客家妇女HPV感染型别分布的研究

目的:探讨人乳头瘤状病毒(Human Papillomavirus,HPV)在客家妇女人群中的型别分布情况,为客家地区HPV分子流行病学研究提供依据和检查出宫颈的癌前病变,达到在癌前病变时及早治疗,降低宫颈癌的发生率。方法:应用DNA杂交技术对2008年2月-2010年8月来医院就诊的11750例年龄在18—89岁的可疑患者进行21种HPV基因分型检测,其中包括16种高危亚型,5种低危压型。结果:11750例标本中阳性例教2386例,HPV阳性检出率为20.306%,其中高危感染率:93.822%,低危感染率:6.178%。结论:客家地区妇女HPV感染率高,主要为单一感染,多重感染有上升趋势;感染亚型主要是16、52和58型,体现了客家地区妇女感染HPV的特殊性。     

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。     

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.     

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。     

1955例武汉市农村妇女HPV感染状况与危险因素分析

目的:探讨武汉市农村妇女HPV在宫颈炎、宫颈上皮内瘤变(CIN)、宫颈癌中的感染分布情况及HPV感染危险因素。方法:在2011年武汉市20万农村妇女宫颈癌初筛阳性患者中随机抽取1955例,采用飞行时间质谱检测法对宫颈刷片进行HPV分型测定,分析HPV在宫颈炎、CIN、宫颈癌中的感染情况。结果:1955例宫颈刷片标本中发现HPV感染1115例,感染率为57.03%。HPV在不同宫颈疾病中的感染率不同,HPV在宫颈炎中的感染率为40.72%,CIN中为89.64%,宫颈癌中为92.86%,差异有统计学意义(P<0.01);HPV感染患者中,单纯高危型及单纯低危型HPV感染所占比例分别为92.74%、3.23%,差异有统计学意义(P<0.01)。1955例患者中HPV 16型感染率最高(18.16%),其次是HPV 58型(13.35%)、HPV52型(11.00%)、HPV 33型(5.68%)。1955例患者中单一亚型感染率为41.43%,双重及多重感染率为15.60%。不同初婚年龄、临床症状、宫颈癌家族史及是否熬夜等患者HPV感染率比较,差异有统计学意义(P<0.05)。结论:武汉市农村妇女高危型HPV感染是宫颈癌及CIN发生的必要因素。初婚年龄较早、有宫颈癌家族史、经常熬夜等为HPV感染的危险因素。     

HPV治疗性疫苗研究现状

<正>宫颈癌是目前我国仅次于乳腺癌的女性常见恶性肿瘤,每年约有3万妇女死于宫颈癌。高危型人乳头瘤病毒(human papilloma virus,HPV)的持续感染是引发宫颈癌的最主要原因,HPV感染最多的高危型别为16、18、52、58、31,其中尤以HPV16、18感染率最高。如今,HPV疫苗作为防治宫颈癌及HPV相关疾病的重要手段被广泛关注。预防性的HPV二价疫苗     

我国西部地区宫颈癌患者HPV感染现状及影响因素分析

目的了解我国西部地区宫颈鳞状细胞癌(squamous cell carcinoma,SCC)和宫颈腺癌(cervical adenocarcinoma,CADC)患者中人乳头状瘤病毒(human papillomavirus,HPV)的分布情况,为该地区宫颈癌的防治提供流行病学依据。方法收集西部地区新疆维吾尔自治区、重庆市及陕西省所选中心医院经病理诊断为宫颈上皮内瘤变2级及以上(CIN2~+)的病例,包括SCC及CADC。对纳入研究的病理蜡块进行诊断及HPV基因分型。结果我国西部地区SCC及CADC患者HPV感染率分别为97.4%、73.5%,HPV单一感染率分别为95.2%、74.4%,HPV多重感染率分别为2.1%、8.5%。SCC及CADC患者中高危型HPV感染率分别为96.8%、80.3%,其中HPV16型及HPV18型感染率均为最高,HPV16型阳性检出率分别为77.8%和50.4%,HPV18型阳性检出率分别为6.9%和20.5%。SCC患者及CADC患者低危型HPV感染率均明显低于高危型HPV检出率。绝经年龄、死产数及HPV感染情况在SCC及CADC患者中的分布差异具有统计学意义。结论我国西部地区SCC及CADC患者HPV感染率均较高,HPV感染在SCC中较在CADC中更多见。SCC及CADC患者中HPV 感染的型别均以HPV16型、HPV18型为主,但HPV18 型与CADC的关系比SCC更密切。对宫颈癌的预防工作应在促进宫颈癌筛查、推进HPV疫苗有效接种的同时,加强行为干预工作。     

