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在 HPV 疫苗接种时代,泰国最大的国家三级转诊中心——诗里拉吉医院的宫颈癌筛查中高危型 HPV 检测和 HPV 疫苗接种的流行情况。

Prevalence of High-Risk HPV Detection and HPV Vaccination in Cervical Cancer Screening During the HPV Vaccination Era at Siriraj Hospital - Thailand's Largest National Tertiary Referral Center.

机构信息

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Division of Gynecologic Cytology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Asian Pac J Cancer Prev. 2024 Apr 1;25(4):1241-1245. doi: 10.31557/APJCP.2024.25.4.1241.

Abstract

OBJECTIVE

To investigate the prevalence of high-risk (HR) human papillomavirus (HPV) detection and HPV vaccination among women undergoing cervical cancer screening during the HPV vaccination era at Siriraj Hospital - Thailand's largest national tertiary referral center.

METHODS

This prospective cross-sectional study was conducted at our center's outpatient gynecology clinic during September-December 2021. Women aged ≥18 years with no previous hysterectomy, no history of preinvasive or invasive cervical cancer, and no current pregnancy who visited for cervical cancer screening were eligible for enrollment. Women with abnormal vaginal discharge/bleeding, and specimens with inadequate cellularity were excluded. We collected sociodemographic data, history of HPV vaccination, cervical cytology results, and high-risk HPV testing results. Reverse transcription polymerase chain reaction was used to determine HPV genotype.

RESULTS

A total of 216 women (mean age: 41.7 years (range: 25-65), 75.9% premenopausal) were enrolled. Twenty of 216 (9.3%) women tested positive for HR-HPV, and 15 of 216 (6.9%) women had been previously vaccinated for HPV. The most common HPV genotypes detected were Group B infection (HPV 35/39/51/56/59/66/68) (38.9%), followed by HPV16 (27.78%), Group A infection (HPV 31/33/52/58) (27.8%), and HPV18 (5.56%). No HPV45 infection was detected. The detection rate of cytologic abnormalities was 4.16%. Three-quarters (77.8%) of patients with cytologic abnormalities were HR-HPV positive.

CONCLUSION

Among the 216 women who underwent cervical cancer screening in this study, there was a 9.3% prevalence of HR-HPV infection, and a 6.9% prevalence of HPV vaccination. Among the 15 vaccinated women, 2 tested positive for HPV16 (1 normal cytology, 1 abnormal cytology).

摘要

目的

在泰国最大的国立转诊中心——诗里拉吉医院,调查 HPV 疫苗接种时代进行宫颈癌筛查的女性中高危(HR)人乳头瘤病毒(HPV)检测和 HPV 疫苗接种的流行情况。

方法

本前瞻性横断面研究于 2021 年 9 月至 12 月在我院门诊妇科诊所进行。入组标准为年龄≥18 岁、无子宫切除术史、无宫颈前病变或浸润性癌病史、无当前妊娠且就诊行宫颈癌筛查的女性。有异常阴道分泌物/出血以及标本细胞量不足的女性被排除在外。我们收集了社会人口统计学数据、HPV 疫苗接种史、宫颈细胞学结果和高危 HPV 检测结果。逆转录聚合酶链反应用于确定 HPV 基因型。

结果

共纳入 216 名女性(平均年龄:41.7 岁(范围:25-65),75.9%为绝经前)。216 名女性中有 20 名(9.3%)检测出 HR-HPV 阳性,216 名女性中有 15 名(6.9%)曾接种过 HPV 疫苗。最常见的 HPV 基因型是 B 组感染(HPV 35/39/51/56/59/66/68)(38.9%),其次是 HPV16(27.78%)、A 组感染(HPV 31/33/52/58)(27.8%)和 HPV18(5.56%)。未检测到 HPV45 感染。细胞学异常的检出率为 4.16%。75%(77.8%)的细胞学异常患者 HR-HPV 阳性。

结论

在本研究中进行宫颈癌筛查的 216 名女性中,HR-HPV 感染率为 9.3%,HPV 疫苗接种率为 6.9%。在 15 名已接种疫苗的女性中,有 2 名检测出 HPV16 阳性(1 例细胞学正常,1 例细胞学异常)。

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