Department of Obstetrics & Gynecology, University of Cape Town/Groote Schuur Hospital, Cape Town, South Africa.
Int J Cancer. 2014 Mar 15;134(6):1389-98. doi: 10.1002/ijc.28425. Epub 2013 Nov 14.
In sub-Saharan Africa, invasive cervical cancer (ICC) incidence and mortality are among the highest in the world. This cross-sectional epidemiological study assessed human papillomavirus (HPV) prevalence and type distribution in women with ICC in Ghana, Nigeria, and South Africa. Cervical biopsy specimens were obtained from women aged ≥ 21 years with lesions clinically suggestive of ICC. Histopathological diagnosis of ICC was determined by light microscopy examination of hematoxylin and eosin stained sections of paraffin-embedded cervical specimens; samples with a confirmed histopathological diagnosis underwent HPV DNA testing by polymerase chain reaction. HPV-positive specimens were typed by reverse hybridization line probe assay. Between October 2007 and March 2010, cervical specimens from 659 women were collected (167 in Ghana, 192 in Nigeria and 300 in South Africa); 570 cases were histologically confirmed as ICC. The tumor type was identified in 551/570 women with ICC; squamous cell carcinoma was observed in 476/570 (83.5%) cases. The HPV-positivity rate in ICC cases was 90.4% (515/570). In ICC cases with single HPV infection (447/515 [86.8%]), the most commonly detected HPV types were HPV16 (51.2%), HPV18 (17.2%), HPV35 (8.7%), HPV45 (7.4%), HPV33 (4.0%) and HPV52 (2.2%). The prevalence of single and multiple HPV infections seemed higher among HIV-positive women and HPV type distribution appeared to differ according to tumor type and HIV status. In conclusion, HPV16, 18, 45 and 35 were the most common HPV types in sub-Saharan African women with ICC and HPV infections were more common in HIV-positive women.
在撒哈拉以南非洲，浸润性宫颈癌（ICC）的发病率和死亡率位居世界前列。本项横断面流行病学研究评估了加纳、尼日利亚和南非 ICC 女性患者的人乳头瘤病毒（HPV）流行率和型别分布情况。研究纳入了年龄≥21 岁、临床疑似 ICC 病变的女性患者，获取其宫颈活检样本。通过对石蜡包埋宫颈标本的苏木精-伊红染色切片进行光学显微镜检查，对 ICC 进行组织病理学诊断；对经组织病理学确诊的样本采用聚合酶链反应进行 HPV DNA 检测。HPV 阳性标本采用反向杂交线探针分析进行 HPV 型别鉴定。2007 年 10 月至 2010 年 3 月，共采集了 659 名女性的宫颈标本（加纳 167 例、尼日利亚 192 例、南非 300 例）；570 例经组织学确认为 ICC。在 570 例 ICC 患者中，551 例的肿瘤类型得以明确，其中 476 例（83.5%）为鳞状细胞癌。在 ICC 病例中，HPV 阳性率为 90.4%（515/570）。在 HPV 单一感染的 ICC 病例中（447/515[86.8%]），最常检测到的 HPV 类型为 HPV16（51.2%）、HPV18（17.2%）、HPV35（8.7%）、HPV45（7.4%）、HPV33（4.0%）和 HPV52（2.2%）。HIV 阳性女性中 HPV 单一和多重感染的患病率似乎更高，且 HPV 型别分布似乎因肿瘤类型和 HIV 状态而异。综上，HPV16、18、45 和 35 是撒哈拉以南非洲 ICC 女性中最常见的 HPV 类型，HIV 阳性女性中 HPV 感染更为常见。
