女性生殖道人乳头瘤病毒多重感染基因谱的研究

目的:探讨生殖道人乳头瘤病毒(HPV)基因型在女性多重感染者中的分布.方法:采用核酸分子快速导流杂交基因芯片分型技术(HybriMax)对大连地区5599例女性进行HPV多重感染检测.结果:5599例女性中检出354例(6.32％) HPV多重感染患者,21个亚型中检出20个基因型.高危-高危基因型、高危-低危基因型、低危-低危基因型多重感染者分别为155例(43.8％)、18例(5.1％)、181例(51.1％).354例多重阳性感染者中二重感染最多,占77.68％ (275/354),常见感染模式为HPV16+58、HPV 16 +52;其次为三重感染,占15.25％ (54/354),常见感染模式为HPV31 +58 +CP8304,占5.56％ (3/54).合并基因型数最多的为七重感染,四重及四重以上多重感染基因型构成复杂多变,尚未发现常见感染模式.各年龄组HPV多重感染率差异显著(x2=88.91,P＜0.005).≤20岁女性的HPV多重感染率最高(15.6％);随年龄增加,HPV多重感染率逐渐下降,而＞50岁女性的HPV多重感染率有增加趋势.结论:大连地区HPV多重感染率较低,但以高危混合型为主.用HybriMax法对HPV DNA进行多重感染基因谱检测,对宫颈病变的防治具有重要意义.     

健康体检女性人乳头瘤病毒感染特征分析

目的探讨人乳头瘤病毒(HPV)感染状况以及亚型分布特征。方法收集2015年2月至2017年8月在大连医科大学附属第二医院健康体检中心自愿进行HPV分型检测的女性资料3552例,利用PCR膜杂交法对宫颈分泌物样本进行HPV基因型分型检测。结果 HPV感染711例,感染率为20.02%,其中高危型、低危型及高低危混合型HPV感染率分别为15.37%(546/3552)、2.59%(92/3552)、2.06%(73/3552);感染率较高的高危型HPV基因亚型依次为:HPV16、58、52及53,低危型感染率较高的亚型依次为CP8304、HPV42;样本以单一感染为主(占全部感染的74.68%);≤30岁组为感染的高峰年龄组(感染率为27.46%),各年龄组均以单一感染为主。结论女性HPV感染类型以高危型和单一感染为主,常见的高危型HPV基因型为16、58、52和53型,不同年龄段的感染率及单一感染和多重感染特征存在差异。     

福建闽东地区畲族妇女宫颈HPV感染的检测

目的对福建闽东地区畲族妇女进行宫颈人乳头状瘤病毒(HPV)亚型感染的筛查,以探讨其分布规律。方法采用核酸分子杂交分型技术,对闽东地区19～73岁有性生活的畲族妇女进行宫颈HPV基因分型检测。结果165例样本中,HPV感染者41例,整体感染率24.85%。检出10种高危型HPV(HPV-16,18,31,33,45,52,56,58,59,68)34例,感染率为20.61%(34/165例);检出4种低危型HPV(HPV-6,53,44,CP8304)7例,感染率为4.24%(7/165例)。单一亚型占78.05%(32/41例),双重或多重亚型占21.95%(9/41例),以二重感染多见。感染率居前3位的是:HPV-52(8.48%)、HPV-58(5.45%)、HPV-16(4.85%)。结论闽东地区畲族妇女HPV感染率和多重感染比例均较高,以高危型HPV52型感染最多,HPV感染亚型分布有一定的区域性,值得关注。     

