年轻女性宫颈人乳头瘤病毒感染亚型与宫颈病变的调查

目的：探讨年轻女性（年龄25~35岁）人乳头瘤病毒（HPV）感染亚型与宫颈病变的特点。方法采集1273例患者宫颈上皮细胞标本,采用PCR-反向点杂交法对其进行21种HPV分型的检测。结果1273例年轻女性患者,HPV阳性有130例,检出率为10.2%;单一型感染为115例,包括高危型感染105例,感染率为91.3%,低危型感染10例,感染率为8.7%;最常见高危型是HPV16,共35例,其次为HPV58,共17例;HPV16感染导致宫颈高级别上皮内瘤变10例,低级别上皮内瘤变11例;高危HPV阳性患者,宫颈活检证实为鳞状细胞癌的病例2例,均是HPV16感染。结论年轻女性HPV阳性检出率较高,以单一型感染和高危型感染为主,高危型HPV感染与宫颈高级别上皮内瘤变和宫颈癌的发生密切相关,其中HPV16亚型是导致年轻女性宫颈癌的主要原因。     

HPV不同亚型在宫颈癌前病变及宫颈癌中的分布情况

目的:探讨HPV不同亚型在宫颈癌前病变及宫颈癌中的分布情况。方法:选取我院于2015年1月至2017年1月期间收治的124例宫颈癌患者和宫颈癌前病变患者,其中宫颈癌患者有36例,宫颈癌前病变患者有88例。对所有入选患者的宫颈脱落细胞进行采集,并且进行人乳头瘤病毒检测,观察分析HPV不同亚型在宫颈癌前病变及宫颈癌中的分布情况。结果:共有89例（71.77%）患者检测出HPV阳性,其中宫颈癌患者的阳性检出率为100%,显著高于癌前病变患者中的阳性检出率60.23%（P＜0.05）。宫颈癌患者中HPV18和HPV16亚型的感染率最高,分别为44.44%和47.22%;在88例宫颈癌前病变患者中,低级别型患者的HPV33和HPV52、HPV16亚型感染率最高,分别为9.68%和32.36%、32.36%;高级别型患者的HPV58、HPV52、HPV18、HPV16亚型感染率最高,分别为13.64%、13.64%、22.73%、31.82%。89例HPV感染患者中有9例患者出现多重感染,多重感染率为10.11%,其中三重及以上感染率为3.37%。所有宫颈癌HPV感染患者均为单一感染;癌前病变患者中低级别多重感染率为9.68%,高级别多重感染率为27.27%。结论:宫颈癌患者和宫颈癌前病变患者中均以HPV16和HPV18亚型感染率较高,此外宫颈癌前病变患者中的HPV58和HPV52亚型患者也具有较高的感染率;临床上使用HPV感染检测并针对HPV的综合治疗能够有效预防和控制宫颈癌及其癌前病变的发生,值得广泛推广运用。     

HPV L1壳蛋白在HPV单型感染和多重感染中的表达意义

目的检测人乳头瘤病毒L1(HPV L1)壳蛋白在各级宫颈病变中的阳性率,同时探讨其在HPV单型感染和多重感染中的表达及意义。方法选取2017年1月至2017年6月,上海市浦东新区人民医院妇科门诊宫颈活检且高危HPV阳性的250例患者,用免疫细胞化学法联合非同位素标记核酸分子杂交技术行HPV L1壳蛋白检测。HPV DNA分型检测采用PCR-反向点杂交法。结果 HPV L1壳蛋白在正常或宫颈炎、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)及宫颈癌(SCC)4组的阳性率分别为21. 6%、52. 8%、22. 2%、0,各组间阳性率差异有统计学意义(P0. 05)。HPV L1壳蛋白在单型与多重感染的阳性率分别为29. 7%和21. 6%,差异无统计学意义(P0. 05)。HPV L1壳蛋白在≤35岁、36～49岁及≥50岁3个年龄组阳性率分别为25. 5%、27. 3%、44. 0%,差异无统计学意义(P0. 05)。结论 HPV L1壳蛋白阳性率在HPV感染中随着宫颈病变级别的加重而下降,可作为宫颈上皮内病变进展的1种预测标志物。HPV L1壳蛋白与HPV感染亚型以及单型或多重感染无明确相关性。     

