Salman Lina, Gien Lilian T, Vicus Danielle, Shier Michael, Kupets Rachel, Gibbons Suzanne, Ashfaq Samar, Severini Alberto, Covens Allan
Division of Gynecologic Oncology, London Health Sciences Centre, University of Western Ontario, London, ON.
Division of Gynecologic Oncology, Odette Cancer Centre, Sunnybrook Health Science Centre, University of Toronto, Toronto, ON.
J Obstet Gynaecol Can. 2025 Mar;47(3):102783. doi: 10.1016/j.jogc.2025.102783. Epub 2025 Jan 31.
To determine the prevalence of human papillomavirus (HPV) types by genotyping high-grade squamous intraepithelial lesion (HSIL), adenocarcinoma in situ (AIS), and early-stage invasive cervical cancer (ICC) in patients who have been exposed or are naïve to the HPV vaccine.
This was a cross-sectional study. All patients over the age of 18 years who presented to the colposcopy clinic with HSIL, AIS, or ICC who were expected to undergo a cervical biopsy, loop electrosurgical excisional procedure, or cone biopsy were eligible and approached for informed consent. HPV typing was performed to identify the causative HPV types.
Between November 2016 and May 2023, 113 patients (34 vaccinated with at least 1 dose, and 79 non-vaccinated) consented to this study. The median ages at coitarche and study entry were 18 (range 14-37) and 34 (range 24-66) years, respectively. Only 3 patients were vaccinated prior to coitarche. Histology was as follows: HSIL = 97, AIS = 9, HSIL and AIS = 2, squamous cell carcinoma = 4, and 1 patient with adenocarcinoma. The causative HPV type was 16 or 18 in 59% of the vaccinated group and in 66% of the non-vaccinated group. Most vaccinated patients (74%) reported receiving 2-3 doses of HPV vaccine.
In our cohort, the distribution of causative HPV 16 and 18 in patients presenting with HSIL/AIS/ICC was similar between vaccine-naïve and vaccinated patients. This data suggests cervical screening guidelines should not differentiate between "vaccinated" and "non-vaccinated" women without further details of their vaccination.
通过对已接种或未接种人乳头瘤病毒（HPV）疫苗的高级别鳞状上皮内病变（HSIL）、原位腺癌（AIS）和早期浸润性宫颈癌（ICC）患者进行基因分型，确定HPV各型别的流行情况。
这是一项横断面研究。所有18岁以上因HSIL、AIS或ICC到阴道镜诊所就诊且预计将接受宫颈活检、环形电切术或锥形活检的患者均符合条件，并被要求签署知情同意书。进行HPV分型以确定致病的HPV型别。
2016年11月至2023年5月期间，113名患者（34名至少接种过1剂疫苗，79名未接种疫苗）同意参与本研究。初次性交年龄和研究入组时的中位年龄分别为18岁（范围14 - 37岁）和34岁（范围24 - 66岁）。仅3名患者在初次性交前接种过疫苗。组织学结果如下：HSIL = 97例，AIS = 9例，HSIL合并AIS = 2例，鳞状细胞癌 = 4例，腺癌1例。接种疫苗组中59%的患者致病HPV型别为16或18，未接种疫苗组中这一比例为66%。大多数接种疫苗的患者（74%）报告接种了2 - 3剂HPV疫苗。
在我们的队列中，未接种疫苗和接种疫苗的HSIL/AIS/ICC患者中，致病HPV 16和18的分布相似。该数据表明，在没有进一步疫苗接种细节的情况下，宫颈筛查指南不应区分“接种疫苗”和“未接种疫苗”的女性。