武昌区域单中心人乳头瘤病毒感染及不同基因型的分布特征

目的探讨人乳头瘤病毒(HPV)在武昌地区的感染情况及分布特点,以期获得感染HPV在该地区的流行病学概况和特点。方法随机选取2013年7月至2018年6月就诊于武汉市武昌医院的有性生活史女性患者宫颈脱落细胞并进行HPV感染检测和基因分型。计算比较HPV在不同年龄组中的感染特点。结果 HPV感染率为18.8%。其中高危型占74.9%,低危型占15.2%。各年龄组高危型感染率均明显高于低危型感染率,高危型和低危型感染率最高的年龄段均为30岁以下年轻女性,分别为25.8%和21.0%。高危型中,感染率最高前3种基因型为HPV16(20.0%),HPV18(18.0%),HPV52(14.0%)。低危型中,感染率最高的前3种基因型为HPV11(33.0%),HPV6(32.0%)和HPV CP8304(26.0%)。HPV阳性患者中,单基因型和二重基因型HPV感染率分别为76.2%和18.0%,部分患者为五重感染。除了HPV43,其他基因型均可在多重感染的样本中检测到。结论武昌地区女性HPV的感染率为18.8%,且以高危型感染为主,主要基因型为HPV16、HPV18和HPV52。30岁以下年轻女性为高发人群。加强HPV的筛查和增强女性的自检意识具有非常重要的临床意义。     

542例女性HPV感染基因分型检测结果分析

目的:了解女性生殖道人乳头瘤病毒(HPV)感染的型别分布及特点。方法:采用人乳头瘤病毒基因分型(PCR-反向点杂交)技术对542例女性进行HPV亚型分析。结果:HPV感染阳性率31%,23种HPV亚型(除HPVMM4、51型外)均有检出,其中高危型28.2%,单一型感染为22.0%,混合型感染9.0%。(结论)女性HPV感染亚型及年龄分布具有明显的区域性。     

不孕与宫颈人乳头瘤病毒感染的关系研究

目的:调查不孕患者宫颈人乳头瘤病毒(HPV)的感染率及亚型分布。方法:采用快速导流杂交法对217例输卵管不孕患者和174例非输卵管不孕患者进行21种HPV亚型检测。结果:391例不孕患者的HPV阳性率为17.90%,其中输卵管不孕患者的HPV阳性率为20.28%,非输卵管不孕患者的HPV阳性率为14.94%,两组差异无统计学意义(χ2=1.869,P0.05)。HPV阳性的不孕患者中HPV高危型占82.86%,高危型中检出率最高的是HPV 58,其次是HPV 52。输卵管不孕组和非输卵管不孕组HPV感染均以高危型为主,两组间HPV高危型感染率差异无统计学意义(χ2=1.343,P0.05)。结论:HPV高危型感染可能是女性不孕症的危险因素之一,且HPV阳性不孕患者中绝大部分为HPV高危型。     

22234例子宫颈高危型HPV感染及亚型分布研究

目的:分析17种型别的高危型人乳头瘤病毒(HPV)在22234例子宫颈癌筛查中的感染率及亚型分布特点。方法:回顾性分析2018年1月1日至2019年1月1日22234例于华中科技大学同济医学院附属协和医院行子宫颈癌筛查患者高危型HPV感染率及感染亚型。结果:22234例接受子宫颈癌筛查患者中,一种或以上高危型HPV阳性者3574例(16.1%),其中HPV16或(和)HPV18阳性者703例(3.2%)。在3574例高危型HPV阳性女性中,最常见的高危HPV感染是HPV52(24.4%),其次为HPV58(16.5%)、HPV16(14.0%)、HPV53(12.6%)和HPV39(8.6%)。与HPV16阴性患者相比,在HPV16阳性的患者中,除HPV31、HPV35、HPV45、HPV26和HPV82以外的12种高危型HPV的感染风险均显著降低约2~5倍(OR 0.169~0.530,P<0.05);与HPV18阴性患者相比,HPV18阳性的患者中HPV16、HPV33、HPV39、HPV51、HPV52、HPV58和HPV53的感染风险均显著下降(P<0.05)。结论:女性高危型HPV感染率较高,最常见的高危型HPV是HPV52和HPV58感染,并且HPV16、18感染对多个其他型别高危型HPV感染有保护作用。     

都市高收入人群宫颈高危HPV感染与TCT的相关研究

目的了解北京市高收入女性人群宫颈高危HPV感染常见分型及高危HPV感染与液基细胞学异常的相关性。方法对2008年1月至2008年12月间就诊于北京五洲女子医院妇科门诊的女性2023例,采用导流杂交法进行16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、6、11、42、43、44、CP8304等21种宫颈人乳头状瘤病毒亚型的分型检测。同时进行液基薄层细胞学检测(TCT)。结果检测2023人次中感染高危HPV亚型618例,感染率30.5%,排在前5位的高危亚型是58(21.68%)、16(16.99%)、33(11.32%)、53(8.09%)、52(7.76%)。感染高危HPV618例中TCT异常的278例,其中ASCUS133例、LSIL124例、HSIL21例。结论北京市高收入女性人群宫颈高危HPV感染率较高,主要为单一感染,感染亚型主要是58、16、33、53、52型。其中16、58型的致病性较其他分型高。     

