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[阿达纳地区人乳头瘤病毒(HPV)基因型流行率及分布的测定:一项基于医院的2014 - 2021年研究]

[Determination of Human Papilloma Virus (HPV) Genotype Prevalance and Distrubution in Adana: A Hospital-Based Study Between 2014-2021].

作者信息

Alışkan Hikmet Eda, Öğüç Şanlı Özlem, Aka Bolat Filiz, Alkaş Yağınç Didem, Toprak Uğur

机构信息

Başkent University Faculty of Medicine, Department of Microbiology, Adana, Türkiye.

Başkent University Faculty of Medicine, Department of Pathology, Adana, Türkiye.

出版信息

Mikrobiyol Bul. 2023 Jan;57(1):119-133. doi: 10.5578/mb.20239910.

Abstract

Cervical cancer is the fourth most common cancer among women all over the world. It is accepted that cervical cancer is highly related to the HPV. The International Agency for Research on Cancer (IARC) has classified 13 HPV types as group 1 carcinogens (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 66), which are commonly referred to as high risk-HPVs (hr-HPVs). Among these, hr-HPV-16 is undoubtedly the most carcinogenic based in the burden of cervical cancer (CC) and its precursor lesions. In our study, we analyzed retrospectively the data of a total of 2329 female patients who applied to the obstetrics and gynecology outpatient clinic of our hospital over a seven-year-period, whose cervical smear were carried out by the polymerase chain reaction (PCR) and cytology. In this study, it was aimed to determine the data of of HPV prevalence in our region during the seven-year-period from April 2014 to April 2021 and the most common genotypes and to interpret them together with the cervical smears cytology and biopsy results if it is available. HPV 3, 6, 11, 16, 18, 21, 26, 31, 33, 35, 39, 40, 42, 45, 51, 52, 53, 54, 55, 56, 58, 59, 61, 62, 66, 67, 68, 70, 72, 73, 81, 82, 83, 84 were identified by using linear array HPV genotyping test (Roche Diagnostics, Switzerland) from April 2014 to October 2017. HPV genotypes were identified by using HPV Genotypes 14 Real-TM Quant (Qiagen, Germany) between October 2017 and April 2021. This method detected HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68. The data were analyzed using IBM SPSS Statistics (Version 25.0) predictive analytics software. Continuous variables are indicated as mean ± standard deviation, and discrete variables are indicated as number [percentage (%)]. Chi-square test is used to investigate dependencies between variables. All analyzes were evaluated to provide 95% confidence level and 80% test power. p<0.05 was accepted as significant for the analysis results. Out of 2329 patients, 1283 were found to be HPV negative (54.6%) and the others were found to be HPV positive (45.4%) by using real-time PCR in the cervical smears. It was detected that out of 1046 HPV positive patients, 585 of them (55.9%) had one HPV genotype and 461 of them (44.1%) had more than one HPV genotypes. As we divided all of the patients into two groups as <30 (Group I) ve > 30 (Group II) according to age range, HPV positivity was found 134/296 (45.2%) in Group I and 912/2033 (44.8%) in Group II. When we compared the HPV positive/negative results of Groups I and II by using chi-square test, no significant difference was found between the two age groups in terms of HPV positivity (p= 0.894). In our study, the most common HPV types were HPV 16 (14.2%), HPV 68 (8.2%), HPV 56 (8.2%), HPV 52 (7.1%), HPV 51 (6.8%), HPV 31 (6.5%), HPV 66(6.1%), HPV 39 (5.8%) and HPV 18 (5.6%) among the women with normal and abnormal cytology in the cervical smears. ASC-US was the most common abnormal epithelial cell change detected with HPV16 and 18 genotypes and it was detected 26.07% and 21.88% in patients, respectively. In our study, we found HPV prevalance in our region as 45.4% and the most common type was HPV 16. As a result, we concluded that it is important to determine regional HPV prevalance data, which is an important step in cervical cancer prevention strategies, and regional data of detected HPV genotypes.

摘要

宫颈癌是全球女性中第四大常见癌症。人们普遍认为宫颈癌与人类乳头瘤病毒(HPV)高度相关。国际癌症研究机构(IARC)已将13种HPV类型归类为1类致癌物(HPV 16、18、31、33、35、39、45、51、52、56、58、59和66),这些通常被称为高危型HPV(hr-HPV)。其中,基于宫颈癌(CC)及其前驱病变的负担,hr-HPV-16无疑是最具致癌性的。在我们的研究中,我们回顾性分析了在七年期间到我院妇产科门诊就诊的2329名女性患者的数据,这些患者的宫颈涂片通过聚合酶链反应(PCR)和细胞学检查进行。本研究旨在确定2014年4月至2021年4月这七年期间我们地区HPV的流行数据、最常见的基因型,并在有宫颈涂片细胞学和活检结果的情况下将它们与这些结果一起进行解读。2014年4月至2017年10月期间,使用线性阵列HPV基因分型检测(瑞士罗氏诊断公司)鉴定出HPV 3、6、11、16、18、21、26、31、33、35、39、40、42、45、51、52、53、54、55、56、58、59、61、62、66、67、68、70、72、73、81、82、83、84。2017年10月至2021年4月期间,使用HPV基因分型14 Real-TM定量检测(德国Qiagen公司)鉴定HPV基因型。该方法检测到HPV基因型16、18、31、33、35、39、45、51、52、56、58、59、66、68。使用IBM SPSS Statistics(版本25.0)预测分析软件对数据进行分析。连续变量表示为均值±标准差,离散变量表示为数量[百分比(%)]。使用卡方检验来研究变量之间的相关性。所有分析的评估均提供95%的置信水平和80%的检验效能。分析结果以p<0.05为有统计学意义。在2329名患者中,通过宫颈涂片的实时PCR检测发现1283名患者HPV阴性(54.6%),其他患者HPV阳性(45.4%)。在1046名HPV阳性患者中,检测到其中585名(55.9%)有1种HPV基因型,461名(44.1%)有不止一种HPV基因型。当我们根据年龄范围将所有患者分为<30岁(I组)和>30岁(II组)两组时,I组HPV阳性率为134/296(45.2%),II组为912/2033(44.8%)。当我们使用卡方检验比较I组和II组的HPV阳性/阴性结果时,发现两个年龄组在HPV阳性率方面无显著差异(p = 0.894)。在我们的研究中,宫颈涂片细胞学正常和异常的女性中最常见的HPV类型为HPV 16(14.2%)、HPV 68(8.2%)、HPV 56(8.2%)、HPV 52(7.1%)、HPV 51(6.8%)、HPV 31(6.5%)、HPV 66(6.1%)、HPV 39(5.8%)和HPV 18(5.6%)。非典型鳞状细胞不能明确意义(ASC-US)是检测到的与HPV16和18基因型相关的最常见异常上皮细胞变化,在患者中分别检测到26.07%和21.88%。在我们的研究中,我们发现我们地区的HPV流行率为45.4%,最常见的类型是HPV 16。因此,我们得出结论,确定地区HPV流行数据很重要,这是宫颈癌预防策略中的重要一步,以及检测到的HPV基因型的地区数据也很重要。

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