Leite Katia Ramos Moreira, Pimenta Ruan, Canavez Juliana, Canavez Flavio, de Souza Fernando R, Vara Ligia, Estivallet Carmen, Camara-Lopes Luiz Heraldo
Genoa/LPCM Laboratory, São Paulo, Brazil,
Laboratório de Investigação Médica, Disciplina de Urologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil,
Acta Cytol. 2020;64(5):420-424. doi: 10.1159/000506725. Epub 2020 Apr 1.
Nearly 500,000 new cases of cervical cancer are estimated annually worldwide. Three vaccines are currently licensed to prevent cervical cancer. The success of vaccination depends mainly on the prevalence of HPV genotypes, and many cases of HPV infection have been diagnosed after vaccination. Our aim was to search for HPV genotyping in cervical samples to verify the proportion of women that remain susceptible to infection even after vaccination.
21,017 liquid-based cervical (LBC) specimens were received for cytology and HPV detection from 2015 to 2018. Before slide preparations for cytology, a 1,000-μL aliquot was taken from the LBC fixative and subjected to automated DNA extraction and multiplex PCR followed by capillary electrophoresis to detect and classify HPV.
HPV was detected in 895 (4.3%) specimens. The most prevalent genotype was HPV-16, followed by HPV-58 and HPV-66. A total of 258 (28.8%) cases were positive for high-risk (HR)-HPV types (66, 59, 39, 56, 30, 35, 53, 51, 68, 82, and 70) that are not covered by the HPV vaccines.
A significant proportion of HPV types detected in cytological specimens are representative of HR-HPV not covered by the available vaccines. The health system should be aware of the considerable percentage of women who are not being immunized and will continue to need cervical cancer screening.
全球每年估计有近50万例宫颈癌新发病例。目前有三种疫苗被批准用于预防宫颈癌。疫苗接种的成功主要取决于HPV基因型的流行情况，并且许多HPV感染病例是在接种疫苗后被诊断出来的。我们的目的是在宫颈样本中进行HPV基因分型，以核实即使在接种疫苗后仍易感染的女性比例。
2015年至2018年共接收了21,017份宫颈液基（LBC）标本用于细胞学检查和HPV检测。在制备用于细胞学检查的玻片之前，从LBC固定剂中取出1000μL等分试样，进行自动DNA提取和多重PCR，然后进行毛细管电泳以检测和分类HPV。
在895份（4.3%）标本中检测到HPV。最常见的基因型是HPV-16，其次是HPV-58和HPV-66。共有258例（28.8%）病例为HPV疫苗未涵盖的高危（HR）-HPV类型（66、59、39、56、30、35、53、51、68、82和70）阳性。
在细胞学标本中检测到的相当一部分HPV类型代表了现有疫苗未涵盖的HR-HPV。卫生系统应意识到有相当比例的女性未接种疫苗，并且将继续需要宫颈癌筛查。