已婚女性宫颈上皮细胞中人乳头瘤病毒基因分型2000例分析

目的:探讨江苏省南京地区2000例已婚女性宫颈上皮细胞中23种HPV感染基因型的分布情况。方法:宫颈上皮细胞标本取自江苏省南京市扬子石化集团公司的2000例已婚女性,采用基因扩增及基因芯片技术对其宫颈上皮细胞进行23种HPV基因型别进行检测和分析。结果:2000例已婚女性宫颈上皮细胞标本中检出HPV感染者205例,HPV总感染率为10.25%(205/2000),其中单一型别阳性检出率为8.80%(176/2000)。单一型别感染中HPV43型33例,其阳性检出率为1.65%(33/2000),是最主要的感染型别;其次HPV58型22例,其阳性检出率为1.10%(22/2000)。混合型HPV感染29例,其阳性检出率为1.45%(29/2000);其中HPV16型混合感染占34.48%(10/29),是混合型感染的主要型别;其次是HPV43型混合感染占31.03%(9/29)。29岁以下、30～39岁、40～49岁和50岁以上HPV感染率分别为10.00%、7.24%、11.45%和12.96%。结论:HPV43型、58型单一型别及16型和43型的混合型是感染南京地区2000例已婚女性的主要基因型别,且发病人群呈现低龄化趋势。基因芯片技术可检测出宫颈上皮细胞标本中的多种HPV基因型,对女性宫颈癌的预防及病因学的研究具有重要的作用。     

宫颈重度鳞状上皮内病变和宫颈癌组织中人乳头瘤病毒感染及基因分型的研究

目的:探讨人乳头瘤病毒感染及其基因型与宫颈重度鳞状上皮内病变(HSIL)和宫颈癌的关系.方法:采用可检测25种HPV基因型的基因芯片方法分别检测HSIL(23例)和宫颈癌(46例)组织的HPV基因型,计算两组患者宫颈组织中HPV的感染率及各基因型的感染率,比较HPV及其主要基因型与宫颈病变的关系.结果:69例宫颈病变患者中HPV阳性率为98.55%(68/69);HSIL组单一型别感染率为81.82%,多型别感染率为18.18%,HPV的型别分布以HPV16、52、58最常见;宫颈癌患者中单一型别感染率为95.45%,多型别感染率为4.55%,HPV的型别分布以HPV16、58最常见.所检出的HPV型别中以HPV16的检出率最高.结论:①HPV感染,特别是高危型HPV感染与HSIL和宫颈癌的关系密切;②宫颈病变严重程度可能与HPV基因型多寡无关,而与感染HPV亚型的致病能力密切相关;③HSIL与宫颈癌感染的HPV基因型呈多样性.且均为高危型感染,其中以HPV 16型最常见.     

2006-2008年北京地区25～54岁育龄妇女HPV亚型感染状况的调查

目的 调查北京地区25～54岁育龄妇女生殖道HPV亚型的感染状况.方法 从2006年9月-2008年12月,对在北京城市和乡镇居住的5552例妇女以每5岁为一个年龄段进行了 以人群为基础的横断面抽样调查,主要进行流行病学问卷调查、宫颈脱落细胞涂片液基薄层细胞学检查(TCT)和基因芯片HPV亚型检测.结果 HPV总感染率为6.68%(371/5552),高危型HPV感染率为5.76%(320/5552),低危型HPV感染率为2.00%(111/5552).常见的HPV亚型为16型(2.61%,145/5552)、58型(0.97%,54/5552)、33型(0.85%,47/5552)、43型(0.74%,41/5552)和56型(0.70%,39/5552).人群感染高峰年龄段为30～34岁(8.21%,82/999)和40～44岁(7.48%,86/1150).结论 北京地区妇女常见HPV亚型为高危型16、58、33型及低危型43型,并且存在两个年龄段感染高峰.

