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人乳头瘤病毒和宫颈病变在老年女性中的流行:宫颈癌预防中不容忽视的挑战。

Prevalence of human papillomavirus and cervical lesions among elderly women: an unignored challenge to cervical cancer prevention.

机构信息

Department of Gynecology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Ann Med. 2024 Dec;56(1):2404548. doi: 10.1080/07853890.2024.2404548. Epub 2024 Sep 19.

Abstract

The prevalence of human papillomavirus (HPV) genotype and cervical neoplasia in women older than 64 years, who are outside the age demographic of cervical cancer screening in China, has been under-researched. This study conducts a retrospective analysis of women from a tertiary hospital in Guangzhou, with the aim to offer valuable insights for cervical cancer prevention and control in elderly women. The study incorporated 876 women, all aged 64 and above. In this age bracket, the prevalence rate of any HPV genotype was found to be 19.27%. The top six HR HPV genotypes were HPV 16, HPV 52, HPV 58, HPV 31, HPV 33, and HPV 18. The persistence rate of any HPV type over a 24-month period in this age group was as high as 33.33%. Among women over 64, around 16.47% of HPV-positive patients were diagnosed with cervical cancer. HPV 58 infection was the most substantial risk factor for histological CIN2+ (OR 3.556; 95% CI, 1.107-11.415;  = 0.032) in women over 64 years of age with HPV-positive/NILM status. In conclusion, the burden of HPV infection is significant among women over 64 years in Guangzhou. Re-evaluation of cervical cancer screening strategies for women after the age of 64 is imperative. Moreover, the HPV 16/18/52/58 genotype model could serve as an alternative triage approach to identify histological CIN2+ among elderly women with HPV-positive/NILM status.

摘要

人乳头瘤病毒(HPV)基因型在 64 岁以上、不在中国宫颈癌筛查年龄范围内的女性中的流行情况以及宫颈病变的研究较少。本研究对广州一家三级医院的女性进行回顾性分析,旨在为老年女性宫颈癌的预防和控制提供有价值的信息。该研究纳入了 876 名年龄均在 64 岁及以上的女性。在这个年龄段,任何 HPV 基因型的流行率为 19.27%。前 6 位高危 HPV 基因型为 HPV 16、HPV 52、HPV 58、HPV 31、HPV 33 和 HPV 18。在这个年龄组中,任何 HPV 类型在 24 个月内的持续率高达 33.33%。在 64 岁以上的女性中,约 16.47%的 HPV 阳性患者被诊断为宫颈癌。HPV 58 感染是 HPV 阳性/NILM 状态的 64 岁以上女性发生组织学 CIN2+的最重要危险因素(OR 3.556;95%CI,1.107-11.415;P=0.032)。总之,广州 64 岁以上女性 HPV 感染负担较重。有必要重新评估 64 岁以上女性的宫颈癌筛查策略。此外,HPV 16/18/52/58 基因型模型可作为 HPV 阳性/NILM 状态的老年女性识别组织学 CIN2+的替代分流方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c2/11413955/8060a5aad36a/IANN_A_2404548_F0001_C.jpg

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