汕头市妇女HPV-52感染与宫颈鳞状上皮病变的关系

目的： 探讨汕头市妇女感染人乳头状瘤病毒（HPV）的主要亚型，及其在宫颈鳞状上皮病变中的致病特点及风险分析。方法： 收集2015~2018年在汕头市中心医院同时进行HPV分型检测和薄层液基细胞学（LCT）检查的病例37 700例，及其中3 924例进行宫颈活检的病例。HPV分型检测采用医用核酸分子快速杂交基因分型试剂盒，包含15种高危HPV，即HPV-16、-18、-31、-33、-35、-39、-45、-5l、-52、-53、-56、-58、-59、-66和-68；6种低危型HPV，即HPV-6、-11、-42、-43、-44、CP8304。细胞学检查按照伯塞斯达系统（TBS）分级（2014版）标准进行分类，分为未见上皮内病变或恶性病变（NILM）、非典型鳞状细胞-意义不明确（ASC-US）、低级别鳞状上皮内病变（LSIL）、非典型鳞状细胞-不排除高级别鳞状上皮内病变（ASC-H）、高级别鳞状上皮内病变（HSIL）和鳞状细胞癌（SCC）。使用SPSS 19.0软件建立数据库，计数资料率的比较采用频数分布进行统计，风险评估采用卡方检验2×2列表。结果： 37 700位LCT检查病例中HPV-52总感染率为3.55%（1 338/37 700），HPV-52单一感染882例，HPV-52多重感染（指两种及以上HPV亚型感染）456例，其中包含两重感染313例，三重及以上感染143例，HPV-52多重感染最常见的3种亚型分别是HPV-58/52（12.46%，39/313）、HPV-53/52（11.18%，35/313）、HPV-16/52（11.18%，35/313）。HPV-52多重感染患者LCT筛查结果出现ASC-US及以上病变尤其是HSIL中，最多见型别为HPV-16/52。宫颈活检结果风险分析显示，与HPV-52单一感染比较，HPV-52/16多重感染患HSIL/SCC风险增加（P < 0.01，OR=8.27），并且增加HSIL发展到SCC的发病风险（P=0.01，OR=12.65）。与包含HPV-52但不包含HPV-16的多重感染比较，HPV-52/16多重感染增加患HSIL或者SCC风险（P < 0.01，OR=3.36），并且增加HSIL发展为SCC的风险（P=0.03，OR=1.29）。结论： HPV-52是汕头市妇女最常见的HPV感染宫颈亚型，但患者主要发生HSIL病变，当合并HPV-16感染时增加癌前病变及癌变风险。     

成都市9142例女性HPV感染状况、亚型分布及与宫颈病变的关系分析

目的：分析成都市9142例女性人乳头瘤病毒(human papillomavirus, HPV)感染状况、基因亚型分布特征及与宫颈病变的关系，为预防HPV感染及宫颈病变和宫颈癌的防治提供参考。方法：收集2015年1月-2019年12月我院妇科9142例女性就诊者的宫颈分泌物，采用PCR荧光探针法进行HPV基因分型检测，分析HPV感染率、基因亚型分布及年龄分布特征，并比较不同HPV基因亚型与宫颈鳞状上皮内病变的关系。结果：HPV感染率为20.91%，单一HPV感染有1502例(78.23%)；多重感染占21.77%。23种HPV基因亚型均有检出，检出率最高的前5位HPV亚型依次为HPV52、16、53、58、51，均为高危亚型。各年龄组感染率呈“V”形分布， HPV 感染率的年龄分布之间，差异有统计学意义(χ2=86.038，P<0.001)。在单一感染患者中，≥55岁组感染率最高(24.00%)，其次为25~29岁组(17.51%)；在多重感染患者中，<25岁组染率最高(14.71%)，其次为≥55岁组(10.50%)。高危亚型的HPV感染者发生宫颈鳞状上皮内病变的比例明显高于低危亚型HPV感染者[45.92%(759/1653) vs 26.25%(68/259); χ2=35.267, P<0.001]。结论：成都市女性HPV感染率较高，年龄分布以<25岁组和≥55岁组感染率最高，感染率排在前5位的基因亚型依次为HPV52、16、53、58、51，均为高危亚型，高危亚型HPV感染患者发生宫颈鳞状上皮内病变的风险较低危亚型更高。     

