Wang Yuli, Xue Jisen, Dai Xinyue, Chen Lulu, Li Junli, Wu Yancheng, Hu Yan
Department of Gynecology, The 1st Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
Cancer Med. 2018 Jul;7(7):3492-3500. doi: 10.1002/cam4.1559. Epub 2018 May 30.
To add the growing literature on baseline of high-risk human papillomavirus (HR-HPV) genotype distribution in cervical intraepithelial neoplasia (CIN) before the widespread using of HPV vaccines in Chinese mainland and to improve risk stratification of HR-HPV-positive women. Retrospectively, the data of age, cervical HPV genotypes, cytology, and pathology were collected from 1166 patients who received loop electrosurgical excision procedure (LEEP). HPV genotypes were analyzed with Flowcytometry Fluorescence Hybridization Method. And then HPV prevalence, HR-HPV genotype distribution and the correlation of HR-HPV genotypes with CIN2+ (CIN2 or severer) were analyzed. The role of multiple HR-HPV types infection with or without HPV16/18 in the pathogenesis of CIN2+ was also analyzed. The 6 most common HR-HPV genotypes were HPV16, 58, 52, 33, 18, and 31 in descending order. Compared to HR-HPV-negative women, HPV16, 33 or 58 positive women had higher risk of CIN2+ (OR = 5.10, 95% CI = 2.68-9.70; OR = 3.09, 95% CI = 1.39-6.84; OR = 3.57, 95% CI = 1.85-6.89, respectively). And women who were infected by multiple HR-HPV types infection with HPV16/18 also had higher risk of CIN2+ (OR = 2.58, 95% CI = 1.35-4.92). However, multiple HR-HPV types infection without HPV16/18 did not increase the risk significantly (P = .08). Compare to bivalent Cervarix and quadrivalent Gardasil , HPV prophylactic vaccine targeting HPV31, 33, 52, and 58 might provide women more protection from HPV-induced cervical cancer in China. The women who infected by HPV16, 33, 58, or multiple HR-HPV types with HPV16/18 have higher risk of CIN2+ and need to be paid more attention in screening processes. And the role of multiple HR-HPV types infection without HPV16/18 needs be further identified in more studies.
为补充中国大陆广泛使用HPV疫苗之前关于宫颈上皮内瘤变（CIN）中高危型人乳头瘤病毒（HR-HPV）基因型分布的不断增加的文献，并改善HR-HPV阳性女性的风险分层。回顾性地收集了1166例行环形电切术（LEEP）患者的年龄、宫颈HPV基因型、细胞学和病理学数据。采用流式细胞荧光杂交法分析HPV基因型。然后分析HPV感染率、HR-HPV基因型分布以及HR-HPV基因型与CIN2+（CIN2或更严重病变）的相关性。还分析了伴有或不伴有HPV16/18的多种HR-HPV类型感染在CIN2+发病机制中的作用。6种最常见的HR-HPV基因型依次为HPV16、58、52、33、18和31。与HR-HPV阴性女性相比，HPV16、33或58阳性女性发生CIN2+的风险更高（OR分别为5.10，95%CI为2.68-9.70；OR为3.09，95%CI为1.39-6.84；OR为3.57，95%CI为1.85-6.89）。并且伴有HPV16/18的多种HR-HPV类型感染的女性发生CIN2+的风险也更高（OR为2.58，95%CI为1.35-4.92）。然而，不伴有HPV16/18的多种HR-HPV类型感染并未显著增加风险（P=0.08）。与二价希瑞适和四价加德西相比，针对HPV31、33、52和58的HPV预防性疫苗可能为中国女性提供更多针对HPV诱发宫颈癌的保护。感染HPV16、33、58或伴有HPV16/18的多种HR-HPV类型的女性发生CIN2+的风险更高，在筛查过程中需要更多关注。不伴有HPV16/18的多种HR-HPV类型感染的作用需要在更多研究中进一步明确。
