Human papillomavirus infections among Japanese women: age-related prevalence and type-specific risk for cervical cancer
Human papillomavirus infections among Japanese women: age-related prevalence and type-specific risk for cervical cancer
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DOI：
10.1111/j.1349-7006.2009.01161.x
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发表时间：
2009-07-01
期刊：
影响因子：
5.7
通讯作者：
Yoshikawa, Hiroyuki
中科院分区：
文献类型：
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作者：
Onuki, Mamiko;Matsumoto, Koji;Yoshikawa, Hiroyuki
为了获得日本人乳头瘤病毒（HPV）筛查和疫苗接种的基线数据，我们分析了2282名日本妇女的HPV DNA数据（1517名细胞学正常，318名宫颈上皮内瘤变[CIN] 1级，307名CIN2-3, 140名浸润性宫颈癌[ICC]），这些妇女于1999年至2007年期间到建波大学医院或茨城清南医疗中心医院进行宫颈疾病筛查或治疗。采用基于l1的PCR方法进行个体HPV基因分型。ICC中最常见的HPV类型依次为HPV16（40.5%）、HPV18（24.4%）、HPV52（8.4%）、HPV58（3.1%）和HPV33（3.1%）。通过比较正常细胞学与CIN2-3和ICC之间的HPV型别分布，疾病进展的估计风险因基因型而有很大差异：HPV16、HPV18、HPV31、HPV33、HPV35、HPV52和HPV58（患病率比1.92,95%可信区间1.58-2.34）；其他致癌类型（0.31,95%可信区间0.19-0.50）；非致癌型（0.09,95%可信区间0.03-0.43）。在日本女性中，HPV16和/或HPV18，包括与其他类型的合并感染，导致67.1%的ICC和36.2%的CIN2-3。更重要的是，HPV16和/或HPV18的总体患病率根据女性的年龄差异很大：20-29岁女性最高（ICC, 90.0%; CIN2-3, 53.9%），此后随年龄增长而下降，60岁及以上女性最低（ICC, 56.3%; CIN2-3, 25.0%）。总之，特定类型的HPV检测可能有助于识别具有CIN2-3进展和癌症高风险的日本女性。在日本，目前的人乳头瘤病毒疫苗估计对ICC提供约70%的保护，可能更有助于减少育龄年轻妇女宫颈癌和癌前病变的发病率。（癌症科学2009；100:1312-1316）
To obtain baseline data for human papillomavirus (HPV) screening and vaccination in Japan, we analyzed HPV DNA data from 2282 Japanese women (1517 normal cytology, 318 cervical intraepithelial neoplasia [CIN] grade 1, 307 CIN2-3, and 140 invasive cervical cancer [ICC]) that visited the University of Tsukuba Hospital or Ibaraki Seinan Medical Center Hospital for screening or treatment of cervical diseases between 1999 and 2007. An L1-based PCR method was used for individual HPV genotyping. The most common HPV types in ICC were, in order of decreasing prevalence, HPV16 (40.5%), HPV18 (24.4%), HPV52 (8.4%), HPV58 (3.1%), and HPV33 (3.1%). Based on the comparison of HPV type distributions between normal cytology and CIN2-3 and ICC, estimated risk of disease progression varied considerably by genotype: HPV16, HPV18, HPV31, HPV33, HPV35, HPV52, and HPV58 (prevalence ratio, 1.92; 95% confidence interval 1.58-2.34); other oncogenic types (0.31, 95% confidence interval 0.19-0.50); and non-oncogenic types (0.09, 95% confidence interval 0.03-0.43). HPV16 and/or HPV18, including coinfections with other types, contributed to 67.1% of ICC and 36.2% of CIN2-3 among Japanese women. More importantly, the overall prevalence of HPV16 and/or HPV18 varied greatly according to the women's age: highest in women aged 20-29 years (ICC, 90.0%; CIN2-3, 53.9%), decreasing with age thereafter, and lowest in women aged 60 years or older (ICC, 56.3%; CIN2-3, 25.0%). In conclusion, type-specific HPV testing may help identify Japanese women at high risk of progression to CIN2-3 and cancer. In Japan, current HPV vaccines are estimated to provide approximately 70% protection against ICC and may be more useful in reducing the incidence of cervical cancer and precancer in young women of reproductive age. (Cancer Sci 2009; 100: 1312-1316)