汕头市妇女HPV-52感染与宫颈鳞状上皮病变的关系

目的： 探讨汕头市妇女感染人乳头状瘤病毒（HPV）的主要亚型，及其在宫颈鳞状上皮病变中的致病特点及风险分析。方法： 收集2015~2018年在汕头市中心医院同时进行HPV分型检测和薄层液基细胞学（LCT）检查的病例37 700例，及其中3 924例进行宫颈活检的病例。HPV分型检测采用医用核酸分子快速杂交基因分型试剂盒，包含15种高危HPV，即HPV-16、-18、-31、-33、-35、-39、-45、-5l、-52、-53、-56、-58、-59、-66和-68；6种低危型HPV，即HPV-6、-11、-42、-43、-44、CP8304。细胞学检查按照伯塞斯达系统（TBS）分级（2014版）标准进行分类，分为未见上皮内病变或恶性病变（NILM）、非典型鳞状细胞-意义不明确（ASC-US）、低级别鳞状上皮内病变（LSIL）、非典型鳞状细胞-不排除高级别鳞状上皮内病变（ASC-H）、高级别鳞状上皮内病变（HSIL）和鳞状细胞癌（SCC）。使用SPSS 19.0软件建立数据库，计数资料率的比较采用频数分布进行统计，风险评估采用卡方检验2×2列表。结果： 37 700位LCT检查病例中HPV-52总感染率为3.55%（1 338/37 700），HPV-52单一感染882例，HPV-52多重感染（指两种及以上HPV亚型感染）456例，其中包含两重感染313例，三重及以上感染143例，HPV-52多重感染最常见的3种亚型分别是HPV-58/52（12.46%，39/313）、HPV-53/52（11.18%，35/313）、HPV-16/52（11.18%，35/313）。HPV-52多重感染患者LCT筛查结果出现ASC-US及以上病变尤其是HSIL中，最多见型别为HPV-16/52。宫颈活检结果风险分析显示，与HPV-52单一感染比较，HPV-52/16多重感染患HSIL/SCC风险增加（P < 0.01，OR=8.27），并且增加HSIL发展到SCC的发病风险（P=0.01，OR=12.65）。与包含HPV-52但不包含HPV-16的多重感染比较，HPV-52/16多重感染增加患HSIL或者SCC风险（P < 0.01，OR=3.36），并且增加HSIL发展为SCC的风险（P=0.03，OR=1.29）。结论： HPV-52是汕头市妇女最常见的HPV感染宫颈亚型，但患者主要发生HSIL病变，当合并HPV-16感染时增加癌前病变及癌变风险。     

巴中地区女性体检人群HPV病毒感染情况及对宫颈病变发生率的影响

目的:了解四川省巴中地区女性人乳头瘤病毒(human papillomavirus,HPV)感染情况,分析其型别与宫颈病变的相关性。方法:收集2015年01月至2019年06月在我院进行健康体检的5 046例女性作为研究对象,采用荧光定量PCR法对15种高危HPV基因亚型进行检测,分析是否发生HPV感染及不同HPV亚型对宫颈鳞状上皮内病变的影响。结果:HPV感染率为24.36%(1 229/5 046)。单一HPV感染954例,占全部感染的77.62%,感染率为18.91%;多重HPV感染275例,占全部感染的22.38%,感染率为5.45%。感染率前5位的HPV亚型分别为HPV16(3.86%,195例)、HPV18(3.63%,183例)、HPV52(2.26%,114例)、HPV58(1.61%,81例)、HPV51(1.41%,71例)。≤30岁、31~40岁、41~50岁、>50岁四个年龄组HPV阳性感染率分别为30.28%、22.89%、25.31%、20.00%,各年龄组感染率之间差异有统计学意义(P<0.001)。多重感染患者的高度鳞状上皮内病变的非典型鳞状上皮细胞（ASC-H）、低度鳞状上皮内病变（LSIL）、高度鳞状上皮内病变（HSIL）和鳞状细胞癌（SCC）四种宫颈鳞状上皮内病变的发生比例高于单一感染患者,但差异尚未显示有统计学意义(P=0.608)。结论:巴中地区女性体检人群HPV感染率较高,应加强和普及本地区HPV筛查工作。     

