Xu Hui-Hui, Wang Kai, Feng Xing-Jun, Dong Shan-Shan, Lin Aifen, Zheng Ling-Zhi, Yan Wei-Hua
Laboratory of Gynecologic Oncology, Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China.
Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China.
Oncotarget. 2018 Jan 11;9(20):15386-15397. doi: 10.18632/oncotarget.24169. eCollection 2018 Mar 16.
High-risk HPV (hrHPV) is related to cervical carcinogenesis, although clinical data comparing the natural history and carcinogenic potential of type-specific HPV remain limited. Furthermore, the nationwide prevalence rates of overall and type-specific HPV among women with cervical precancerous lesions and cancer have not been reported. Here, a meta-analysis was performed for type-specific HPV distribution among 30,165 HPV-positive women, including 12,094 invasive cervical cancers (ICCs), 10,026 cervical intraepithelial neoplasia grade 2/3 (CIN2/3), 3246 CIN1, and 4799 normal cervices from 45 PCR-based studies. We found that HPV16 was the most common hrHPV type involved in cervical disease. The HPV16 positivity rate varied little across normal (22.7%) and CIN1 individuals (23.6%) but increased through the CIN2 (37.6%) and CIN3 patients (51.9%) to 65.6% in ICC cases. HPV16, 18, 35, 39, 45, and 59 were more frequent in ICC than CIN3, with ICC:CIN3 ratios ranging from 2.3 for HPV18 to 1.1 for HPV35/45. HPV31, 33, 52, and 58 were more frequent in CIN3 compared with normal cervices but less common in ICC compared with CIN3 (ICC:CIN3 ratios ranging from 0.6 for HPV58 and 0.4 for HPV52). The ICC:normal ratios were particularly high for HPV18, 52 and 58 in West China (4.1, 3.9 and 2.9, respectively) and for HPV45 and 59 in North China (1.6 and 1.1, respectively). In summary, this study is the most comprehensive analysis of type-specific HPV distribution in cervical carcinogenesis and could be valuable for HPV-based cervical cancer screening strategies and vaccination policies in China.
高危型人乳头瘤病毒（hrHPV）与宫颈癌发生相关，尽管比较特定型别HPV自然史和致癌潜力的临床数据仍然有限。此外，宫颈癌前病变和癌症女性中总体及特定型别HPV的全国患病率尚未见报道。在此，我们对来自45项基于聚合酶链反应研究的30165例HPV阳性女性进行特定型别HPV分布的荟萃分析，这些女性包括12094例浸润性宫颈癌（ICC）、10026例宫颈上皮内瘤变2/3级（CIN2/3）、3246例CIN1以及4799例正常宫颈。我们发现HPV16是参与宫颈疾病的最常见hrHPV型别。HPV16阳性率在正常个体（22.7%）和CIN1个体（23.6%）中变化不大，但在CIN2患者（37.6%）和CIN3患者（51.9%）中升高，在ICC病例中达65.6%。HPV16、18、35、39、45和59在ICC中比CIN3中更常见，ICC与CIN3的比值范围从HPV18的2.3到HPV35/45的1.1。与正常宫颈相比，HPV31、33、52和58在CIN3中更常见，但与CIN3相比在ICC中较少见（ICC与CIN3的比值范围从HPV58的0.6到HPV52的0.4）。在中国西部，HPV18、52和58的ICC与正常宫颈的比值特别高（分别为4.1、3.9和2.9），在中国北方，HPV45和59的ICC与正常宫颈的比值特别高（分别为1.6和1.1）。总之，本研究是对宫颈癌发生中特定型别HPV分布最全面的分析，可能对中国基于HPV的宫颈癌筛查策略和疫苗接种政策具有重要价值。