Abstract：

Objective To investigate subtype of HPV infection among women at age of 25 to 54 years in Beijing. Methods From Sept. 2006 to Dec. 2008, 5552 reproductive women at age of 25 to 54 years classified into each 5-year as group were screened. Each participant completed a questionnaire and a sample of exfoliated cervical cells for liquid-based cytology and HPV subtype gene testing was performed.Results The overall prevalence of HPV was 6.68% (371/5552). High-risk HPV and Low-risk HPV prevalence were 5.76% (320/5552) and 2.00% (111/5552), respectively. The most common HPV types were HPV16 (2.61%, 145/5552), HPV58 (0. 97%, 54/5552), HPV33 (0.85%, 47/5552), HPV43 (0.74% ,41/5552) and HPV56(0.70% ,39/5552). There were two peaks of HPV prevalence: groups of 30 -34 years and 40 -44 years. Conclusion The most common HPV subtypes in Beijing were HPV 16,58, 33 and 43 and HPV prevalence showed a bi-medal age-specific curve.     

A survey on the prevalence of high-risk subtypes of human papilloma virus among women with cervical neoplasia in Isfahan University of Medical Science

Aim  

Given the importance of epidemiological studies on the prevalence of human papilloma virus (HPV) and its subtypes to plan more effective strategies for cervical cancer prevention, the aim of this study was to determine the prevalence of HPV in women with cervical intraepithelial neoplasia and cancer in Isfahan.     

Prevalence of high risk human papillomavirus types 16/18 in cytologically abnormal cervical smears in Alexandria,Egypt. A cytological and molecular study

IntroductionIn Egypt, cervical cancer ranks as the second most frequent cancer after breast cancer, among women between 15 and 44 years of age. High-risk human papillomavirus (HPV) 16 and 18 detection holds the potential to be used as a tool to detect women, at risk for consequent development of cervical cancer because of their predominance and potentially greater oncogenic nature than other high risk HPV subtypes.ObjectiveTo determine the prevalence of high-risk HPV 16/18 DNA in women with abnormal cervical cytology.Subjects and methods45 cases were collected from Egyptian women seeking routine gynecologic care. Ten cytologically normal cervical smear cell samples were included in the study as a control to be tested for the presence of HPV 16/18 DNA and were collected from asymptomatic patients having cystorectocele or coming for loop insertion or removal. The 45 specimens were subjected to real-time polymerase chain reaction, using multiplex HPV 16 and 18 PCR kit.Results45 cervical smears were collected in the present study. Cytopathological examination revealed that 5 (11.1%) were ASCUS, 8 (17.8) were LSIL, 5 (11.1%) were HSIL, 1 (2.2%) was squamous cell carcinoma (SCC), 1 (2.2%) was adenocarcinoma and 25 (55.6%) were benign (inflammatory). 20 patients with abnormal cervical cytology and 10 controls were included in the present study. In patients with abnormal cervical cytology, 5 (25%) were ASCUS, 8 (40%) were LSIL, 5 (25%) were HSIL, and 1 (5%) was SCC and 1 (5%) was adenocarcinoma. Statistical analysis revealed a significant difference between patient and control groups as regards regularity of menstruation where irregular menstruation and higher prevalence of menopausal women, abnormal vaginal bleeding, menorrhagia, vaginal infection, and abnormal cervical appearance were encountered in patients. A statistically significant higher prevalence of married women was found in the control group. There was no significant difference in the distribution of patients and control as regards HPV 16 or HPV 18 in which 20% of patients were HPV 16 positive and 10% of patients were HPV 18 positive compared with none in the control group. 6 were positive either for HPV 16 or 18, while 39 were negative. The HPV 16/18 positive patients had significantly higher age and marital duration when compared with HPV 16/18 negative group. Significantly, most of the HPV 16/18 positive patients were menopause. A significantly higher prevalence of women with cervicitis, contraceptive users and married women was in the HPV 16/18 negative group.ConclusionThe study generates epidemiological data of prevalence of HPV 16/18 in cytologically abnormal cervical smears in women seeking routine gynecologic care at the outpatient clinics of the Obstetrics and Gynecology Department at El Shatby University. High-risk HPV DNA testing by PCR of cervical samples diagnosed according to the Bethesda 2001 guidelines may benefit the management of patients with abnormal cervical smears, especially among women aged 46 years and older, in menopausal women and in women complaining of PMB. Therefore, HPV DNA testing should be made use of as an adjunct to cervical smears.     