人乳头状瘤病毒感染与宫颈病变的相关性分析？

目的：分析宫颈上皮内瘤变（ CIN）及宫颈癌（ CC）中人乳头状瘤病毒（ HPV）亚型,探讨HPV感染与宫颈病变的相关性。方法：慢性宫颈炎或液基细胞学异常的妇女检测21种HPV基因亚型和阴道镜下宫颈定位活检,分析2481例CC和CIN患者的HPV感染情况。结果：在2481例CIN和CC患者中,HPV感染率85．0%,HPV感染与宫颈组织学结果有较强的相关性（P〈0．001,Pearson列联系数=0．648）。 CC及CINⅢ、CINⅡ患者以HPV16、18感染最多见,其次见HPV58、33、31、52、45、59、68等亚型。304例患者宫颈感染HPV16、18、58、52、33等亚型后,发生高度鳞状上皮内病变（HSIL）、不明意义的非典型鳞状细胞（ASCUS）及低度鳞状上皮内病变（LSIL）的频率增加,TCT分型与HPV分型有较弱的相关关系（P=0．002,Pearson列联系数=0．322）。细胞学结果提示HSIL、AS-CUS,宫颈组织学诊断以CC、CINIII和CINII为多,TCT分型与组织学分型也有较弱的相关性（ P=0．026,Pearson列联系数=0．172）。结论：HPV16、18、58、33、52、31、45等高危型HPV感染是宫颈癌（ CC）及癌前病变（ CIN）最常见的风险因素。高危型HPV单独或混合感染宫颈后,细胞学检测HSIL、ASCUS及LSIL的发生率增加,细胞学结果与组织学分型的相关性促进了CC和CIN的及时诊治。     

粤东地区妇女 人乳头瘤病毒感染 情况和亚型分布 及其与宫颈癌的关系

目的：检测粤东地区妇女人乳头瘤病毒（HPV）感染情况及亚型分布,探讨其与宫颈癌的关系。方法：选取2015年10月-2016年9月粤东地区7家三级医院30 000例行宫颈筛查的妇女作为研究对象。收集所有对象宫颈脱落细胞,采用HybriMax方法对HPV感染情况进行检测。对8 739例宫颈病变患者进行宫颈组织活检与HPV分型。比较分析不同病变类型以及年龄段HPV感染率与亚型分布。结果：脱落细胞检查个体中,HPV阳性者9 000例,感染率为30.00%。在8 739例行宫颈活检的宫颈病变患者中,HPV感染率为58.29%（5 094/8 739）,慢性宫颈炎中HPV感染率为40.00%（1 088/2 720）,CINⅠ中为53.59%（1 396/2 605）,CINⅡ/Ⅲ中为71.61%（1 647/2 300）,宫颈癌中为86.45%（963/1 114）。在各种宫颈病变中,HPV 16、18、33、58、52是最常见的高危亚型,感染率依次是14.02%、6.28%、5.23%、4.46%、3.71%。在宫颈癌患者中,最常见的亚型是HPV 16; ≥ 60岁的人群中HPV感染率最高,达到49.92%。结论：粤东地区HPV感染最常见的亚型为16、18、33、58、52型,宫颈病变程度越重,HPV的感染率越高。在宫颈癌患者中,HPV 16是最为常见的亚型,中老年患者的HPV感染率高于年轻人,单一感染可能更易导致宫颈癌的发生。     

高危型HPV感染在宫颈癌前病变、宫颈癌中的临床意义

目的:分析高危型HPV感染在宫颈癌前病变、宫颈癌发生和发展中的关系，为宫颈病变的筛查和HPV疫苗的选择提供理论依据。方法:选择来我院妇科肿瘤中心就诊的1 197例患者作为研究对象，根据病理检查结果将病例分为慢性宫颈炎组（212例）、LSIL组（142例）、HSIL组（484例）和宫颈癌组（359例），检测各组高危型HPV感染的情况，分析不同组HPV的阳性率及HPV亚型的分布。结果:慢性宫颈炎组 HPV 感染阳性率为9.43%，LSIL组为78.87%，HSIL组为92.15%，宫颈癌组为97.77%，各组间阳性率两两比较差异有统计学意义（P<0.001）。各组中，高危HPV单一感染率均大于多重感染率，差异有统计学意义（P<0.001）。慢性宫颈炎组以HPV52、HPV16、HPV58为主要亚型（阳性率分别为 3.77%、2.83%和 1.41%），LSIL组以HPV52、HPV16、HPV58为主要亚型（阳性率分别为 23.94%、21.13%和 16.90%），HSIL组以HPV16、HPV52、HPV58为主要亚型（阳性率分别为33.06%、29.34%和 19.42%），宫颈癌组以HPV16、HPV58、HPV52为主要亚型（阳性率分别为 65.18%、20.89%和 10.86%）。本地区HSIL及宫颈癌人群感染率最高的5种亚型是HPV16、HPV18、HPV33、HPV52、HPV58。结论:宫颈病变程度越严重，HPV阳性率越高，不同程度宫颈病变HPV感染的亚型分布有差异。高危型HPV检测对本地区宫颈病变的早期筛查及HPV疫苗的接种有重要的指导意义。     

