HPV多重感染在宫颈病变中的流行分布及意义

目的探讨人乳头状瘤病毒（HPV）多重感染与宫颈病变发生、发展关系。方法应用HPV基因芯片检测技术,对287例宫颈病变患者（CINⅠ130例、CINⅡ69例、CINⅢ48例、宫颈癌40例）的宫颈液基细胞残余标本进行HPV感染基因型检测,并与组织学检测结果比较。结果287例宫颈病变中HPV感染率为89．9％（258／287）,在CINⅠ、CINⅡ、CINⅢ及宫颈鳞癌多重感染率分别为48．6％、40．3％、31．1％、27．5％,CINI与CINⅢ及宫颈癌比较,P均〈0．05;HPV最常见亚型为HPV16、HPV58及HPV52;多重感染中以二重感染常见（51／105,48．6％）,偶有五重感染（3／105,2．9％）。40岁以下者HPV多重感染率高于40岁以上者。结论宫颈HPV多重感染率有随宫颈病变程度增加有降低趋势,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;40岁以下者HPV多重感染发生率高。     

宫颈上皮内瘤变组织中HPV检测及分型结果分析

目的分析温州市宫颈上皮内瘤变（CIN）患者瘤变组织中人乳头瘤病毒（HPV）检测及分型结果。方法采用基因芯片技术检测28例CINI级、25例CINII级、25例CINⅢ级组织中的HPV。结果CINI级者中HPV阳性率为46．4％（13／28）,其中单一HPV感染12例,三重感染（HPV16、33、59）1例;HPV亚型感染频度前三位依次为HPV16（14．3％）、58（10．7％）、52（7．1％）。CINII级者阳性率为64．0％（16／25）,其中单一HPV感染15例,双重感染（HPV11、18）1例;HPV亚型的感染频度前三位依次为HPV16（20．0％）、58（12．0％）、18（12．0％）。CINII级者HPV阳性率为96．0％（24／25）,其中单一HPV感染17例,双重感染7例（HPV16、58双重感染为主,共3例）;HPV亚型感染频度前三位依次为HPV16（52．0％）、58（28．0％）、33（16．0％）。结论温州市各级CIN患者瘤变组织中HPV阳性率较高,其中HPV16、58是最常见的感染亚型。     

人乳头瘤病毒基因分型与宫颈癌的相关性研究

目的研究宫颈癌患者HPV感染情况及基因分布情况,探讨HPV病毒类型与宫颈癌的相关性。方法收集2008年1月—2011年10月我院确诊的宫颈癌患者103例为调查对象,同期应用基因芯片法检测该患者的23种HPV基因感染情况。结果 103例宫颈癌中有86例患者检测到被HPV感染,感染率为83.5%。结论 HPV基因分型和宫颈癌密切相关,宫颈鳞癌的HPV感染率明显高于宫颈腺癌。HPV16型是宫颈鳞癌和腺癌的主要基因型,宫颈癌中HPV基因分布呈多样性,以高危型为主,HPV16、18型占绝大多数,单纯低危型感染仅占少数。     

21种HPV亚型检测在宫颈病变诊断及预测中的价值

目的探讨HPV亚型感染与宫颈病变的关系。方法360例宫颈病变患者组织病理学检查诊断为宫颈炎／宫颈尖锐湿疣254例,宫颈上皮内瘤变（CIN）52例（其中CINⅠ12例、CINⅡ16例、CINⅢ24例）,宫颈癌54例,采用导流杂交基因芯片技术检测宫颈脱落细胞中HPV亚型,分析不同病变的HPV感染情况。结果本组HPV感染率为83．3％（300／360）;宫颈炎／宫颈尖锐湿疣、CIN、宫颈癌高危型感染率明显高于低危型（P〈0．01）;高危型HPV感染率随宫颈病变程度加重而升高;不同宫颈病变中单一型感染率明显高于多重型感染率（P〈0．01）,多重型感染率随宫颈病变程度加重而升高。不同HPV亚型致病性不同。结论HPV亚型检测可用于宫颈病变的筛查病情判断。     

