You Weizhi, Li Shaocong, Du Ran, Zheng Jizeng, Shen Aifang
Department of Obstetrics and Gynecology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China.
Department of Pathology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China.
Exp Ther Med. 2018 Jan;15(1):412-418. doi: 10.3892/etm.2017.5357. Epub 2017 Oct 23.
The present study aimed to determine the genotype and age distribution of high-risk human papillomavirus (HR-HPV) and evaluate HPV-DNA in subjects with abnormal cervical cytology results by using crowd-based cervical cancer screening cytology data. The Thinprep liquid-based cytologic test (TCT) was performed from January 2013 to January 2014 in the permanent residents of Liaocheng (China) aged 21-65 years who were married or had sexual intercourse. The number of screened women totaled 20,017, among whom 937 had abnormal results, 785 of which were recalled. For subjects in the age range of 21-65 years, an HR-HPV typing test using the fluorescence hybridization method. Among the 785 cases with abnormal TCT findings, repeated testing identified atypical squamous cells of unknown significance/atypical glandular cells in 478, low-grade squamous intraepithelial lesions in 175, high squamous intraepithelial lesions in 127 and squamous cell carcinoma/adenocarcinoma in 5 cases. Among these types, infection rates of HR-HPV were 50.2, 77.1, 89.0 and 100%, respectively. Of the 785 cases with abnormal TCT results, 493 (62.8%) were HR-HPV-positive. A total of 16 types of HR-HPV were detected: HPV-16, -18, -31, -33, -35, -39, -45, -51-53, -56, -58, -59, -66, 68 and 73. Subjects infected with ≥2 types were defined as having a multi-type infection. The infection rate was high in the age groups of 26-30 and 51-55 years, accounting for 87.7% (71/81) and 79.7% (51/64), respectively, while it was lower in the >55 years group at 28.6% (14/54). The top five types of HR-HPV (stated in a decreasing order regarding positivity rate) were HPV16 (21.5%, 169/785), HPV52 (12.2%, 96/785), HPV58 (9.8%, 77/785), HPV33 (9.7%, 76/785) and HPV18 (7.5%, 59/785). Single-type infection was encountered in 45.0% (353/785) and multi-type infection in 17.8% (140/785), among which 98 cases had a two-type infection, 37 had a three-type infection, 2 had a four-type infection, 2 had a five-type infection and 1 case had a six-type infection. In the present study, differences in multi-type HR-HPV infection between groups with different TCT results were statistically significant. In conclusion, compared with CTC screening on its own, complementary HR-HPV testing is an effective method for screening for cervical cancer. The infection rate of HPV16, -52, -58, -33 and -18 was high among patients with cervical cytological abnormalities. Multi-type infection adds to the risk of malignancies. In Liaocheng, high-risk groups were aged 26-30 and 51-55. Attention should be paid during the screening and follow-up visits of these groups.
本研究旨在利用基于人群的宫颈癌筛查细胞学数据，确定高危型人乳头瘤病毒（HR-HPV）的基因型和年龄分布，并评估宫颈细胞学结果异常的受试者的HPV-DNA情况。2013年1月至2014年1月期间，对聊城市（中国）年龄在21 - 65岁、已婚或有过性行为的常住人口进行了薄层液基细胞学检测（TCT）。筛查的女性总数为20017人，其中937人结果异常，785人被召回。对于年龄在21 - 65岁的受试者，采用荧光杂交法进行HR-HPV基因分型检测。在785例TCT结果异常的病例中，复查发现意义不明确的非典型鳞状细胞/非典型腺细胞478例，低度鳞状上皮内病变175例，高度鳞状上皮内病变127例，鳞状细胞癌/腺癌5例。在这些类型中，HR-HPV的感染率分别为50.2%、77.1%、89.0%和100%。在785例TCT结果异常的病例中，493例（62.8%）为HR-HPV阳性。共检测到16种HR-HPV：HPV-16、-18、-31、-33、-35、-39、-45、-51 - 53、-56、-58、-59、-66、68和73。感染≥2种类型的受试者被定义为多重感染。26 - 30岁和51 - 55岁年龄组的感染率较高，分别占87.7%（71/81）和79.7%（51/64），而>55岁年龄组的感染率较低，为28.6%（14/54）。HR-HPV的前五种类型（按阳性率从高到低排列）为HPV16（21.5%，169/785）、HPV52（12.2%，96/785）、HPV58（9.8%，77/785）、HPV33（9.7%，76/785）和HPV18（7.5%，59/785）。单一类型感染占45.0%（353/785），多重感染占17.8%（140/785），其中98例为两重感染，37例为三重感染，2例为四重感染，2例为五重感染，1例为六重感染。在本研究中，不同TCT结果组之间多重HR-HPV感染的差异具有统计学意义。总之，与单独的TCT筛查相比，补充HR-HPV检测是一种有效的宫颈癌筛查方法。HPV16、-52、-58、-33和-18在宫颈细胞学异常患者中的感染率较高。多重感染增加了恶性肿瘤的风险。在聊城，高危人群为26 - 30岁和51 - 55岁。在这些人群的筛查和随访过程中应予以关注。