苏州地区不同年龄女性HPV感染的流行病学调查

目的:调查苏州地区女性人乳头瘤病毒（HPV）感染现状和亚型分布情况，为宫颈癌防治政策提供理论依据。方法:2016年7月至2019年3月对苏州地区20~65岁的女性进行随机抽样调查。采用PCR体外扩增和DNA反向点杂交相结合的HPV基因分型检测技术，分析苏州地区HPV的感染状况。结果:在符合条件的4 275名女性中共检出964例HPV阳性者，阳性率为22.55％（964/4275）。其中高危型HPV（HR-HPV）阳性有812例，占HPV感染人群84.23％（812/964）。在检出的23种HPV亚型中，按感染率由高到低排列分别为52、81、16、58、53、51、68、56、42、33、18、66、59、11、43、31、39、6、45、35、82、83、73亚型。不同年龄段HPV感染率不同，以20~29岁年龄段感染率最高（21.26%）(135/635)，其次为40~49岁年龄段（20.27%）(238/1 174)，HPV感染中以单一感染为主642例（66.60%）(642/964)。结论:HPV感染在苏州地区呈现单一、高危亚型感染为主的特征，该地区HPV感染亚型主要为52、81、16、58、53、51。     

Human Papillomavirus Genotype Distribution among Thai Women with High-Grade Cervical Intraepithelial Lesions and Invasive Cervical Cancer: a Literature Review

Infection with high-risk human papillomavirus (HR-HPV) is an essential cause of cervical cancer. Becauseof substantial geographical variation in the HPV genotype distribution, data regarding HPV type-specificprevalence for a particular country are mandatory for providing baseline information to estimate effectivenessof currently implemented HPV-based cervical cancer prevention. Accordingly, this review was conducted toevaluate the HR-HPV genotype distribution among Thai women with precancerous cervical lesions i.e. cervicalintraepithelial neoplasia grade 2-3 (CIN 2-3), adenocarcinoma in situ (AIS), and invasive cervical cancer byreviewing the available literature. The prevalence of HR-HPV infection among Thai women with CIN 2-3 rangedfrom 64.8% to 90.1% and the three most common genotypes were HPV 16 (38.5%), HPV 58 (20.0%), and HPV18 (5.5%). There were high squamous cell carcinoma/CIN 2-3 prevalence ratios in women with CIN 2-3 infectedwith HPV 33 and HPV 58 (1.40 and 1.38, respectively), emphasizing the importance of these subtypes in the riskof progression to invasive cancer among Thai women. Data regarding the prevalence and genotype distributionof HR-HPV in Thai women with AIS remain unavailable. Interesting findings about the distribution of HPVgenotype in cervical cancer among Thai women include: (1) a relatively high prevalence of HPV 52 and HPV58 in invasive squamous cell carcinoma; (2) the prevalence of HPV 18-related adenocarcinoma is almost doublethepreviously reported prevalence, and (3) 75% of neuroendocrine carcinomas are HPV18-positive when takinginto account both single and multiple infections.     

Genotype Distribution and Prevalence of High-Risk Human Papillomavirus Infection among Women in Samsun Province of Turkey

