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中国西部宫颈癌前病变患者人乳头瘤病毒分布情况分析

Analysis of HPV distribution in patients with cervical precancerous lesions in Western China.

作者信息

Li Kemin, Yin Rutie, Li Qingli, Wang Danqing

机构信息

The Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, China.

出版信息

Medicine (Baltimore). 2017 Jul;96(29):e7304. doi: 10.1097/MD.0000000000007304.

Abstract

Cervical human papillomavirus (HPV) infection is a dangerous disease, whose subtypes exhibit different distribution patterns in particular countries, regions, and races. In this study, the HPV distribution in patients with cervical precancerous lesions in Western China was investigated to assess a probability for prevention of cervical cancer and the clinical application of an HPV vaccine in China. The retrospective study of patients with different HPV subtypes and cervical precancerous lesions, who have undergone loop eelectrosurgical excision procedure, cold knife conization, or a total hysterectomy in our hospital from January 2016 to August 2016, was performed. All patients were tested for 27 HPV subtypes via the liquid suspension chip technology (Luminex 200). A total of 3393 cases of cervical intraepithelial neoplasia (CIN) were investigated, including 1098 cases of CIN I, 762 cases of CIN II, and 1533 cases of CIN III. The overall HPV infection rate was 82.58%. The high-risk HPV infection rate was 76.61%, and the low-risk rate was 9.88%. The most common 5 subtypes were HPV16, HPV52, HPV58, HPV33, and HPV18. The patients were grouped into 6 age groups: ≤20, 21 to 30, 31 to 40, 41 to 50, 50 to 64, and ≥65. The HPV subtypes' distribution varied across different age groups. In patients with cervical precancerous lesions in Western China, the top 5 HPV subtypes with the highest infection rates were HPV16, HPV52, HPV58, HPV33, and HPV18. The rate of cervical precancerous lesions unrelated to HPV was 17.42%. Thus, HPV screening with no cytology may leave unobserved about 20% of cervical precancerous lesions, which is worth of significant clinical attention.

摘要

宫颈人乳头瘤病毒(HPV)感染是一种危险疾病,其亚型在特定国家、地区和种族中呈现出不同的分布模式。本研究调查了中国西部宫颈上皮内瘤变患者的HPV分布情况,以评估在中国预防宫颈癌的可能性及HPV疫苗的临床应用。对2016年1月至2016年8月期间在我院接受环形电切术、冷刀锥切术或全子宫切除术的不同HPV亚型及宫颈上皮内瘤变患者进行了回顾性研究。所有患者均通过液体悬浮芯片技术(Luminex 200)检测27种HPV亚型。共调查了3393例宫颈上皮内瘤变(CIN)患者,其中CIN I 1098例、CIN II 762例、CIN III 1533例。总体HPV感染率为82.58%。高危HPV感染率为76.61%,低危感染率为9.88%。最常见的5种亚型为HPV16、HPV52、HPV58、HPV33和HPV18。患者分为6个年龄组:≤20岁、21至30岁、31至40岁、41至50岁、50至64岁和≥65岁。HPV亚型分布在不同年龄组中有所不同。在中国西部宫颈上皮内瘤变患者中,感染率最高的前5种HPV亚型为HPV16、HPV52、HPV58、HPV33和HPV18。与HPV无关的宫颈上皮内瘤变率为17.42%。因此,不进行细胞学检查的HPV筛查可能会漏诊约20%的宫颈上皮内瘤变,这值得临床高度关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7488/5521883/1835bdf079ec/medi-96-e7304-g003.jpg

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