南京地区2387例有性生活女性的宫颈脱落细胞高危 HPV 检测分析

目的：观察南京地区妇女宫颈高危型人乳头瘤病毒（ HR-HPV）感染情况。方法采用4800 HR-HPV技术检测2387例有性生活女性的宫颈脱落细胞,进行HPV基因型检测,计算HR-HPV感染的阳性率和年龄段的关系及亚型感染分布特点。结果 HR-HPV阳性者446例,阳性率18．68％, HPV16感染105例（4．40％）,HPV18感染25例（1．05％）,其他12种高危型感染316例（13．24％）。20～29岁、30～39岁、40～49岁、50～59岁、≥60岁年龄段 HR-HPV 的感染率分别为17．25％（113/655）、22．67％（182/803）、15．59％（94/603）、19．58％（47/240）、11．6％（10/86）,各年龄组的HPV阳性检出率比较P＜0．05。446例HR-HPV感染的女性中, HPV16在20～29岁感染率最高,为5．34％;HPV18在50～59岁感染率最高,为2．08％;其他12种HR-HPV在30～39岁感染率最高,为16．44％。结论南京地区HR-HPV感染率较高,感染高峰在30～39岁和50～59岁,以HPV 16、18型为主。     

1511例宫颈糜烂患者HPV感染状况分析

目的探讨宫颈糜烂患者人乳头瘤病毒（HPV）的感染情况。方法选择超薄液基细胞学技术（TCT）检测正常的宫颈糜烂患者1511例,采用HybriMax方法进行HPV基因型分型检测,分析该人群中HPV感染率及病毒亚型的分布情况。结果受检者中HPV感染者302例（19．98％）,年龄（30．76±5．79）岁,以单一病毒亚型感染为主,重度糜烂比轻度糜烂感染率高。在单一病毒亚型感染者中,感染率最高的为58亚型;多重感染中,最高者为16亚型。结论TCT正常的宫颈糜烂患者中依然有较高的HPV感染,对宫颈糜烂患者实施HPV检测与追踪,将有利于对宫颈癌高危人群的监控。     

贵州地区宫颈上皮内瘤变和宫颈浸润癌患者HPV感染状态及其亚型分布

目的观察贵州地区宫颈上皮内瘤变（CIN）和宫颈浸润癌患者人乳头状瘤病毒（HPV）的感染状态及其亚型分布。方法采用导流杂交技术对30例CIN（CIN组）、33例宫颈浸润癌患者（宫颈癌组）、60例自愿接受宫颈HPV感染筛查的妇女（对照组）进行HPV分型检测,所有受检者均来自贵州地区。结果 CIN组HPV阳性13例（43.33%）,宫颈癌组19例（57.58%）,对照组5例（8.33%）。CIN组、宫颈癌组与对照组比较,P均〈0.01。CIN组共检出7种亚型HPV,均为高危型（HR-HPV）,无多型HPV感染（M-HPV）。其中HPV16 7例,HPV31、52各2例,HPV18、33、53、58各1例。宫颈癌组检出5种亚型,亦均为HR-HPV,M-HPV3例。其中HPV16 11例,HPV534例,HPV58 3例,HPV18、59各1例。对照组检出7种亚型,HR-HPV中的HPV16、18、31、39、53、58和低危型HPV的HPV6各1例;M-HPV 1例。CIN组、宫颈癌组HPV16感染率明显高于对照组,P均〈0.05。HR-HPV感染与CIN（OR=8.412,95%CI为2.62~26.99）和宫颈浸润癌（OR=14.929,95%CI为4.74~46.98）紧密相关,且主要与HPV16感染有关（CIN：OR=17.957,95%CI为2.09~154.15;宫颈浸润癌：OR=29.500,95%CI为3.60~242.07）,P均〈0.05。结论贵州地区CIN和宫颈浸润癌与HR-HPV感染密切相关,HPV16为主要感染亚型。     