海南地区宫颈癌的HPV基因型检测及其临床意义

目的:通过对宫颈癌组织的HPV分型检测,了解本地区宫颈癌HPV感染率及其亚型的分布情况,并分析HPV感染与宫颈癌临床生物学行为之间的关系.方法:收集200例宫颈癌患者病灶组织标本,采用HPV分型基因芯片检测系统,同时对23种HPV亚型(18种高危型和5种低危型)进行检测.结果:①HPV阳性率94.00%,共检出HPV16(69.68%)、HPV 18(16.49%)、HPV 33(1.06%)、HPV 45(1.60%)、HPV 58(1.06%)、HPV、73(0.53%)6种高危型亚型.其中HPV 16+18(7.45%)、HPV 16+45(1.06%)、HPV 18+33(1.06%);②鳞状细胞癌的HPV检出率明显高于腺癌(P<0.05);③HPV阳性率与宫颈癌患者的年龄、临床分期、病理组织学分级、盆腔淋巴结转移、治疗后的复发差异均无统计学意义(P>0.05).结论:本组宫颈癌的HPV感染率很高,且均为高危型,其中以16型和18型占绝对优势;HPV亚型比较局限,仅有6种;HPV多重感染并不多见;高危HPV的存在与鳞状上皮恶变关系密切.     

Human papillomavirus typing in HIV-positive women

OBJECTIVE: Human papillomavirus (HPV) is the major cause of cervical carcinoma and cervical intraepithelial neoplasia worldwide. Certain HPV types have a strong association with and probably a causative role in the pathogenesis of premalignant cervical lesions. Epidemiologic studies in women infected by the human immunodeficiency virus (HIV) have shown an increased incidence of squamous intraepithelial lesions (SILs), which were predominantly high-grade. Six to 30 per cent of women diagnosed with atypical squamous cells of undetermined significance (ASCUS) on a Papanicolaou (Pap) smear harbor SIL in normal screening populations. This study was undertaken to determine the presence of low-and high-risk HPV types in women infected by HIV and to correlate the results to those of the Pap smear. STUDY DESIGN: HPV DNA typing (low- and high-risk) by Digene (Digene Corporation, Gathesburg, MD) hybrid capture methodology was performed on cervical swabs from 209 HIV-positive women. The results of HPV typing were correlated with those of the Pap smear in a retrospective analysis. RESULTS: One hundred and one women (48%) tested positive for HPV subtypes by DNA typing by the hybrid capture method. Of these, 64 patients (63%) had Pap smears which were read as being normal, having benign cellular changes, or having ASCUS (favor reactive process). Of these, 19 patients tested positive for both high-risk and low-risk subtypes, 32 patients tested positive only for high-risk subtypes, and 13 patients tested positive only for low-risk subtypes. CONCLUSION: HPV subtyping identifies a significant group of HIV-positive women who are at risk for developing cervical intraepithelial neoplasia, although they may not show significant abnormalities on their Pap smears.     

Genital human papillomavirus screening by gene chip in Chinese women of Guangdong province

BACKGROUND: Human papillomavirus (HPV) infections are associated with cervical cancer. There were only a few reports and detailed data about epidemiological research of HPV infection in general population of China. AIMS: To determine the prevalence of genital HPV infection in Chinese women of Guangdong province. METHODS: A total of 1705 women were screened by gene chip. All HPV-positive women were further examined by ThinPrep liquid-based cytology test (TCT), and the cervical biopsies of those women with positive HPV-DNA and abnormal TCT were collected for pathological diagnosis. RESULTS: The overall HPV prevalence was 9.03% (154 of 1705), and 72.3% (126 of 154) of total positive samples were high-risk types, with higher prevalence of types 52, 58, 16, 18 and CP8304. For women aged 51 years or older, the overall high-risk HPV prevalence was 12.2% (24 of 179), which was obviously higher than those of other age groups (P < 0.05). CONCLUSIONS: Our results showed that the HPV prevalence in Guangdong is very similar to the world level. Unlike most previous studies, our findings suggest that HPV prevalence increased with age, and that the predominant genotypes in this area were HPV 52 and 58.     

