Dong L, Hu S Y, Zhang Q, Feng R M, Zhang L, Zhao X L, Ma J F, Shi S D, Zhang X, Pan Q J, Zhang W H, Qiao Y L, Zhao F H
Department of Epidemiology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Xiangyuan County Women and Children's Hospital, Changzhi 046200, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Jan 10;38(1):20-25. doi: 10.3760/cma.j.issn.0254-6450.2017.01.004.
To evaluate the dynamic variation of genotypes distribution of human papillomavirus (HPV) over 10-year follow-up in a cervical cancer screening cohort. Based on the Shanxi Province Cervical Cancer Screening Study Ⅰ cohort, we detected HPV genotypes on the well-preserved exfoliated cervical cells from women who were tested HPV positive from year 2005 to year 2014 using reverse linear probe hybridization assay. The changes of prevalence of type-specific HPV over time among the overall population were estimated using linear mixed models. The association between the type-specific HPV and cervical intraepithelial neoplasia grade 2 or worse (CIN2 +) was calculated by linear Chi-square test. Finally, the trends of multiple infections of HPV with the increase of the age were analyzed. During the cervical cancer screening of the overall population from 2005 to 2014, the most common genotypes among the population were HPV16 and 52. The prevalence of HPV16 decreased over time from 4.6 in 2005 to 2.2 in 2010 and 2014 (=8.125, <0.001). The prevalence of HPV52 remained pretty stable and HPV33, 51 and 58 slightly decreased then apparently increased. Further stratification analysis by pathological lesions showed the same trend of the HPV prevalence for the histology normal women with the overall population. Of note, for those women with the cervical intraepithelial neoplasia (CIN2 +), the detection rate of HPV16 decreased from 65.22 in 2005 to 41.03 in 2010 and finally to 31.58 in 2014 ((2)=4.420, =0.036) and that of HPV33 substantially increased. No significant variation was found for other types of HPV. Multiple infection rate varied with the growing age of the women. The genotypes prevalence of HPV tended to vary over time during cervical cancer screening in the context of regular screening combining with immediate treatment for those CIN2 + women. HPV16 prevalence significantly decreased over time, which indicated that the variation of type-specific HPV prevalence should be considered when regular cervical cancer screening was organized using HPV technique.
评估宫颈癌筛查队列中10年随访期间人乳头瘤病毒（HPV）基因型分布的动态变化。基于山西省宫颈癌筛查研究Ⅰ队列，我们使用反向线性探针杂交法，对2005年至2014年检测HPV呈阳性的女性保存良好的宫颈脱落细胞进行HPV基因型检测。使用线性混合模型估计总体人群中特定类型HPV患病率随时间的变化。通过线性卡方检验计算特定类型HPV与宫颈上皮内瘤变2级或更严重病变（CIN2+）之间的关联。最后，分析HPV多重感染率随年龄增长的趋势。在2005年至2014年对总体人群进行宫颈癌筛查期间，人群中最常见的基因型是HPV16和52。HPV16的患病率随时间下降，从2005年的4.6降至2010年和2014年的2.2（=8.125，<0.001）。HPV52的患病率保持相当稳定，HPV33、51和58略有下降然后明显上升。按病理病变进行的进一步分层分析显示组织学正常女性的HPV患病率与总体人群有相同趋势。值得注意的是，对于那些宫颈上皮内瘤变（CIN2+）的女性，HPV16的检测率从2005年的65.22降至2010年的41.03，最终在2014年降至31.58（（2）=4.420，=0.036），而HPV33的检测率大幅上升。其他类型的HPV未发现显著变化。多重感染率随女性年龄增长而变化。在定期筛查并对CIN2+女性立即治疗的情况下，宫颈癌筛查期间HPV的基因型患病率随时间趋于变化。HPV16患病率随时间显著下降，这表明在使用HPV技术进行定期宫颈癌筛查时应考虑特定类型HPV患病率的变化。
