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在中国广州,58630 名女性的宫颈人乳头瘤病毒基因型和宫颈病变的流行情况和特征。

Prevalence and characteristics of cervical human papillomavirus genotypes and cervical lesions among 58630 women from Guangzhou, China.

机构信息

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.

出版信息

J Infect Public Health. 2023 Oct;16(10):1531-1536. doi: 10.1016/j.jiph.2023.07.013. Epub 2023 Jul 21.

Abstract

BACKGROUND

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.

METHODS

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.

RESULT

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).

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

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