de Sanjosé Silvia, Serrano Beatriz, Tous Sara, Alejo Maria, Lloveras Belén, Quirós Beatriz, Clavero Omar, Vidal August, Ferrándiz-Pulido Carla, Pavón Miquel Ángel, Holzinger Dana, Halec Gordana, Tommasino Massimo, Quint Wim, Pawlita Michael, Muñoz Nubia, Bosch Francesc Xavier, Alemany Laia
Cancer Epidemiology Research Program, ICO; Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain (SDS, BS, ST, BQ, OC, MAP, FXB, LA).
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
JNCI Cancer Spectr. 2019 Jan 7;2(4):pky045. doi: 10.1093/jncics/pky045. eCollection 2018 Oct.
Many countries, mainly high- and upper-middle income, have implemented human papillomavirus (HPV) vaccination programs, with 47 million women receiving the full course of vaccine (three doses) in 2014. To evaluate the potential impact of HPV vaccines in the reduction of HPV-related disease, we aimed to estimate the HPV type distribution and burden of anogenital and head and neck cancers attributable to HPV types (HPVs 16/18/31/33/45/52/58/6/11) included in currently licensed HPV vaccines.
In all, 18 247 formalin-fixed paraffin-embedded specimens were retrieved from 50 countries. HPV DNA detection and typing were performed with the SPF-10 PCR/DEIA/LiPA25 system. With the exception of cervical cancer, HPV DNA-positive samples were additionally subjected to HPV E6I mRNA detection and/or p16 immunohistochemistry. For cervical cancer, estimates were based on HPV DNA, whereas for other sites, estimates were based on HPV DNA, E6I mRNA, and p16 biomarkers.
The addition of HPVs 31/33/45/52/58 to HPVs 16/18/6/11 in the nonavalent HPV vaccine could prevent almost 90% of cervical cancer cases worldwide. For other sites, the nonavalent HPV vaccine could prevent 22.8% of vulvar, 24.5% of penile, 60.7% of vaginal, 79.0% of anal cancers, 21.3% of oropharyngeal, 4.0% of oral cavity, and 2.7% of laryngeal cancer cases.
Our estimations suggest a potential impact of the nonavalent HPV vaccine in reducing around 90% of cervical cancer cases and a global reduction of 50% of all the cases at HPV-related cancer sites.
许多国家，主要是高收入和中高收入国家，已经实施了人乳头瘤病毒（HPV）疫苗接种计划，2014年有4700万女性接种了完整疗程的疫苗（三剂）。为了评估HPV疫苗在减少HPV相关疾病方面的潜在影响，我们旨在估计目前已获许可的HPV疫苗中所包含的HPV类型（HPV 16/18/31/33/45/52/58/6/11）导致的肛门生殖器癌和头颈癌的HPV类型分布及负担。
总共从50个国家检索了18247份福尔马林固定石蜡包埋标本。使用SPF-10 PCR/DEIA/LiPA25系统进行HPV DNA检测和分型。除宫颈癌外，HPV DNA阳性样本还需额外进行HPV E6I mRNA检测和/或p16免疫组化。对于宫颈癌，估计基于HPV DNA，而对于其他部位，估计基于HPV DNA、E6I mRNA和p16生物标志物。
在九价HPV疫苗中将HPV 31/33/45/52/58添加到HPV 16/18/6/11中，可预防全球近90%的宫颈癌病例。对于其他部位，九价HPV疫苗可预防22.8%的外阴癌、24.5%的阴茎癌、60.7%的阴道癌、79.0%的肛门癌、21.3%的口咽癌、4.0%的口腔癌和2.7%的喉癌病例。
我们的估计表明，九价HPV疫苗在减少约90%的宫颈癌病例方面具有潜在影响，并可使全球HPV相关癌症部位的所有病例减少50%。