360例宫颈疾病患者HPV亚型检测与分析

采用核酸分子快速杂交基因分型技术对360例宫颈分泌物进行21种人乳头瘤病毒（HPV）亚型检测,对高危型HPv感染病例与宫颈细胞（病理）学检查结果进行回顾性分析。结果显示,360例宫颈疾病患者中HPV感染135例（37．5％）。高危型以16、58型为主,构成比分别为20.1％和12．9％。按宫颈炎／糜烂、不典型鳞状上皮细胞（ASCUS）、宫颈上皮内轻度瘤变（CINⅠ）、宫颈上皮内中度瘤变（CINⅡ）、宫颈上皮内重度瘤变（CINⅢ）／宫颈癌顺序,高危型HPV感染率依次递增分别为：20％、50％、66．7％、91．2％和94、1％。CINⅡ、CINⅢ／宫颈癌中高危型HPV感染率明显高于宫颈炎／糜烂、ASCUS和CINⅠ（P均〈0．05）。认为HPV感染率及亚型分布有地域差异,以高危型HPV16型感染最多。随着宫颈病变程度加重,高危HPV感染率增高。     

川东北地区泌尿生殖道感染女性患者人乳头瘤病毒感染情况分析

目的 了解川东北地区泌尿生殖道感染女性患者人乳头瘤病毒（HPV）感染状况及其基因亚型.方法 选取来自南充、遂宁、广安、达州等四川东北地区的女性泌尿生殖道感染患者1 193例,采集其宫颈脱落组织,应用基因芯片技术进行HPV分型检测.结果 HPV总阳性检出率为49.12％ （586/1193）,其中高危型HPV、低危型HPV、混合型HPV感染率分别为31.43％、30.60％、18.86％;高危型HPV检出率最高的是HPV16（14.17％）,其他高危型HPV的感染率从高到低依次为HPV58、HPV33、HPV18、HPV52、HPV56、HPV35、HPV31/HPV59、HPV45/HPV68、HPV53、HPV66、HPV73、HPV83/HPVMM4、HPV51;低危型HPV检出率最高的是HPV6（15.00％）,其他低危型HPV的感染率从高到低依次为HPV11、HPV43、HPV42;而HPV39、HPV44未检测到.HPV阳性患者中,41～ 50岁年龄段的高危型HPV感染比例最高,≤20岁年龄段低危型HPV的感染比例最高.结论 川东北地区女性HPV感染率高,HPV的感染率与年龄有一定关系;HPV16、HPV58和HPV33是最主要的高危型感染型别,HPV6、HPV11是最主要的低危型感染型别.     

妇科门诊女性生殖道人乳头状瘤病毒及病原体感染情况调查北大核心CSCD

目的探讨妇女人乳头状瘤病毒（HPV）及其他常见病原微生物感染现状。方法收集2009年1月～2011年12月在鄂州市中心医院妇科门诊就诊的2021例妇女的宫颈和阴道拭子标本,PCR检查HPVDNA及其基因分型,同时检测病原体感染情况。结果2021例病例HPV阳性625例,阳性率为30．93％。在625例HPV阳性病例中,除52例为混合基因型,其余573例共检测出35种HPV的不同亚型,检出率较高的亚型分别是HPV16（14．83％）、HPV58（9．08％）、HPV53（7．50％）、HPV42（6．28％）、HPV31和HPV6（各5．41％）;HPV高危型和可能高危型占52．53％,HPV低危型占22．86％,HPV未知危险型占24．61％。在HPV阳性625例妇女中,感染沙眼衣原体占12．80％,解脲支原体占33．92％,无乳链球菌占8．96％,阴道毛滴虫占1．12％,细菌性阴道病占9．44％,假丝酵母菌占12．64％。结论鄂州地区妇女高危型HPV感染率较高,早期筛查、控制HPV感染是降低宫颈癌发病率的有效途径．     

Comparison between two human papillomavirus genotyping assays targeting the L1 or E6/E7 region in cervical cancer biopsies

Introduction

Human papillomavirus (HPV) testing is increasingly used in cervical cancer prevention strategies, and a variety of HPV genotyping assays have been developed. We aimed to compare the performance of two HPV genotyping techniques in formalin-fixed paraffin-embedded (FFPE) tissue specimens from a series of invasive squamous cell carcinoma (SCC) cases.

