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在中国一项基于人群的队列研究中,高危型人乳头瘤病毒感染的基因型特异性分布及变化,以及其与病理正常但细胞学异常女性宫颈病变进展风险的关联。

Genotype-specific Distribution and Change of High-risk Human Papillomavirus Infection and the Association with Cervical Progression Risk in Women with Normal Pathology and Abnormal Cytology in a Population-based Cohort Study in China.

作者信息

Jia Haixia, Ding Ling, Han Yang, Lyu Yuanjing, Hao Min, Tian Zhiqiang, Wang Jintao

机构信息

Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China.

Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China.

出版信息

J Cancer. 2021 May 19;12(14):4379-4388. doi: 10.7150/jca.57993. eCollection 2021.

Abstract

Women with normal pathology screened from abnormal cervical cytology are a special population with higher progression risk than women with normal cytology. However, the associations between genotype distribution and changes of high-risk human papillomavirus (HR-HPV) infection and cervical progression risk in this special population remain unclear. A total of 1232 women with normal pathology screened from abnormal cervical cytology were enrolled into this cohort with 2-year follow-up. HPV genotyping detection was performed through flow-through hybridization. Hazard ratios (HRs) and Odds ratios (ORs) were calculated using Cox proportional hazard regression and logistic regression models, respectively. Overall HR-HPV prevalence at baseline was 29.0%, with HPV16, 52, 58, 53 and 51 the top five genotypes. The 2-year persistence rate of HR-HPV infection was 31.9%. Compared with HR-HPV negative, the adjusted HRs of overall HR-HPV, HPV16, 31/33, 58, 51, and 53 infections for the progression risk of normal cervix were 5.31, 7.10, 6.95, 5.74, 5.04, and 4.88, respectively. Multiple HR-HPV infection cannot lead to an additional risk of progression relative to single HR-HPV infection. In comparison with HR-HPV persistently negative, same-type HR-HPV persistence was positively associated with progression risk of normal cervix (adjusted OR: 22.26), but different-type HR-HPV persistence was not linked to cervical progression. Genotypes and persistence of HR-HPV infection could stratify the cervical progression risk in women with normal cervical pathology and abnormal cytology and provide evidence for development of next generation of vaccines. HPV51 and 53 deserved attention apart from HPV16, 31, 33, and 58.

摘要

从异常宫颈细胞学筛查出病理正常的女性是一个特殊人群,其进展风险高于细胞学正常的女性。然而,在这一特殊人群中,高危型人乳头瘤病毒(HR-HPV)感染的基因型分布及变化与宫颈进展风险之间的关联仍不清楚。本队列研究纳入了1232例从异常宫颈细胞学筛查出病理正常的女性,并进行了为期2年的随访。通过导流杂交法进行HPV基因分型检测。分别使用Cox比例风险回归模型和逻辑回归模型计算风险比(HRs)和比值比(ORs)。基线时HR-HPV总体患病率为29.0%,HPV16、52、58、53和51为前五种基因型。HR-HPV感染的2年持续率为31.9%。与HR-HPV阴性相比,总体HR-HPV、HPV16、31/33、58、51和53感染导致正常宫颈进展风险的校正HRs分别为5.31、7.10、6.95、5.74、5.04和4.88。相对于单一HR-HPV感染,多重HR-HPV感染不会导致额外的进展风险。与HR-HPV持续阴性相比,同一类型HR-HPV持续感染与正常宫颈的进展风险呈正相关(校正OR:22.26),但不同类型HR-HPV持续感染与宫颈进展无关。HR-HPV感染的基因型和持续感染情况可对宫颈病理正常但细胞学异常的女性的宫颈进展风险进行分层,并为新一代疫苗的研发提供依据。除了HPV16、31、33和58外,HPV51和53也值得关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a940/8176416/94ea5b6427cc/jcav12p4379g001.jpg

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