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人乳头瘤病毒(HPV)疫苗接种后,法国年轻性活跃女性中HPV基因型及宫颈相关病变的患病率和分布情况

Prevalence and distribution of HPV genotypes and cervical-associated lesions in sexually active young French women following HPV vaccine.

作者信息

Bretagne C H, Jooste V, Guenat D, Riethmuller D, Bouvier A M, Bedgedjian I, Prétet J L, Valmary-Degano S, Mougin C

机构信息

Service d'Anatomie et cytologie pathologiques, CHU Besançon, Bd Fleming, 25000 Besançon, France.

Registre Bourguignon des Cancers Digestifs, Hôpital Universitaire Dijon-Bourgogne, 21000 Dijon, France; INSERM, U1231, EPICAD Team, Université Bourgogne-Franche-Comté, 21000 Dijon, France.

出版信息

J Gynecol Obstet Hum Reprod. 2018 Dec;47(10):525-531. doi: 10.1016/j.jogoh.2018.05.011. Epub 2018 May 25.

Abstract

BACKGROUND

Despite the availability of safe and effective HPV vaccines in France, more than 80% of girls remain unvaccinated.

SETTING

A regional university hospital referral center in France.

OBJECTIVE

To estimate the overall prevalence and distribution of HPV in vaccinated, sexually active young French women who were screened for cervical cancer by cytology and HPV testing.

METHODS

High-risk HPV (HR-HPV) prevalence, genotype-specific prevalence and extent of multiple infections were assessed in 125 cervical samples from females with available vaccine data using hc2 assay and INNO-LiPA assay. HPV status was analyzed in accordance with cytological data.

RESULTS

In our series, mean age was 23 years, overall prevalence of HR-HPV was 52% and was correlated with the lesion grade. The diversity of HPV genotypes was broad. Single HR-HPV infections were identified in 11%, 21% and 47% of women with NILM, ASC-US/-H and LSIL respectively. Multiple infections with HR-HPV were detected in 28% of the specimens. Only 24.5% of women with NILM presented infections with 2 genotypes or more, vs 28% of women with ASC-US/-H and 35% of women with LSIL. The overall prevalence of genotypes covered by the quadrivalent vaccine was low (5.9%); with 4.2%, 0%, 0.8% and 0.8% for HPV 16, HPV 18, HPV 6 and HPV 11 respectively.

CONCLUSION

Among HPV-vaccinated young women, HR-HPV are detected at a high rate, and an association with the grade of cytological abnormalities was observed. However, HPV 16 and 18, both targeted by the vaccines, are remarkably rare among young French women since program implementation.

摘要

背景

尽管法国有安全有效的人乳头瘤病毒(HPV)疫苗,但超过80%的女孩仍未接种疫苗。

地点

法国一家地区大学医院转诊中心。

目的

评估通过细胞学和HPV检测筛查宫颈癌的已接种疫苗、有性活动的年轻法国女性中HPV的总体患病率及分布情况。

方法

使用hc2检测法和INNO-LiPA检测法,对125份有疫苗接种数据的女性宫颈样本进行高危型HPV(HR-HPV)患病率、基因型特异性患病率及多重感染程度的评估。根据细胞学数据对HPV状态进行分析。

结果

在我们的研究系列中,平均年龄为23岁,HR-HPV的总体患病率为52%,且与病变分级相关。HPV基因型的多样性广泛。分别在11%、21%和47%的未见上皮内病变或恶性病变(NILM)、非典型鳞状细胞意义不明确(ASC-US/-H)和低度鳞状上皮内病变(LSIL)的女性中检测到单一HR-HPV感染。在28%的样本中检测到HR-HPV多重感染。NILM的女性中只有24.5%出现两种或更多基因型感染,而ASC-US/-H的女性为28%,LSIL的女性为35%。四价疫苗涵盖的基因型总体患病率较低(5.9%);HPV 16、HPV 18、HPV 6和HPV 11的患病率分别为4.2%、0%、0.8%和0.8%。

结论

在接种HPV疫苗的年轻女性中,HR-HPV的检出率较高,且观察到与细胞学异常分级有关联。然而,自疫苗接种计划实施以来,疫苗所针对的HPV 16和18在年轻法国女性中极为罕见。

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