人乳头瘤病毒基因亚型分布及与宫颈病变关系分析

目的:探讨女性HPV感染率和基因亚型分布,分析其与宫颈病变的关系.方法:收集四川大学华西第二医院2011年9月至2012年8月妇科就诊29832例女性患者的宫颈脱落细胞进行HPV基因分型检测.对2398例同时具有宫颈活检组织病理诊断结果的患者进行分组,包括慢性宫颈炎症组599例;CIN Ⅰ组437例;CINⅡ/Ⅲ组906例(CINⅡ338例,CINⅢ568例);宫颈癌组456例.结果:HPV感染率为25.20％(7518/29832),其中高危型HPV、低危型HPV、HPV多重感染率分别为21.03％(6275/29832)、4.17％(1243/29832)、5.94％(1772/29832).常见的高危型HPV为HPV16、58、33、52、18.随着年龄增加,HPV感染率呈现增高趋势.随着宫颈病变的严重程度增加,HPV感染率增高.所有宫颈病变中,常见的高危型HPV由高至低依次为HPV16、58、33、18、52;在宫颈癌组中为HPV16、18、58、33、52;在CINⅡ/Ⅲ组为16、58、33、52、18.在HPV阳性的不同程度宫颈病变中均以单一感染为主,除慢性宫颈炎组外,单一感染的比例随宫颈病变程度增加而增加.结论:本研究最常见的高危型HPV为16、58、33、52、18,与其他地区相比存在一定的地区差异.HPV感染率随年龄增加呈现增高趋势.在不同宫颈病变中,HPV的型别分布有所不同,单一感染可能更易导致宫颈癌的发生.     

贵阳市宫颈高级别鳞状上皮内病变及宫颈癌患者HPV亚型分布状况及感染状态分析

目的探讨贵阳市高致癌性人乳头瘤病毒(HPV)基因亚型及感染特点。方法对907例高级别及以上病变(HSIL+)患者的宫颈脱落细胞进行HPV分型检测,分析HPV基因亚型的分布状况及感染状态。结果①HSIL组感染率最高的7种HPV亚型为HPV16、52、58、33、51、18及31型,ICC组感染率最高的7种HPV亚型为HPV16、58、18、33、39、52、53型;ICC组与HSIL组比较,HPV16型、18型感染率升高,差异有统计学意义(χ~2=38.573,P 0.001;χ~2=7.817,P=0.005);②HSIL+患者以HPV单一型别感染为主,ICC组较HSIL组HPV多重型别感染率下降。结论 HPV16、18型是贵阳市宫颈癌高致癌性基因亚型,58、52、33型亦属常见高危亚型;HSIL+患者以HPV单一型别感染为主,HPV多重感染不增加宫颈癌的发病概率。     

妊娠期与非妊娠期人乳头瘤病毒的感染率比较

目的:探讨HPV在不同妊娠时期感染率及基因分型的差别。方法:利用DNA杂交导流技术检测180例妇女妊娠早、中、晚期宫颈分泌物中HPV的表达及基因分型,同时检测180例非妊娠期健康妇女的宫颈分泌物作为对照。结果:180例非妊娠期健康妇女的宫颈标本中,HPV感染率为13%(23/180)。检出高危基因型(HPV16/18/31/52/56型)16例;低危基因型(HPV6/11型)5例;常见亚型(HPV53)2例。在妊娠期妇女的标本中,早、中、晚孕期感染率分别为19%(34/180)、20%(36/180)及32%(58/180)。检出高危基因型(HPV16/18/31/33/52/58/68型)81例;低危基因型(HPV6/11/42型)43例;常见亚性(HPV53/66)4例。其中有多重型感染患者。结论:妊娠期HPV感染率明显高于非妊娠期健康妇女,且感染率随妊娠进展而逐渐上升,其中高危亚型尤为明显,需要引起临床重视。     

Prevalence of human papillomavirus in cervical swabs in the Okinawa Islands,Japan

Although human papillomavirus (HPV) is the main risk factor for invasive cervical cancer, the mechanisms of developing carcinoma are not entirely understood. In particular, the biology and natural history of HPV infection are still unknown. Therefore, we have investigated the incidence of human papillomavirus infection by polymerase chain reaction (PCR) in cervical swabs obtained from women who had cervical cancer screening in three separate areas of the islands of Okinawa. The prevalence of HPV in women aged between 30 and 85 years in the three local areas, Yonashiro-town, Naha-city, and Hirara-city, was consistent (9 to 10%). HPV of various oncogenic types, including HPV16, 18, 31, 33, 35, 35, and 58, were identified in HPV-positive swabs and the prevalence of these types varied in the three areas. Received: 21 August 2001 / Accepted: 18 November 2001 Correspondence to T. Maehama     

