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人乳头瘤病毒(hrHPV)阳性病例转诊行阴道镜检查的基因分型、宫颈上皮内瘤变(CIN)和特定型别宫颈上皮内瘤变的分布:一项中国大陆女性的多中心研究。

Genotype, cervical intraepithelial neoplasia, and type-specific cervical intraepithelial neoplasia distributions in hrHPV+ cases referred to colposcopy: A multicenter study of Chinese mainland women.

机构信息

School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Dalian Medical University, Dalian, Liaoning Province, China.

出版信息

J Med Virol. 2024 Mar;96(3):e29475. doi: 10.1002/jmv.29475.

Abstract

To investigate age and type-specific prevalences of high-risk human papillomavirus (hrHPV) and cervical intraepithelial neoplasia (CIN) in hrHPV+ women referred to colposcopy. This is a retrospective, multicenter study. Participants were women referred to one of seven colposcopy clinics in China after testing positive for hrHPV. Patient characteristics, hrHPV genotyping, colposcopic impressions, and histological diagnoses were abstracted from electronic records. Main outcomes were age-related type-specific prevalences associated with hrHPV and CIN, and colposcopic accuracy. Among 4419 hrHPV+ women referred to colposcopy, HPV 16, 52, and 58 were the most common genotypes. HPV 16 prevalence was 39.96%, decreasing from 42.57% in the youngest group to 30.81% in the eldest group. CIN3+ prevalence was 15.00% and increased with age. As lesion severity increases, HPV16 prevalence increased while the prevalence of HPV 52 and 58 decreased. No age-based trend was identified with HPV16 prevalence among CIN2+, and HPV16-related CIN2+ was less common in women aged 60 and above (44.26%) compared to those younger than 60 years (59.61%). Colposcopy was 0.73 sensitive at detecting CIN2+ (95% confidence interval[CI]: 0.71, 0.75), with higher sensitivity (0.77) observed in HPV16+ women (95% CI: 0.74, 0.80) compared to HPV16- women (0.68, 95% CI: 0.64, 0.71). Distributions of hrHPV genotypes, CIN, and type-specific CIN in Chinese mainland hrHPV+ women referred to colposcopy were investigated for the first time. Distributions were found to be age-dependent and colposcopic performance appears related to HPV genotypes. These findings could be used to improve the management of women referred to colposcopy.

摘要

为了研究因高危型人乳头瘤病毒(hrHPV)阳性而转诊至阴道镜检查的女性中年龄和类型特异性的高危型 HPV 及宫颈上皮内瘤变(CIN)的流行率。这是一项回顾性的多中心研究。参与者是在中国 7 家阴道镜检查诊所中的一家接受检查后被检测为 hrHPV 阳性的女性。从电子记录中提取患者特征、hrHPV 基因分型、阴道镜印象和组织学诊断。主要结局是与 hrHPV 和 CIN 相关的年龄特异性流行率以及阴道镜检查的准确性。在 4419 名因 hrHPV 阳性而转诊至阴道镜检查的女性中,HPV16、52 和 58 是最常见的基因型。HPV16 的流行率为 39.96%,从最年轻组的 42.57%降至最年长组的 30.81%。CIN3+的流行率为 15.00%,并随年龄增长而增加。随着病变严重程度的增加,HPV16 的流行率增加,而 HPV52 和 58 的流行率降低。在 CIN2+中,HPV16 的流行率没有随年龄增加而变化,60 岁及以上的 HPV16 相关 CIN2+(44.26%)女性比 60 岁以下的女性(59.61%)少见。阴道镜检查对 CIN2+的敏感性为 0.73(95%置信区间[CI]:0.71,0.75),HPV16+女性(95%CI:0.74,0.80)的敏感性高于 HPV16-女性(0.68,95%CI:0.64,0.71)。首次调查了中国大陆因高危型 HPV 阳性而转诊至阴道镜检查的女性的高危型 HPV 基因型、CIN 和特定类型 CIN 的分布情况。结果发现分布与年龄有关,阴道镜检查的表现似乎与 HPV 基因型有关。这些发现可用于改善转诊至阴道镜检查的女性的管理。

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