Methods

Archival FFPE tissue blocks from 78 SCC cases were initially considered. DNA was extracted from dewaxed tissue sections and tested with the INNO-LiPA HPV Genotyping Extra assay (Innogenetics), and the F-HPV typing kit (Genomed) targeting the L1 and E6/E7 regions, respectively.

Results

The INNO-LiPA assay showed a higher sensitivity (98.6%) than the F-HPV assay (78.6%). A total of 12 (17.1%) biopsies showed multiple-type infections evidenced by at least one assay. Among the SCC cases tested, HPV16 and/or 18 were detected in 70% of the cases, and 18.4% of them had multiple infections with other high-risk types.

Conclusions

Our results suggest that the INNO-LiPA assay has a better performance than the F-HPV in FFPE specimens, probably due to its smaller amplicon size and the wider range of detectable HPV types. The prevalence of multiple infections could be higher than previously reported, as evidenced by the combination of the two assays.     

宫颈病变患者病变组织HPV整合状态的变化及意义

目的检测宫颈病变患者病变组织中HPV-16、18整合状态,并探讨HPV DNA整合状态与宫颈癌演变的关系。方法采用多重PCR技术扩增HPV16、18 E2全长基因和E6基因,对扩增产物电泳后条带面积灰度值进行半定量分析,判定HPV的整合状态。结果54例宫颈病变患者宫颈组织中49例患者检出HPV16感染（90．74％）。在49例HPV16阳性组织中,26例慢性宫颈炎患者HPV完全以游离状态存在,8例原位癌组织中3例检测为整合状态（37．5％）,7例早期浸润癌5例整合（71．4％）,8例中晚期癌全部以整合状态存在（100％）。不同宫颈病变患者宫颈组织HPV整合率相比,P〈0．01。结论随着宫颈病变程度加重,HPV基因组整合率逐渐增高,HPV DNA整合可能是宫颈癌演变的早期标志。对HPV DNA整合状态进行检测,可早期预测宫颈癌细胞病变的性质。     

人乳头瘤病毒检测阳性者宫颈黏膜病理表现分析

目的探讨人乳头瘤病毒（HPV）基因亚型检测,在宫颈病变筛查中的意义。方法选择2008年7月1日至12月31日,在台州医院宫颈疾病门诊要求进行宫颈病变筛查的病人,检测HPV-DNA21种亚型。对检测阳性者,常规行阴道镜检查与宫颈活检。结果 3300例病人中,筛查出HPV阳性者990例,阳性率30%,高危型61.8%（612/990）,低危型28.9%（286/990）,未确定型9.3%（92/990）。990例HPV-DNA阳性者行宫颈活检报告：湿疣样改变39.4%（390/990）,慢性宫颈炎21.6%（214/990）,宫颈上皮内瘤变（CIN）Ⅰ级18.8%（186/990）,CINⅡ13.1%（130/990）,CINⅢ4.7%（46/990））,宫颈癌2.4%（24/990）。结论高危型HPV持续感染与宫颈病变密切相关,高危型HPV检测可进一步浓缩高风险人群,使筛查更加有针对性,而感染HPV不等同于患宫颈癌。     

