Human papillomavirus genotypes associated with cervical precancerous lesions and cancer in the highest area of cervical cancer mortality, Longnan, China.
Human papillomavirus genotypes associated with cervical precancerous lesions and cancer in the highest area of cervical cancer mortality, Longnan, China.
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中国陇南宫颈癌死亡率最高地区人乳头瘤病毒基因型与宫颈癌前病变及癌症的相关性
DOI：
10.1186/s13027-017-0116-y
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发表时间：
2017
影响因子：
3.7
通讯作者：
Zhang D
中科院分区：
文献类型：
--
作者：
Zhao J;Guo Z;Wang Q;Si T;Pei S;Wang C;Qu H;Zhong J;Ma Y;Nie C;Zhang D
研究背景陇南市宫颈癌死亡率高达39/10万，居全国首位。方法收集2012 - 2016年陇南市宫颈炎、宫颈上皮内瘤变1 ~ 3级（CINI ~ III）、浸润性鳞状细胞癌（SCC）患者329例。结果宫颈炎组、CIN Ⅱ/Ⅲ组、宫颈鳞癌组HPV阳性率分别为38.60%、74.60%、87.50%、89.05%，3组比较差异有显著性（P <0.001），宫颈鳞癌组HPV阳性率也明显高于宫颈炎组（P <0.01）。宫颈炎组以HPV 16基因型最多见，CINI、CIN II/III组以HPV 16、58、52基因型最多见，SCC组以HPV 16、58、18基因型最多见。HPV 16在宫颈炎、CINI、CIN II/III和SCC中的阳性率分别为45.46%、46.81%、60.32%和78.69%。与宫颈炎和CINI相比，HPV 16阳性患者发生SCC的OR值分别为2.96（95%可信区间[CI]：1.09- 8.00，P <0.05）和4.20（95%可信区间[CI]：2.05- 8.61，P <0.001）。此外，宫颈炎、CINI、CINII/III和SCC组的多重感染率分别为9.09%、27.66%、26.98%和25.41%，其中HPV 16 + 58是最常见的组合。结论这些发现凸显了HPV 16、58、HPV 16 + 58的关键作用。结论陇南地区女性宫颈癌的发生率为52%，宫颈鳞癌的发生率为18%，充分认识HPV基因型分布的地区差异是宫颈癌防治的任务。
BackgroundThe mortality of cervical cancer in Longnan is as high as 39/10 million, ranking first in China.MethodsBetween 2012 to 2016, 329 samples with cervicitis, cervical intraepithelial neoplasia grade 1 to 3 (CINI to III), and invasive squamous cell carcinoma (SCC) were collected. HPV genotypes were examined with a validated kit for 23 different HPV subtypes.ResultsCompared to cervicitis, the HPV positivity is significantly higher in CINI, CIN II/III, and SCC (38.60%, 74.60%, 87.50% and 89.05%,P <0.001) and the positivity is also higher in SCC compared to CINI (P <0.01). The most frequently detected genotypes were HPV16 in cervicitis, HPV16, 58 and 52 in CINI and CIN II/III, and HPV16, 58 and 18 in SCC groups. HPV16 positivity in cervicitis, CINI, CIN II/III, and SCC patients were 45.46%, 46.81%, 60.32% and 78.69%, respectively. Compared to cervicitis and CINI, the odds ratios (OR) for SCC in HPV16 positive patients were 2.96 (95% confidence interval [CI]: 1.09–8.00,P <0.05) and 4.20 (95% confidence interval [CI]: 2.05–8.61,P <0.001), respectively. In addition, the multiple infections in cervicitis, CINI, CINII/III and SCC group are 9.09%, 27.66%, 26.98% and 25.41% and HPV16 + 58 was the most common combinations.ConclusionThese findings highlight the key role of HPV16, 58, 52 and 18 in the development of CIN and SCC in Longnan women and a fully aware of regional differences in HPV genotype distribution are tasks for cervical cancer control and prevention.