Clinical significance of serum human papillomavirus DNA in cervical carcinoma

OBJECTIVE: To study the association between serum human papillomavirus (HPV) deoxyribonucleic acid (DNA) and clinicopathologic prognostic factors and the clinical usefulness of serum HPV DNA in early-stage cervical cancer. METHODS: Deoxyribonucleic acids extracted from cervical tissues and sera of patients with stage IB or IIA cervical cancer and 40 controls including patients with cervical carcinoma in situ or benign disease were examined for HPV DNA with L1 consensus and types 16- and 18-specific E7 primers. Multivariable logistic regression was used to determine significant correlates of positive serum HPV DNA, and the receiver operating characteristic curve was applied in risk-factor assessment. RESULTS: Human papillomavirus DNA was not detected in sera from patients with carcinoma in situ or benign disease. Among the 112 patients with cervical cancer, we detected 27 positive samples (24.1%) in serum. Positive HPV DNA in serum was significantly associated with lymphovascular invasion and deep stromal invasion with or without parametrial extension (P <.001 for both conditions), pelvic lymph nodal metastasis (P =.001), large tumor size, and elevated levels of serum squamous cell carcinoma antigen (P <.001 for both conditions). When serum HPV DNA was used to predict high-risk patients who require adjuvant therapy, a sensitivity of 45.2%, a specificity of 88.6%, a positive predictive value of 70.4%, and a negative predictive value of 72.9% were obtained. CONCLUSION: The presence of serum HPV DNA in patients with early-stage cervical cancer was correlated with poor prognosis factors that warrant adjuvant therapy.     

Detection of human papillomavirus types 16, 18 and 33 in exfoliated cervical cells by polymerase chain reaction]

Human papillomavirus (HPV) types 16, 18 and 33 were identified by means of the polymerase chain reaction using exfoliated cells from the uterine cervix in 361 patients. Of 261 patients without cervical lesions, 10(3.8%) patients had HPV DNA whereas 7(70.0%) of 10 patients with invasive cervical carcinomas had HPV DNA. The younger patients' group (29 year-old or less) without cervical lesions had a 6.5% HPV positive rate which was distinctly higher than the older patients' groups. No menopausal patient without cervical lesions had HPV DNA. In the cervical dysplasia group, the HPV DNA positive rate tended to be higher in the older patients. Type 16 was detected more often than types 18 or 33. However, the detectable incidence of type 16 in the follow up group was lower than in the cervical carcinoma groups. The younger patients without cervical lesions had a higher incidence of type 16 than the older patients. The younger patients with cervical neoplastic lesions had a lower incidence of type 16 than the older patients. These results suggest that type 16 has a higher frequency of cervical HPV infections than types 18 and 33. In addition, human papillomavirus is not the only causative factor in cervical carcinomas.     

宫颈癌HPV预防性疫苗的研究进展

人乳头瘤病毒（HPV）感染是常见的性传播疾病之一。高危人乳头瘤病毒（hrHPV）持续感染是宫颈癌前病变及宫颈癌的主要危险因素。HPV16和HPV18型导致全球大约70%的宫颈癌。宫颈癌普查可减少宫颈癌发生的危险,但不能阻止HPV的感染。很多报道表明,有效的HPV疫苗可以减少HPV相关的宫颈癌、生殖道疣状物的发病率和死亡率。因此,为了有效预防这类疾病,全世界开展了HPV预防性疫苗的研究。目前临床应用的HPV疫苗有HPV 2价疫苗、4价疫苗及9价疫苗,它们可以有效预防相应HPV类型的感染,从而大量减少与此相关的宫颈病变及宫颈癌的发病率和死亡率。本文就HPV、宫颈癌及这3类HPV疫苗的免疫原性、接种剂量的数量和临床应用进行综述。     