十堰地区妇女宫颈人乳头瘤病毒感染及基因亚型分布情况调查分析

目的:对十堰地区妇女宫颈(HPV)亚型进行筛查,以探讨其分布规律。方法:采用核酸分子快速导流杂交基因芯片技术,对1 116例妇科就诊患者的宫颈刷片标本进行了21种HPV基因分型检测。结果:1 116例样本中,HPV感染者283例,总感染率25.36%,高危型HPV感染率14.52%,低危型HPV感染率2.96%,高危型及低危型混合感染阳性率7.89%;单一基因型别195例,占阳性患者的68.91%;双重混合感染59例,占阳性患者的20.85%;三重以上混合感染者29例,占阳性患者的10.25%。HPV感染阳性率居前5位的高危亚型依次是HPV16型50例(4.48%)、HPV52型47例(4.21%)、HPV53型28例(2.51%)、HPV58型17例(1.52%)及HPV39型15例(1.34%),常见的低危型是HPV6(1.26%)和HPV42(1.26%)。结论:十堰地区妇女HPV感染率较高,且以高危型HPV感染为主,感染型别既符合亚洲及中国地区人群的分布规律,又有独特的区域分布特点,并且多重感染率高,值得重视。     

髙危型HPV检测在宫颈病变诊断中的价值

目的探讨高危型HPV检测在宫颈病变诊断中的价值。方法720例宫颈病变患者先进行HPV DNA的杂交捕获法二代（HPV—HCⅡ）和液基细胞学（TCT）的检测,其中224例因细胞学异常（意义未明的非典型鳞状细胞以及以上的病变）行阴道镜下活检。结果720例患者HPV阳性者264例（36．7％）,阴性者456例（63．3％）。HPV阳性组患者年龄（37．77±8．48）岁,HPV阴性组年龄（39．25±8．83）岁,两组比较P〈0．05。224例细胞学异常患者HPV感染率分别为炎症和复鳞上皮乳头瘤样增生64．9％（61／94）、宫颈上皮内瘤变（CIN）Ⅰ82．8％（24／29）、CINⅡ89．7％（26／29）、CINⅢ93．5％（58／62）、浸润癌100％（10／10）,随病理级别的升高HPV感染率显著升高（P〈0．05）。57例细胞学检测为ASC-US的患者中宫颈高度病变（≥CINⅡ）检出率为24．6％（14／57）,HPV阳性组检出率为33．3％（12／36）,阴性组为9．5％（2／21）,两组比较,P〈0．05,阴性组无浸润癌和CINⅢ的检出。87例细胞学为LSIL的患者中宫颈高度病变检出率为34．5％（30／87）,HPV阳性组检出率为39．5％（30／76）,阴性组为0,两组比较P〈0．01,阴性组无高度病变的检出。结论高危型HPV检测可以明显提高宫颈高度病变在细胞学为ASC-US及LSIL中的检出率。     

The prevalence and genotype distribution of human papilloma virus in cervical squamous intraepithelial lesion and squamous cell carcinoma in Taizhou,China

Human papillomavirus (HPV) infection is a common sexually transmitted disease worldwide and the leading cause of cervical cancer. Current vaccines do not cover all HPV genotypes whereas the distribution of HPV genotypes varies in different geographic regions. The study aimed to investigate the distribution of HPV genotypes in patients with cervical squamous intraepithelial lesion (SIL) and cervical squamous cell carcinoma (SCC) in Taizhou City of Jiangsu Province, China. A total of 940 patients including 489 cases with cervical low-grade squamous intraepithelial lesions (LSIL), 356 cases with cervical high-grade squamous intraepithelial lesions (HSIL), and 95 cases with cervical SCC, underwent a biopsy or surgery in Taizhou People''s Hospital between January 2019 and December 2019. The HPV testing results were retrospectively analyzed. The overall prevalence of any, high-risk, and low-risk HPV was 83.83%, 81.91%, and 12.13%, respectively. The 5 most common HPV genotypes were HPV16 (35.64%), HPV52 (16.91%), HPV58 (13.94%), HPV33 (8.94%), and HPV18 (7.98%). The prevalence of any and HR-HPV in SCC was significantly higher than those in LSIL and HSIL, while the prevalence of LR-HPV in SCC was significantly lower than those in LSIL and HSIL (P < .01). Single and dual HPV infections were prevalent in SCC, LSIL, and HSIL. Furthermore, the prevalence of dual HPV infection in SCC was significantly higher than those in LSIL and HSIL (P = .002). The HPV prevalence varied by age, being highest among women with SCC, LSIL, and HSIL aged 40 to 49 years, 40 to 49 years, and 50 to 59 years, respectively. In conclusion, the findings revealed a very high prevalence of HPV in women with cervical lesions in Taizhou. Routine HPV tests must cover all common HPV genotypes in clinical practice.     

