Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, No.44 Xiaoheyan Road, Shenyang, 110042, Liaoning province, China.
Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, No.36 Sanhao Street, Shenyang, 110004, Liaoning province, China.
BMC Cancer. 2020 May 19;20(1):443. doi: 10.1186/s12885-020-06935-w.
Human papillomavirus (HPV) testing is more sensitive than cytology for detecting cervical cancer and its precursors. This study aimed to analyze the prevalence of high-risk HPV genotypes and evaluate the role of HPV genotyping triage for detecting high-grade squamous intraepithelial lesions, adenocarcinoma in situ and cervical cancer (HSIL+) in HPV-positive women with normal cytology.
A retrospective study was performed in women who had undergone co-screening at the China Medical University-affiliated Shengjing Hospital between 2012 and 2014.
Of the 34,587 women, 2665 HPV-positive women with normal cytology who had received colposcopy were eligible for analysis. In HSIL+ groups of 204 women, the common genotypes were HPV16, HPV52, HPV58, HPV33, HPV31 and HPV18 in order of prevalence. The proportion of histological HSIL+ in women infected with HPV33 or HPV31 was not significantly different compared to women infected with HPV16 (P = 0.30, P = 0.19, respectively). The odds ratios for histological HSIL+ were 3.26 (95% confidence interval [CI]: 2.41-4.40) in women with HPV16/18, 4.21 (95% CI: 2.99-5.93) in those with HPV16/18/31/33, and 5.73 (95% CI: 3.30-9.97) in those with HPV16/18/31/33/52/58. Including HPV31/33 genotyping together with HPV16/18 significantly increased the proportion of HSIL+ detection from 63.2 to 77.5% (P = 0.002) without significantly increasing the colposcopy per HSIL+ detection ratio (7.7 to 8.1, P = 0.66).
HPV genotyping played an important role in managing HPV-positive women with normal cytology. Genotyping for HPV31/33 should be added to the previously recommended HPV16/18 genotyping in triaging HPV-positive women in northeastern China.
人乳头瘤病毒（HPV）检测比细胞学检查更敏感，可用于检测宫颈癌及其前体病变。本研究旨在分析高危型 HPV 基因型的流行率，并评估 HPV 基因分型在 HPV 阳性、细胞学正常的妇女中筛查高级别鳞状上皮内病变、原位腺癌和宫颈癌（HSIL+）的作用。
本回顾性研究纳入了 2012 年至 2014 年在中国医科大学附属盛京医院进行联合筛查的女性。
在 34587 名女性中，共有 2665 名 HPV 阳性、细胞学正常、行阴道镜检查的妇女符合分析条件。在 204 名 HSIL+ 患者中，常见的基因型依次为 HPV16、HPV52、HPV58、HPV33、HPV31 和 HPV18。与 HPV16 感染相比，HPV33 或 HPV31 感染患者的组织学 HSIL+比例无显著差异（P=0.30，P=0.19）。HPV16/18、HPV16/18/31/33、HPV16/18/31/33/52/58 感染者发生组织学 HSIL+的比值比分别为 3.26（95%置信区间[CI]：2.41-4.40）、4.21（95% CI：2.99-5.93）和 5.73（95% CI：3.30-9.97）。同时进行 HPV31/33 基因分型可使 HSIL+的检出率从 63.2%提高至 77.5%（P=0.002），而每检出 1 例 HSIL+所需行阴道镜检查的比例（7.7 至 8.1）无显著增加（P=0.66）。
HPV 基因分型在管理 HPV 阳性、细胞学正常的妇女中具有重要作用。在中国东北地区，HPV 阳性、细胞学正常的妇女行 HPV 基因分型时，除 HPV16/18 基因分型外，还应增加 HPV31/33 基因分型。
