Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, People's Republic of China.
Biobank, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Arch Virol. 2021 Mar;166(3):853-862. doi: 10.1007/s00705-021-04960-z. Epub 2021 Jan 24.
The aim of this study was to describe the distribution of human papillomavirus (HPV) genotypes among cervical cancers and pre-cancers in Shaanxi province of western China. A total of 17,341 women who were screened for cervical cancer from January 2014 to December 2016, using HPV genotyping and ThinPrep cytologic test were included. The prevalence and attribution of HPV genotypes were stratified by cervical lesion and age group. Of the subjects, 26.3% were infected with HPV, 28.0% of whom had multiple infections. The crude HPV prevalence increased from atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions (ASCUS/LSIL, 64.3%) to high-grade squamous intraepithelial lesions (HSIL, 79.8%) and to invasive cervical cancer (ICC, 89.7%, P < 0.001). The three most prevalent genotypes were HPV 16 (8.0%), 58 (4.2%), and 52 (4.0%), and HPV 16, 31 and 33 were positively correlated with increased severity of cervical lesions. Additionally, the divalent vaccine genotypes HPV 16 and 18 accounted for 68.2% of ICC cases. Although 78.5% of ICC and 60.3% of HSIL cases were attributed to 9-valent vaccine genotypes, the other genotypes not covered by any vaccine still resulted in increases in coverage, with 1.5% for ICC, 5.3% for HSIL, and 13.5% for ASCUS/LSIL. HPV prevalence in western China was consistent with other regions of China. Early vaccination with 9-valent HPV vaccine is recommended in this locality for females younger than 26 years with no prior infection, while divalent the vaccine is more appropriate for women between 26 and 45 years, considering the efficacy, safety and cost-effectiveness of vaccines.
本研究旨在描述中国西部陕西省宫颈癌及癌前病变中人类乳头瘤病毒（HPV）基因型的分布。本研究共纳入了 17341 名 2014 年 1 月至 2016 年 12 月期间因宫颈癌筛查的女性，采用 HPV 基因分型和液基细胞学检查进行检测。根据宫颈病变和年龄组分层分析 HPV 基因型的流行率和归因。在这些受试者中，26.3%的人感染了 HPV，其中 28.0%的人存在多重感染。HPV 的粗流行率从非典型鳞状细胞不能明确意义/低级别鳞状上皮内病变（ASCUS/LSIL，64.3%）逐渐增加到高级别鳞状上皮内病变（HSIL，79.8%）和浸润性宫颈癌（ICC，89.7%，P<0.001）。三种最常见的基因型是 HPV 16（8.0%）、58（4.2%）和 52（4.0%），HPV 16、31 和 33 与宫颈病变严重程度的增加呈正相关。此外，二价疫苗 HPV 16 和 18 基因型占 ICC 病例的 68.2%。虽然 ICC 的 78.5%和 HSIL 的 60.3%归因于九价疫苗基因型，但任何疫苗都没有涵盖的其他基因型仍然会导致覆盖率增加，ICC 增加 1.5%，HSIL 增加 5.3%，ASCUS/LSIL 增加 13.5%。中国西部地区 HPV 的流行率与中国其他地区一致。鉴于疫苗的疗效、安全性和成本效益，对于没有既往感染的 26 岁以下女性，建议在该地区接种九价 HPV 疫苗；对于 26 至 45 岁的女性，二价疫苗更为合适。