Oral and cervical HPV infection in HIV-positive and HIV-negative women attending a sexual health clinic in São Paulo,Brazil

Objective

To investigate the prevalence of HPV infections in the oral and cervical mucosa of HIV-positive and HIV-negative women attending a sexual health clinic.

Methods

One-hundred HIV-positive women and 100 HIV-negative women were recruited from a sexual health clinic in São Paulo, Brazil. All participants were given an oral and cervical examination. Cytologic samples were evaluated via HPV DNA test.

Results

In oral samples, HPV DNA was observed in 11 women from the HIV-positive group and 2 from the HIV-negative group. High-risk HPV subtypes were prevalent in both groups and no difference between groups was detected. HPV DNA was detected in cervical scrapings from 41 HIV-positive women and 45 HIV-negative women (P = 0.67). No participants showed oral lesions, whereas 15 HIV-positive and 17 HIV-negative women presented with macroscopic genital lesions.

Conclusion

HPV is detected more often in cervical scrapings than in oral samples. However, HPV oral shedding is more frequent in HIV-positive than in HIV-negative individuals. Concurrence of infection (high and low risk) was not observed in oral and cervical mucosa.     

Atypical squamous cells of undetermined significance: human papillomavirus testing in adolescents

OBJECTIVE: To estimate the age-stratified prevalence of oncogenic human papillomavirus (HPV) infection and to evaluate risk factors for HPV acquisition among women with atypical squamous cells of undetermined significance (ASC-US). METHODS: This was a chart review of all women with ASC-US smears who underwent oncogenic HPV testing between July 2002 and February 2004. To be eligible, HPV DNA results had to be available. Data extracted from charts included demographic information as well as certain patient characteristics historically associated with HPV acquisition or carriage. RESULTS: Of 527 eligible women with ASC-US, 357 (68%, 95% confidence interval [CI] 64-72%) tested positive for oncogenic HPV. As compared with women who tested negative, this population was significantly younger and less likely to be married. When stratified by age, 77% of the women aged younger than 20 years were positive for high-risk subtypes, compared with 58% of women aged older than 25 years (P < .01). In the multivariate analysis, young age (relative risk [RR] 1.30, 95% CI 1.14.-1.49), current smoking (RR 1.14, 95% CI 1.03-1.25) and a history of chlamydial infection (RR 1.20, 95% CI 1.09-1.32) were associated with an increased likelihood of HPV infection, while oral contraceptive use (RR 0.86, 95% CI 0.72-1.03) had a marginal protective effect. The protective effect of oral contraceptives was most pronounced among adolescent women (RR 0.57, 95% CI 0.31-1.03). CONCLUSION: Given that the rate of oncogenic HPV infection approached 80% in our population of adolescent women with ASC-US, the usefulness of HPV testing in this age group requires further investigation. LEVEL OF EVIDENCE: II-3.     

Cervical cancer screening of HIV-positive women: is a prolongation of the screening interval meaningful?

OBJECTIVE: Cervical cancer screening guidelines stated recently that the screening interval of healthy women can be extended up to 3 years. Can those recommendations be applied for high risk populations? MATERIAL AND METHODS: In a prospective setting 305 HIV-positive women have been enrolled in this analysis between September 2000 and December 2003. Patients have been characterized according to HPV (human papilloma virus) prevalence, CIN (cervical intraepithelial neoplasia) incidence and CD4 cell count. RESULTS: 41 % of all HIV-positive women were HPV positive (oncogene subtypes). In patients with diminished CD4 cells the HPV prevalence increased to 60 % (54/90). CIN was found in 27 % (83/305) women. CIN was more frequent by HPV-positive women with a CD4 cell count < 200 mm (3) (52 %, 38/72). The CIN incidence was also high in HIV-positive women with negative HPV infection and diminished CD4 cell count (39 %, 7/18 vs.7 %, 11/161). CONCLUSIONS: The current cervical cancer screening guidelines are not helpful in HIV-positive women. The CIN incidence is significantly higher as in the HIV-positive population. For this reason this high risk population as e. g. HIV-infected women need an intensive care of diagnostic tools and short screening intervals to detect CIN.