combination with other subtypes. HPV11 was most common in LSIL.
There is no difference of HPV type distribution in women from 4 regions of Thailand with prominent HPV16 and HPV18 in all cases. The bivalent and quadrivalent vaccines have the potential to prevent 48.6 % and 74.5% of cervical cancers in Thai women. The potential of cancer prevention would rise to 87.6% if other frequent HR-HPV types (HPV58, 52, and 45) were also targeted by an HPV vaccine.
泰国女性宫颈病变中HPV亚型的感染模式尚未得到系统研究。本文旨在确定宫颈病变中HPV的患病率、基因型和感染模式，并评估HPV预防性疫苗的潜在效果。
对来自泰国4个地区（北部、南部、东北部和中部）8家机构的410名泰国患者的福尔马林固定石蜡包埋宫颈组织块进行研究。样本包括169例低级别鳞状上皮内病变（LSIL）、121例高级别鳞状上皮内病变（HSIL）和120例鳞状细胞癌（SCC）。使用通用引物GP5 +和GP6 +通过PCR扩增HPV-DNA。然后通过包含37种HPV特异性5'-氨基连接寡核苷酸探针的反向线性印迹分析确定HPV基因型。感染模式分为单一感染（一种HPV类型）、双重感染（两种HPV类型）和多重感染（三种或更多种HPV类型）。
受试者的平均年龄为42岁。HPV感染的患病率为88.8%。HPV患病率最高的是南部地区（97.1%），最低的是中部地区（78.6%）。在84.6%的LSIL、90.1%的HSIL和93.3%的SCC中检测到HPV-DNA。共鉴定出20种HPV基因型。五种最常见的高危HPV是HPV16（83.2%）、HPV18（59.3%）、HPV58（9.3%）、HPV52（4.1%）和HPV45（3.8%）。在双重和多重感染模式中，最常见的基因型是HPV16/18（27.8%）和HPV11/16/18（54.9%）。HPV6仅在LSIL中发现，从未与其他亚型同时出现。HPV11在LSIL中最常见。
泰国4个地区女性的HPV类型分布没有差异，所有病例中均以HPV16和HPV18为主。二价和四价疫苗有可能预防泰国女性48.6%和74.5%的宫颈癌。如果HPV疫苗也针对其他常见的高危HPV类型（HPV58、52和45），癌症预防的潜力将升至87.6%。
