Human papillomavirus prevalence and type distribution in invasive cervical cancer in sub-Saharan Africa
Human papillomavirus prevalence and type distribution in invasive cervical cancer in sub-Saharan Africa
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DOI：
10.1002/ijc.28425
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发表时间：
2014-03-15
影响因子：
6.4
通讯作者：
Schmidt, Johannes
中科院分区：
文献类型：
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作者：
Denny, Lynette;Adewole, Isaac;Schmidt, Johannes
在撒哈拉以南非洲，浸润性宫颈癌（ICC）的发病率和死亡率是世界上最高的。这项横断面流行病学研究评估了加纳、尼日利亚和南非ICC妇女中人乳头瘤病毒（HPV）的患病率和类型分布。宫颈活检标本来自年龄21岁的女性，临床上提示ICC病变。通过石蜡包埋的宫颈标本的苏木精和伊红染色切片的光学显微镜检查确定ICC的组织病理学诊断;通过聚合酶链反应对经确认的组织病理学诊断的样本进行HPV DNA检测。HPV阳性标本用反向杂交线探针法分型。2007年10月至2010年3月，收集了659名妇女的宫颈标本（加纳167例，尼日利亚192例，南非300例）; 570例经组织学证实为ICC。在551/570名ICC女性中确定了肿瘤类型;在476/570（83.5%）例病例中观察到鳞状细胞癌。宫颈癌HPV阳性率为90.4%（515/570）。在单一HPV感染的ICC患者中（447/515 [86.8%]），最常见的HPV类型为HPV 16（51.2%）、HPV 18（17.2%）、HPV 35（8.7%）、HPV 45（7.4%）、HPV 33（4.0%）和HPV 52（2.2%）。在HIV阳性的妇女中，单一和多重HPV感染的患病率似乎较高，HPV类型分布似乎因肿瘤类型和HIV状态而异。总之，HPV 16、18、45和35型是撒哈拉以南非洲ICC女性中最常见的HPV类型，HPV感染在HIV阳性女性中更常见。这是在撒哈拉以南非洲进行的第一项研究，使用标准化和验证的方法进行人乳头瘤病毒（HPV）检测和分型，并集中进行病理学审查以确认组织学诊断。在加纳、尼日利亚和南非的浸润性宫颈癌妇女中，HPV阳性率为90.4%，HPV 16、18、45和35是最常见的类型，HIV阳性妇女中单一和多重HPV感染的患病率似乎高于HIV阴性妇女。
In sub-Saharan Africa, invasive cervical cancer (ICC) incidence and mortality are among the highest in the world. This cross-sectional epidemiological study assessed human papillomavirus (HPV) prevalence and type distribution in women with ICC in Ghana, Nigeria, and South Africa. Cervical biopsy specimens were obtained from women aged 21 years with lesions clinically suggestive of ICC. Histopathological diagnosis of ICC was determined by light microscopy examination of hematoxylin and eosin stained sections of paraffin-embedded cervical specimens; samples with a confirmed histopathological diagnosis underwent HPV DNA testing by polymerase chain reaction. HPV-positive specimens were typed by reverse hybridization line probe assay. Between October 2007 and March 2010, cervical specimens from 659 women were collected (167 in Ghana, 192 in Nigeria and 300 in South Africa); 570 cases were histologically confirmed as ICC. The tumor type was identified in 551/570 women with ICC; squamous cell carcinoma was observed in 476/570 (83.5%) cases. The HPV-positivity rate in ICC cases was 90.4% (515/570). In ICC cases with single HPV infection (447/515 [86.8%]), the most commonly detected HPV types were HPV16 (51.2%), HPV18 (17.2%), HPV35 (8.7%), HPV45 (7.4%), HPV33 (4.0%) and HPV52 (2.2%). The prevalence of single and multiple HPV infections seemed higher among HIV-positive women and HPV type distribution appeared to differ according to tumor type and HIV status. In conclusion, HPV16, 18, 45 and 35 were the most common HPV types in sub-Saharan African women with ICC and HPV infections were more common in HIV-positive women.What's new? This was the first study conducted in sub-Saharan Africa using standardized and validated methods for human papillomavirus (HPV) detection and typing, and centralized pathology review for confirmation of the histological diagnosis. In women with invasive cervical cancer from Ghana, Nigeria, and South Africa, the HPV-positivity rate was 90.4%, HPV16, 18, 45, and 35 were the most common types, and the prevalence of single and multiple HPV infections seemed higher among HIV-positive than among HIV-negative women.