Background: The human papillomavirus (HPV) is an important public health problem that can cause cervical cancer. HPVs were classified into high-risk (HR-HPV) and low-risk (LR-HPV) types. In this study, we aimed to determine the prevalence and genotype distribution of HR-HPV infection in Samsun province in Turkey. Methods: Cervical smear samples taken from 5406 women over a 23-month period were evaluated for the presence of HPV infection. The detection of HPV genotypes was performed using RT-PCR technology. HPV detection and genotyping were performed using RT-PCR method. HR- HPV types are divided into 3 groups as type 16,  type 18 and other types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, with or without type 16 and 18).  The results were evaluated statistically. Results: The mean age of HR-HPV positive patients was 39.56 years (20-68 years). The prevalance of HR-HPV types did not differ between different age groups (p˃0.05). Overall, 9.17% of women (496/5406 samples) were found to be positive at least one type of HR-HPV. HPV type 16 was detected in 28.62%, type 18 in 9.67%, and other types in 78.83%. The most common HR-HPV type was other types (p˂0.001). Type 16 was most common than type 18 (p˂0.001). The patients were evaluated by dividing them into 6 age groups. Type 16 positivity was higher in 30-39 ages while type18 and other types positivity were higher in the 40-49 age group. When the 23-month period of HPV test was evaluated according to months and seasons, the highest prevalance was seen in June 2021 and Summer 2021. Conclusion: To our knowledge, this is the first large-scale study of HR-HPV prevalence and genotype distribution among women in Samsun Province of Turkey.  The other types containing one or more types made up the majority of the studied population.     

Analysis of the Prevalence and Quantification of viral load of different human papillomavirus types in Turkish women population

Background: Persistent infection with high-risk (HR) Human Papilloma Virus (HPV) genotypes has been shown to play a significant role in the development of cervical intraepithelial neoplasia (CIN) and CC (cervical cancer). The present study aimed to determine the distribution and quantification of viral load of HPV genotypes in numerous genital samples obtained from women undergoing routine gynaecological care in different regions of Turkey. Methods:HPV typing was done by HPV QUANT-21 Quantitative RT-PCR Kit®, which is intended for the specific identification and quantification of low-risk (HPV 6, 11, 44) and high-risk (HPV 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82) from female subjects in Turkey. Results: From the total of 5975 samples, 2777 were positive for at least one HPV genotype, with an overall frequency of 46.4%. 1695 patients were positive for only one or more LR-HPV genotypes (61%) and 812 patients were positive for one or more HR-HPV genotypes (29%). The frequency of LR-HPV genotypes was 31.4%, while the frequency of HR-HPV genotypes was 118.8%. Our tecnology had a positive advantage to calculate the concentration of each genotypes. Although genotype 52 ranked fifth in frequency, it showed the highest mean concentration, with a value of 5.38 log (copies/sample). Conclusion:The presence and genotype of viruses before HPV vaccination have also gained importance. The data obtained would provide guidance for prevention strategies, mainly of vaccination. We decided to add a new estimate to the effectiveness of currently available HPV vaccines and the development of screening programs to prevent and decrease the incidence of CC in Turkey. Further studies would be planned to measure and define the high infection level that can lead to the development of cervical neoplasia. Using this tecnology could give us a clinical desicion to degree the cytological changes.     

Human Papilloma Virus Prevalence,Genotype Distribution,and Pattern of Infection in Thai Women

Background: The pattern of infection in cervical lesions with respect to HPV subtype has not beensystematically studied in Thai women. The aim here was to determine HPV prevalence, genotype, and infectionpattern in cervical lesions and to estimate the potential efficacy of an HPV prophylactic vaccine. Design: Formalinfixedparaffin-embedded cervical tissue blocks of 410 Thai patients from 8 institutes in 4 regions of Thailand(northern, southern, north-eastern, and central) were studied. The samples included 169 low grade squamousintraepithelial lesions (LSILs), 121 high grade squamous intraepithelial lesions (HSILs), and 120 squamouscell carcinomas (SCCs). HPV-DNA was amplified by PCR using consensus primers GP5+ and GP6+. TheHPV genotype was then determined by reverse linear blot assay that included 37 HPV-specific 5’-amino-linkedoligonucleotide probes. Patterns of infection were classified as single infection (one HPV type), double infection(two HPV types), and multiple infection (three or more HPV types). Results: The mean age of the subjects was42 years. The prevalence of HPV infection was 88.8%. The highest HPV prevalence was found in the southernregion (97.1%) and the lowest in the central region (78.6%). HPV-DNA was detected in 84.6% of LSILs, 90.1%of HSILs, and 93.3% of SCCs. A total of 20 HPV genotypes were identified. The five most common high riskHPV were HPV16 (83.2%), HPV18 (59.3%), HPV58 (9.3%), HPV52 (4.1%), and HPV45 (3.8%). In double andmultiple infection patterns, the most common genotypes were HPV16/18 (27.8%) and HPV11/16/18 (54.9%).HPV6 was found only in LSIL and never in combination with other subtypes. HPV11 was most common inLSIL. Conclusion: There is no difference of HPV type distribution in women from 4 regions of Thailand withprominent HPV16 and HPV18 in all cases. The bivalent and quadrivalent vaccines have the potential to prevent48.6 % and 74.5% of cervical cancers in Thai women. The potential of cancer prevention would rise to 87.6%if other frequent HR-HPV types (HPV58, 52, and 45) were also targeted by an HPV vaccine.     

