中国西部浸润性宫颈癌中的人乳头瘤病毒基因型：流行情况、风险归因及优化疫苗策略

HPV genotypes in invasive cervical cancer: prevalence, risk attribution, and optimized vaccine strategies in western China.

作者信息

Kou Yuling, Tang Xiao, Liang Dongni, Xie Chuan, Zeng Jing, Chen Meng, Fu Wenjing, Li Zhonghua, He Qingfeng, Liu Tianming, Wang Mei, Wang Wei, Wang Cheng

机构信息

Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, China.

出版信息

Front Public Health. 2024 Dec 18;12:1455931. doi: 10.3389/fpubh.2024.1455931. eCollection 2024.

DOI:10.3389/fpubh.2024.1455931

PMID:39744383

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11688338/

Abstract

BACKGROUND

Understanding the HPV genotype distribution in invasive cervical cancer (ICC) is essential for vaccine optimization. This study presents a comprehensive analysis of HPV genotypes in ICC tissues from patients in western China, with the aim of informing regional vaccine policy and prevention strategies.

METHODS

DNA was extracted from 1,908 paraffin-embedded ICC samples, and 23 HPV genotypes were detected via PCR and reverse dot hybridization gene chip assays. The genotypic distribution of HPV infections was analyzed, the attribution of each HPV genotype found in multiple infection cases was calculated using the fractional contribution approximation. Furthermore, the cumulative attribution rates of HPV genotypes included in each vaccine combination were totaled to estimate the potential vaccination coverage of ICC across various histologic types and age groups.

RESULTS

The overall prevalence of HPV infection was 94.9% (95% CI 93.8-95.8) among 1,908 women with ICC. HPV genotypes 16 and 18 were detected in 1645 of 1810 HPV-positive patients (90.9, 95% CI 89.5-92.1) of ICC. HPV16, 18, 33, 52, and 58 were detected in 1,749 patients (96.6, 95% CI 95.7-97.4), the five most common genotypes in different age groups. HPV genotypes contained in the 9-valent vaccine were detected in 1776 patients (98.1, 95% CI 97.4-98.7). By weighted imputation analysis, the cumulative attribution rates of the bivalent vaccine was 83.4%, and that of the nine-valent vaccine was 89.8%. Optimization group A included the five genotypes with the highest prevalence, HPV16, 18, 33, 52, and 58, with a cumulative attribution rates of 88.5%, and optimization group B included the nine most common HPV genotypes, HPV16, 18, 31, 33, 35, 45, 52, 58, and 59, with a cumulative attribution rates of 90.5%.

CONCLUSION

Our comprehensive postsurgical analysis of HPV in ICC patients in western China revealed that the incorporation of the bivalent vaccine into the national program is cost-effective, with group A optimization closely matching the vaccination coverage of the 9-valent vaccine, which can be used to guide future prevention strategies.

摘要

背景

了解浸润性宫颈癌（ICC）中HPV基因型分布对于疫苗优化至关重要。本研究对中国西部患者ICC组织中的HPV基因型进行了全面分析，旨在为区域疫苗政策和预防策略提供依据。

方法

从1908份石蜡包埋的ICC样本中提取DNA，通过PCR和反向点杂交基因芯片检测23种HPV基因型。分析HPV感染的基因型分布，使用分数贡献近似法计算多重感染病例中每种HPV基因型的归因。此外，汇总每种疫苗组合中包含的HPV基因型的累积归因率，以估计不同组织学类型和年龄组ICC的潜在疫苗接种覆盖率。

结果

1908例ICC女性中HPV感染的总体患病率为94.9%（95%CI 93.8-95.8）。在1810例HPV阳性的ICC患者中，1645例检测到HPV16和18型（90.9%，95%CI 89.5-92.1）。1749例患者检测到HPV16、18、33、52和58型（96.6%，95%CI 95.7-97.4），这是不同年龄组中最常见的5种基因型。9价疫苗中包含的HPV基因型在1776例患者中检测到（98.1%，95%CI 97.4-98.7）。通过加权归因分析，二价疫苗的累积归因率为83.4%，九价疫苗的累积归因率为89.8%。优化组A包括患病率最高的5种基因型，即HPV16、18、33、52和58，累积归因率为88.5%，优化组B包括9种最常见的HPV基因型，即HPV16、18、31、33、35、45、52、58和59，累积归因率为90.5%。