Nuclear Medicine Oncology and Radiotherapy Institute, Islamabad, Pakistan.
International Islamic University, Islamabad, Pakistan.
Int J Infect Dis. 2018 Jan;66:83-89. doi: 10.1016/j.ijid.2017.11.009. Epub 2017 Nov 11.
Globally, cervical cancer is the fourth most common cancer in women and the seventh most common cancer overall, accounting for an estimated 300 000 annual deaths. Human papillomavirus (HPV) is the second most common cause of cervical cancer worldwide. HPV screening is not a common practice in Pakistan. The aim of this study was to determine the prevalence of HPV and HPV types in women with a normal cytology of the cervix living in the upper and lower regions of Punjab, Pakistan, and to analyze the risk factors for HPV in this region.
PCR analysis was performed for 1011 female patients with a normal cytology of the cervix from various districts of Punjab Province, Pakistan. Risk factors for the acquisition of HPV were studied. High-risk HPV types (HPV16 and HPV18) were detected using the Abbott Real Time HR HPV test. To determine the genotype, partial L1 region sequences of HPV-positive samples were subjected to sequencing using MY/09/MY11 primers, and a phylogenetic tree was constructed using CLC software.
The study found a 4.74% prevalence of HPV, with the most frequent HPV type found being the low-risk HPV6 (in 25% of infected individuals), followed by HPV55 (22.9%), HPV11 (20.8%), and high-risk types HPV45 (12.5%), HPV33 (8.33%), HPV18 (6.25%), and HPV16 (4.16%). Phylogenetic analysis of all HPV types in this study showed 80-99% nucleotide identity with types related to the same species. The sequences were clustered with China, India, Mexico, Iran, Slovenia, and Germany, showing the diversity in origin of the various genotypes prevalent in Pakistan.
In this population with a normal cervical cytology, the prevalence of high-risk HPV types was very low. The major prevalent HPV genotype in Punjab Province of Pakistan was the low-risk HPV type 6, followed by HPV type 55. Sequencing of the partial L1 region suggested that the region was highly conserved in all reported sequences. This study highlights the need to conduct robust epidemiological studies in the region and to develop regular HPV screening so that the situation does not reach an alarming stage resulting in cervical cancer.
在全球范围内，宫颈癌是女性中第四常见的癌症，也是总体上第七常见的癌症，估计每年有 30 万人因此死亡。人乳头瘤病毒（HPV）是全球范围内导致宫颈癌的第二大常见原因。HPV 筛查在巴基斯坦并不常见。本研究旨在确定生活在巴基斯坦旁遮普省上下地区的宫颈细胞学正常的女性中 HPV 的流行率以及 HPV 类型，并分析该地区 HPV 的危险因素。
对来自巴基斯坦旁遮普省不同地区的 1011 名宫颈细胞学正常的女性患者进行 PCR 分析。研究了 HPV 感染的危险因素。使用 Abbott Real Time HR HPV 检测方法检测高危型 HPV （HPV16 和 HPV18）。为了确定基因型，对 HPV 阳性样本的部分 L1 区序列使用 MY/09/MY11 引物进行测序，并使用 CLC 软件构建系统发育树。
研究发现 HPV 的流行率为 4.74%，最常见的 HPV 类型是低危型 HPV6（在 25%的感染个体中），其次是 HPV55（22.9%）、HPV11（20.8%）和高危型 HPV45（12.5%）、HPV33（8.33%）、HPV18（6.25%）和 HPV16（4.16%）。对本研究中所有 HPV 类型的系统发育分析显示，与同一种属相关的类型具有 80-99%的核苷酸同一性。序列与中国、印度、墨西哥、伊朗、斯洛文尼亚和德国聚类，显示出巴基斯坦流行的各种基因型来源的多样性。
在具有正常宫颈细胞学的人群中，高危 HPV 类型的流行率非常低。巴基斯坦旁遮普省主要流行的 HPV 基因型是低危型 HPV6，其次是 HPV55 型。部分 L1 区测序表明，所有报告的序列在该区域高度保守。本研究强调需要在该地区进行强有力的流行病学研究，并开展常规 HPV 筛查，以避免情况达到导致宫颈癌的令人担忧的阶段。