Prevalence of type-specific HPV infection by age and grade of cervical cytology: data from the ARTISTIC trial

Human papillomavirus (HPV) infection causes cervical cancer and premalignant dysplasia. Type-specific HPV prevalence data provide a basis for assessing the impact of HPV vaccination programmes on cervical cytology. We report high-risk HPV (HR-HPV) type-specific prevalence data in relation to cervical cytology for 24,510 women (age range: 20-64; mean age 40.2 years) recruited into the ARTISTIC trial, which is being conducted within the routine NHS Cervical Screening Programme in Greater Manchester. The most common HR-HPV types were HPV16, 18, 31, 51 and 52, which accounted for 60% of all HR-HPV types detected. There was a marked decline in the prevalence of HR-HPV infection with age, but the proportion due to each HPV type did not vary greatly with age. Multiple infections were common below the age of 30 years but less so between age 30 and 64 years. Catch-up vaccination of this sexually active cohort would be expected to reduce the number of women with moderate or worse cytology by 45%, but the number with borderline or mild cytology would fall by only 7%, giving an overall reduction of 12% in the number of women with abnormal cytology and 27% in the number with any HR-HPV infection. In the absence of broader cross-protection, the large majority of low-grade and many high-grade abnormalities may still occur in sexually active vaccinated women.     

Prevalence and Genotype Distribution of HPV among Women Attending a Cervical Cancer Screening Mobile Unit in Lampang,Thailand

A growing body of literature is evidence that identifying subtypes of high-risk human papillomavirus (HR-HPV) has impacted on various steps of cervical cancer prevention.Thus, it is mandatory to determine the background prevalence and distribution of HPV subtypes for designing and implementing area-specificmanagement. The present study was conducted to evaluate prevalence and distribution of HPV subtypes among women aged 30-70 years living in Lampang, an area with a high incidence of cervical cancer, through use of a mobile screening unit. Of 2,000 women recruited in this study, 108 (5.40%, 95%CI: 4.45-6.48) were found to have HR-HPV infection. Risk was significantly correlated with age and number of partners. Singly or in combination, the most common genotype was HPV 52 (17.6%), followed by HPV 16 (14.81%), HPV 58 (13.89%), HPV 33 (11.11%), HPV 51 (11.11%), and HPV 56 (9.26%). HPV 18 was found in only 5.6% of cases. Together, HPV 16/18 were noted in approximately 20.4% of cases. Eighteen(16.67%) women were positive with multiple subtypes of HR-HPV. Co-infection most frequently involved HPV 16 or HPV 58. These findings have obvious implications for vaccine policy.     

杭州市萧山区妇女人乳头瘤病毒感染现况及影响因素分析

[目的]探讨杭州市萧山区20～60岁常住妇女人乳头瘤病毒（HPV）的感染现状、型别及相关影响因素。[方法]采用多阶段分层随机抽样方法,在浙江省杭州市萧山区26个镇中抽取9个镇的27个样本行政村20～60岁常住妇女4446人进行问卷调查、妇科检查及宫颈HPV检测。[结果]HPV感染率为10.39%（462/4446）,其中HR-HPV感染率为9.69%（431/4446）。HPV感染居前5位的分别是HPV52、16、58、33和18,感染率分别为2.50%、2.14%、1.80%、0.94%和0.88%。影响HPV感染的相关因素分析显示年龄、怀孕次数、人工流产次数、近3年每月性生活次数、文化程度与HPV感染无显著性相关（P〉0.05）;随着宫颈糜烂面积的增大,HPV感染率有逐渐上升趋势,但差异无统计学意义（P〉0.05）。[结论]杭州市萧山区20～60岁常住妇女的HPV感染率为10.39%,其中HR-HPV感染率为9.69%,感染率居前5位的分别是HPV52、16、58、33和18。     

Diagnostic Performance of HPV E6/E7 mRNA and HPV DNA Assays for the Detection and Screening of Oncogenic Human Papillomavirus Infection among Woman with Cervical Lesions in China

