Department of Gynecology, The Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, China.
Department of Gynecology, The Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, China.
J Infect Public Health. 2023 Oct;16(10):1531-1536. doi: 10.1016/j.jiph.2023.07.013. Epub 2023 Jul 21.
To assess the prevalence and characteristics of human papillomavirus (HPV) genotypes and its associated cervical lesions in Guangzhou, China, which may be useful for adjusting area-specific cervical cancer prevention and control strategies.
A total of 58630 women were enrolled. Cervical specimens were collected for HPV DNA testing and/or cervical cytology. Patients with visible cervical lesions or abnormal screening results underwent further cervical biopsies.
The overall HPV positive rate was 14.07%. The top five genotypes in Guangzhou were HPV 52 (3.06%), HPV 16 (2.28%), HPV 58 (1.80%), HPV 51 (1.32%), and HPV 39 (1.15%). The prevalence of overall HPV and vaccine-targeted HPV genotypes showed a significantly decreasing trend from 2016 to 2019 (P < 0.05). While, the infection rate of HPV 35 increased significantly during this time (P = 0.015). The age-specific prevalence of any HPV genotypes showed a bimodal curve, which peaked firstly among the < 20 y age group, and then peaked secondly among the > 59 y age group. Among HPV-positive women, the proportions of HSIL and cervical cancer increased significantly with age (P < 0.05). Among > 59 y age group, 9.35% HPV-positive cases were diagnosed as cervical cancer. HPV 16/18 was the most common cause of cervical cancer. While, the percentage of non-HPV 16/18 infection among cervical cancer patients increased over time, from 15.21% in 2015 to 26.32% in 2019 (P = 0.010). Besides that, the prevalence of non-HPV 16/18 genotypes among cervical cancer patients significantly increased with age, which peaked at the > 59 y age group (P = 0.014).
Although the prevalence of any HPV and vaccine-targeted HPV genotypes decreased significantly with time, it is still important to follow the HPV genotypes and their associated cancer risk after the large-scale popularization of HPV vaccine. And age should be taken into consideration in screening strategies and risk-based management of cervical cancer in Guangzhou.
为了评估人乳头瘤病毒（HPV）基因型在中国广州的流行率和特征及其相关的宫颈病变，这可能有助于调整特定地区的宫颈癌防控策略。
共纳入 58630 名女性。采集宫颈标本进行 HPV DNA 检测和/或宫颈细胞学检查。有可见宫颈病变或筛查结果异常的患者进一步行宫颈活检。
HPV 阳性率总体为 14.07%。广州地区前 5 种 HPV 基因型依次为 HPV 52（3.06%）、HPV 16（2.28%）、HPV 58（1.80%）、HPV 51（1.32%）和 HPV 39（1.15%）。2016 年至 2019 年，HPV 总感染率和疫苗靶向 HPV 基因型的流行率呈显著下降趋势（P<0.05）。而在此期间，HPV 35 的感染率显著增加（P=0.015）。各年龄段 HPV 任何基因型的流行率呈双峰曲线，首先在<20 岁年龄组中达到高峰，然后在>59 岁年龄组中再次达到高峰。在 HPV 阳性女性中，HSIL 和宫颈癌的比例随年龄增长而显著增加（P<0.05）。在>59 岁年龄组中，9.35%的 HPV 阳性病例被诊断为宫颈癌。HPV 16/18 是宫颈癌最常见的病因。然而，宫颈癌患者中非 HPV 16/18 感染的比例随时间推移而增加，从 2015 年的 15.21%增加到 2019 年的 26.32%（P=0.010）。此外，宫颈癌患者中非 HPV 16/18 基因型的流行率随年龄增长而显著增加，在>59 岁年龄组中达到高峰（P=0.014）。
尽管 HPV 总感染率和疫苗靶向 HPV 基因型随时间推移呈显著下降趋势，但在 HPV 疫苗大规模推广后，仍需关注 HPV 基因型及其相关癌症风险。在广州，应根据年龄考虑宫颈癌筛查策略和基于风险的管理。
