Zhuang Lijuan, Xie Xiaoyan, Wang Lihua, Weng Xiulan, Xiu Yingling, Liu Dabin, Zhong Liying
Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, People's Republic of China.
Risk Manag Healthc Policy. 2022 Nov 2;15:2043-2055. doi: 10.2147/RMHP.S384342. eCollection 2022.
The characteristics of high-risk human papillomavirus (HR-HPV) infection in different pathological types of cervical cancer in China are unclear. The aim of this study was to evaluate HR-HPV genotypes and age stratification with cervical squamous cell carcinoma (SCC) and adenocarcinoma (ADC) in China.
Patients diagnosed with cervical cancer by histopathology in Fujian Maternity and Child Health Hospital from January 1, 2014, to December 31, 2017, were included in this study. The HR-HPV genotype was analyzed in cervical specimens. Logistic regression was used to calculate odds ratios (ORs). All tests of statistical significance were two-sided, and the P value<0.05.
A total of 1,590,476 women were screened for cervical cancer, and 688 cervical cancers were detected, including 554 SCC and 93 ADC. The overall HR-HPV infection rate in SCC was higher than that in ADC (91.2% vs 81.7%, P=0.005). HPV-16 was the most prevalent genotype in SCC (70.0%) but was only 31.2% in ADC (P<0.001). However, the prevalence of HPV-18 in ADC was significantly higher than that in SCC (45.2% vs 7.0%; P<0.001). In SCC, the prevalence of HPV-16 was consistently much higher than that of HPV-18 regardless of age group. Among ADC, the prevalence of HPV-18 was higher than that of HPV-16 in women aged ≥45 years. Interestingly, in those aged <35 years, the highest prevalence was observed for HPV-16. HPV-18 infection has the highest risk of ADC (OR= 12.109; P< 0.001), and HPV-45 and HPV-51 were also found to be associated with the occurrence of ADC. However, HPV-16 infection greatly increased the risk of having histological SCC.
HPV-16 and HPV-18 infections are key risk factors for SCC and ADC. The use of HR-HPV genotyping tests in cervical cancer screening and vaccination against major HPV genotypes could reduce the incidence of cervical cancer.
中国不同病理类型宫颈癌中高危型人乳头瘤病毒（HR-HPV）感染特征尚不清楚。本研究旨在评估中国宫颈鳞状细胞癌（SCC）和腺癌（ADC）中HR-HPV基因型及年龄分层情况。
纳入2014年1月1日至2017年12月31日在福建省妇幼保健院经组织病理学诊断为宫颈癌的患者。对宫颈标本进行HR-HPV基因型分析。采用逻辑回归计算比值比（OR）。所有统计学显著性检验均为双侧检验，P值<0.05。
共筛查1,590,476名女性宫颈癌，检测出688例宫颈癌，其中554例SCC和93例ADC。SCC中HR-HPV总体感染率高于ADC（91.2%对81.7%，P = 0.005）。HPV-16是SCC中最常见的基因型（70.0%），但在ADC中仅为31.2%（P<0.001）。然而，ADC中HPV-18的患病率显著高于SCC（45.2%对7.0%；P<0.001）。在SCC中，无论年龄组，HPV-16的患病率始终远高于HPV-18。在ADC中，≥45岁女性中HPV-18的患病率高于HPV-16。有趣的是，在<35岁人群中，HPV-16患病率最高。HPV-18感染患ADC风险最高（OR = 12.109；P<0.001），且发现HPV-45和HPV-51也与ADC的发生有关。然而，HPV-16感染极大增加了组织学SCC的风险。
HPV-16和HPV-18感染是SCC和ADC的关键危险因素。在宫颈癌筛查中使用HR-HPV基因分型检测以及针对主要HPV基因型进行疫苗接种可降低宫颈癌发病率。