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and it is responsible for most cases of cervical uterine cancer. Although HPV infections of the cervix do not always progress to cancer, 90% of cervical cancer cases have been found to be associated with high risk HPV (HRHPV) infection. HPV DNA testing is widely used, along with Papanicolaou (Pap) testing, to screen for cervical abnormalities. However, there are no data on the prevalence of genotype-specific HPV infections assessed by measuring HPV E6/E7 mRNA in women representative of the Chinese population across a broad age range. Materials and Methods: In the present study, we compared the results with the CervicGen HPV RT-qDx assay, which detects 16 HR-HPV genotypes (Alpha-9: HPV 16, 31, 33, 35, 52, and 58; Alpha-7: HPV 18, 39, 45, 51, 59, and 68; and Alpha-5, 6: HPV 53, 56, 66, and 69), and the REBA HPV-ID assay, which detects 32 HPV genotypes based on the reverse blot hybridization assay (REBA) for the detection of oncogenic HPV infection according to cytological diagnosis. We also investigated the prevalence and genotype distribution of HPV infection with a total of 324 liquid-based cytology samples collected in western Shandong province, East China. Results: The overall HPV prevalences determined by HPV DNA and HPV E6/E7 mRNA assays in this study were 79.9% (259/324) and 55.6% (180/324), respectively. Although the positivity of HPV E6/E7 mRNA expression was significantly lower than HPV DNA positivity, the HPV E6/E7 mRNA assay showed greater specificity than the HPV DNA assay (88.6% vs. 48.1%) in normal cytology samples. The prevalence of Alpha-9 (HPV 16, 31, 33, 35, 52, and 58) HPV infection among these women accounted for up to 80.3% and 76.1% of the high-grade lesions detected in the HPV mRNA and DNA tests, respectively. The HR-HPV genotype distribution, based on HPV DNA and E6/E7 mRNA expression by age group in patients with cytologically confirmed lesions, was highest in women aged 40 to 49 years (35.9% for cytologically confirmed cases, Pearson correlation r value=0.993, p<0.001) for high-grade lesions. Among the oncogenic HR-HPV genotypes for all age groups, there was little difference in the distribution of HPV genotypes between the HPV DNA (HPV -16, 53, 18, 58, and 33) and HPV E6/E7 mRNA (HPV -16, 53, 33, 58, and 18) assays. HPV 16 was the most common HPV genotype among women with highgrade lesions. Conclusions: Our results suggest that the HPV E6/E7 mRNA assay can be a sensitive and specific tool for the screening and investigation of cervical cancer. Furthermore, it may provide useful information regarding the necessity for early cervical cancer screenings and the development of additional effective HPV vaccines, such as one for HPV 53 and 58. Additionally, gaining knowledge of HPV distribution may also inform us about ecological changes in HPV after the vaccination.     

Prevalence of Human Papillomavirus in Abnormal Cervical Smears in Malaysian Patients

Cervical cancer is the second most common female malignancy in Malaysia. Despite advances in treatment,the overall survival for this disease has not changed in the last decade. Infection by certain types of HPV isrecognized as a causal and necessary factor for its development. This study was carried out to determine theprevalence of HPV infection in abnormal cervical smears in Malaysian patients using archival cervical smearsretrieved from the Cytopathology Unit, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) betweenthe years 1992-1995. DNA was extracted from 38 abnormal smears comprising 25 intraepithelial lesions and 13cervical carcinomas and 10 normal smears. Amplification of HPV genes was carried out using the polymerasechain reaction (PCR) technique. HPV genotypes were determined using direct sequencing and the results werecompared to the database from Genebank. DNA was successfully extracted from all 48 cervical smears. HighriskHPV (HR-HPV) genotypes were detected in 95% of the abnormal smears. Eight high-risk oncogenic typeswere identified: 16, 18, 31, 51, 52, 56, 58 and 66. All (100%) cervical cancer smears showed presence of HR-HPVcompared to 92% of the cervical intraepithelial lesions. Among the eight HR-HPV genotypes identified, HPV 16and 52 were the commonest (23.7% each) HPV genotypes encountered and among the CIN lesions, HPV 16(28%) was the most frequent. We conclude that HPV 16 is the most prevalent HPV genotype present in abnormalcervical smears in Malaysian patients, and that the use of archival material to assess the presence of HPV ispotentially worthwhile, and can be utilized for longitudinal studies of HPV presence and persistence.