Unchanging pattern of prevalence of esophageal cancer,overall and by histological subtype,in the endoscopy service of the main referral hospital in the central region of Rio Grande do Sul State,in Southern Brazil

Squamous cell carcinoma (SCC) and adenocarcinoma (ADC) are the two main histological types of esophageal cancer. Southern Brazil has the highest rates of esophageal cancer in South America, and the most prevalent subtype of esophageal cancer has been SCC. This study assessed the trend changes in the histological types of esophageal cancer, in a 20‐year period, in the central region of Rio Grande do Sul State, Brazil. We searched all cases of esophageal cancer from 1993 to 2012 by their histological diagnosis, grouping the patients in 4‐year time periods to evaluate time trends. Among 18 441 upper gastrointestinal endoscopies we identified 686 cases of esophageal cancer. Histological study confirmed the diagnosis of SCC in 640 (93.3%) patients and ADC in 46 (6.7%). Overall, 522 men were diagnosed with esophageal carcinoma; from these, 489 (93.6%) presented SCC, and 33 (6.3%) ADC. Among women, 164 had the diagnosis of esophageal cancer, 151 (92%) SCC, and 13 (7.9%) ADC. The proportion found among men and women was 3.1:1, respectively. The prevalence rate of esophageal cancer, along a 20 year‐period, remained stable, as well as the rates of SCC and ADC. SCC was the most common type of esophageal cancer, and ADC presented very low prevalence.     

Prevalence and Genotyping of High Risk Human Papillomavirus in Cervical Cancer Samples from Punjab,Pakistan

Cervical cancer is the third most common cause of cancer-related death in women worldwide. Infection with high-risk human papillomavirus (HPV) is established as the cause of cervical carcinoma, therefore, high risk HPV detection may have prognostic significance for the women who are at increased risk of disease progression. The paucity of data on the incidence of cervical cancer in Pakistan makes it difficult to determine disease burden. Even less information is available regarding the prevalent HPV strains in cervical specimens collected from this region. Cervical cancer is a neglected disease in Pakistan in terms of screening, prevention, and vaccination. Identification and accurate genotyping of the virus burden in cancer specimens is important to inform intervention policies for future management of HPV associated disease and to potentially stratify patients dependent on HPV status. In this study, detection and genotyping of HPV types 16 and 18 from 77 cervical specimens were carried out. Consensus primers GP5+/GP6+, which detect 44 genital HPV types, and type specific primers (TS16 and TS18) were used in conjunction with newly designed type specific primers. Using a combination of these methods of detection, a total of 94.81% (95% CI ±4.95) of cervical lesions were positive for HPV. Single infections of HPV16 were detected in 24.68% (95% CI ±9.63) of total samples and HPV18 was found in 25.97% (95% CI ±9.79) samples. Interestingly, a high proportion of samples (40.26%, 95% CI ±10.95) was positive for both HPV16 and 18, indicating a higher incidence of co-infection than previously reported for similar ethnic regions. The HPV genotype of 3.90% of HPV positive samples remained undetected, although these samples were positive with the GP5+/GP6+ primer set indicating infection with an HPV type other than 16 or 18. These data indicate that the overall incidence of high risk HPV infection in cervical cancer and intraepithelial neoplasia specimens in Punjab, Pakistan is in line with the worldwide prevalence, but that the incidence of HPV16 and 18 co-infections in our cohort is higher than that previously reported.