Lan Zhihua, Zhang Jing, Li Hongtao, He Rongfang, Zhao Qiang, Yang Fang
Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China.
Department of Anorectal Surgery of Traditional Chinese Medicine, The First Affiliated Hospital, University of South China, Hengyang, China.
Front Microbiol. 2023 Jan 4;13:1094560. doi: 10.3389/fmicb.2022.1094560. eCollection 2022.
Human papillomavirus (HPV) infection is closely correlated with cervical lesions. However, the HPV prevalence varies among different districts. This retrospective study investigated the HPV genotype distribution and its relationship with cervical lesions in southern Hunan Province.
The database at our Pathology Department was searched for HPV and morphological results during 2018-2020 were reviewed. A total of 49,955 gynaecological inpatients and outpatients, each of whom underwent HPV testing based on the amplification of L1 sequence and reverse dot blot hybridization, were included in this study. Available cytology and relevant histological examination results were reviewed. Enrolled cases were categorized into seven groups based on their age. Household registry and educational level were evaluated.
Seven thousand two hundred eighty-six females were positive for HPV and the overall HPV positivity rate was 14.59%. The top five most prevalent HPV genotypes were HPV52, 16, 58, 53 and 51 (22.98%, 17.54%, 14.29%, 7.47%, and 5.70%, respectively). The HPV prevalence curve specific to the seven age groups showed a bimodal distribution. High school education or blow and rural residence served as risk factors for HPV infection. Single infection was the main type of HPV infection, and multiple infections occurred in 21.92% of the infected women. Of 3,148 cases had cytological results, 1,149 (36.50%) had abnormal cytological abnormalities. Among 2,833 participants with histological examination, 2000 (70.60%) had cervical abnormalities. Cytological and pathological abnormalities were mainly associated with infection with HPV16, 52 and 58. Further analysis found that HPV16, 58, 52 and 33 were the main genotypes associated with high-grade squamous lesions (HSIL) and that HPV16, 31, 33 and 58 were independent risk factors for HSIL (odd ratio [OR] = 1.70, 1.99, 2.59, 2.29; 95% CI = 1.41-2.03, 1.17-3.41, 1.88-3.59, 1.85-2.82; all < 0.05). HPV16, 58, 52, 18 and 33 were the most frequent genotypes detected in squamous cell carcinoma (SCC) patients, and HPV16 and 18 were independent risk factors for cervical carcinomas (OR = 6.72;95% CI = 5.48-8.25; < 0.001; OR = 1.67, 95% CI = 1.22-2.30; = 0.001).
This retrospective study demonstrated the prevalence and the distribution characteristics of HPV infection and its correlation with cervical lesions in southern Hunan Province. The comprehensive results of this survey can guide HPV vaccine research to protect against some common genotypes in China.
人乳头瘤病毒（HPV）感染与宫颈病变密切相关。然而，不同地区的HPV感染率有所不同。本回顾性研究调查了湖南省南部HPV基因型分布及其与宫颈病变的关系。
检索我院病理科数据库中2018 - 2020年的HPV及形态学检查结果。本研究共纳入49955例妇科住院和门诊患者，所有患者均基于L1序列扩增和反向斑点杂交进行HPV检测。回顾可用的细胞学和相关组织学检查结果。根据年龄将纳入病例分为七组。评估户籍和教育程度。
7286名女性HPV检测呈阳性，总体HPV阳性率为14.59%。最常见的五种HPV基因型为HPV52、16、58、53和51（分别为22.98%、17.54%、14.29%、7.47%和5.70%）。七个年龄组的HPV感染率曲线呈双峰分布。高中及以下学历和农村户籍是HPV感染的危险因素。单一感染是HPV感染的主要类型，21.92%的感染女性发生多重感染。在3148例有细胞学检查结果的病例中，1149例（36.50%）存在细胞学异常。在2833例有组织学检查的参与者中，2000例（70.60%）存在宫颈异常。细胞学和病理学异常主要与HPV16、52和58感染有关。进一步分析发现，HPV16、58、52和33是与高级别鳞状上皮内病变（HSIL）相关的主要基因型，HPV16、31、33和58是HSIL的独立危险因素（比值比[OR]=1.70、1.99、2.59、2.29；95%可信区间[CI]=1.41 - 2.03、1.17 - 3.41、1.88 - 3.59、1.85 - 2.82；均P<0.05）。HPV16、58、52、18和33是在鳞状细胞癌（SCC）患者中检测到的最常见基因型，HPV16和18是宫颈癌的独立危险因素（OR = 6.72；95%CI = 5.48 - 8.25；P<0.001；OR = 1.67，95%CI = 1.22 - 2.30；P = 0.00）。
本回顾性研究揭示了湖南省南部HPV感染的流行情况、分布特征及其与宫颈病变的相关性。本调查的综合结果可为HPV疫苗研究提供指导，以预防中国的一些常见基因型。