阴道上皮内瘤变28例临床分析

目的: 探讨阴道上皮内瘤变(VAIN)的临床特点、危险因素、诊治及预后。方法: 回顾性分析北京协和医院2005-2011年住院收治VAIN病例28例临床资料。其中VAINⅡ7例,VAINⅢ21例。结果: 患者年龄29～76岁(中位年龄48岁)。绝经21例(75%)。26例(93%)无临床症状。25例(89%)病变位于阴道顶端。27例进行超薄液基细胞学涂片(TCT)检查异常。23例人乳头瘤病毒(HPV)检测阳性。15例有子宫切除术史,其中因宫颈上皮内瘤变(CIN)和宫颈癌切除子宫10例。子宫切除术后至诊断VAIN时间：宫颈疾病平均3.1年,非宫颈疾病8.8年。不同级别VAIN在年龄、子宫切除原因、目前及既往合并宫颈疾病、TCT结果差异无统计学意义。28例全部进行手术治疗,3例术后复发。结论: HPV病毒感染、宫颈病变、宫颈病变或宫颈癌行子宫切除术史是VAIN的危险因素;细胞学-阴道镜-组织病理学适用于VAIN的诊断及随诊;宫颈病变切除子宫治疗后应密切随访,尤其是术后3年内应警惕VAIN。　　     

Human papilloma virus (HPV) infection and its relationship with central intra-epithelial neoplasia (CIN)

HPV (Human papillomavirus) infection is strongly associated and is the main cause of cervical cancer. The main target for HPV viruses is the cervical transformation zone. In our work infection with HPV 18 and HPV 16 as also other types of viruses were investigated in 15 patients by taking biopsies. Before hand the patients were signalized by cytology as well as all of them were colposcopically examined. The samples were examined immunohistochemically in the laboratory at the Specialized Hospital for Active Treatment in Oncology. Nine out of 15 patients /60%/ were found positive for HPV-16, five /33%/ were found positive for HPV-18 and 1 /6.6%/ were infected with both HPV types. Our method is very sensitive and practical for determining at very high risk of developing HPV connected cervical cancer.     

高危型人乳头瘤病毒含量检测对宫颈上皮内瘤变筛查的意义#br#

目的探讨三代杂交捕获定量分型技术(DH3)检测人乳头瘤病毒(HPV)含量联合宫颈液基薄层细胞检测(TCT)对宫颈上皮内瘤变筛查的作用。方法选择2019年11月至2021年3月于广西医科大学第四附属医院、柳州市工人医院病理科同时进行DH3和TCT宫颈筛查的女性患者4013例,以病理学检查结果为金标准,对结果进行比较分析。结果在4013例患者中,DH3检测阳性1666例,阴性2347例;TCT阳性1066例,阴性者2947例;病理学检查阳性237例,阴性1431例。DH3定量检测中,HPV含量高于10的病例与病理学检查高级别鳞状上皮内瘤变相符,低级别鳞状上皮内病变诊断病例上稍有偏差,多数病例HPV含量处于临界值。结论HPV病毒含量检测联合TCT筛查宫颈癌可以降低单项检查的误诊率和漏诊率,定量检测有助于对误诊和漏诊病例进行重新审查,对宫颈上皮内瘤变分流和级别筛查具有较高的临床意义。     

IgG antibodies against human papillomavirus type 16 E7 proteins in cervicovaginal washing fluid from patients with cervical neoplasia

Abstract. Tjiong MY, ter Schegget J, Tjong-a-Hung SP, Out TA, van der Vange N, Burger MPM, Struyk L. IgG antibodies against human papillomavirus type 16 E7 proteins in cervicovaginal washing fluid from patients with cervical neoplasia.
Little information is available about the cervicovaginal mucosal antibodies against human papillomavirus (HPV) proteins. In this study specific IgG antibodies against HPV 16 E7 protein were determined in paired samples of cervicovaginal washing fluid and serum from patients with cervical cancer ( n = 22), cervical intraepithelial neoplasia (CIN) ( n = 38), healthy individuals ( n = 22), and serum from children ( n = 41) by a radioactive immunoprecipitation assay (RIPA). HPV 16 E7 specific IgG antibodies were found in cervicovaginal washings ( n = 8) and in sera ( n = 8) of the patients with cervical cancer. About 60% of the patients with HPV 16 positive cervical cancer had HPV 16 E7 specific IgG antibodies. Titration studies showed that the IgG antibody reactivity in cervicovaginal washings was higher than in the paired serum samples of six patients with cervical cancer ( P < 0.001). In the CIN group we found no IgG reactivity in the serum, but in five patients we found a low IgG reactivity in the cervicovaginal washings. No IgG reactivity was found in cervicovaginal washings and sera from healthy individuals and sera from children. HPV 16 E7 specific IgG antibodies seem to be locally produced in a number of patients with HPV 16 positive (pre)malignant cervical lesions. For more definitive evidence for the local production of these antibodies immunostaining should be performed to demonstrate the presence of specific anti-HPV 16 E7 IgG producing plasma cells in the cervical epithelium.     

ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. Number 61, April 2005. Human papillomavirus

More than 15 years ago, a relationship between human papillomavirus (HPV) infection and cervical cancer was recognized. Since then, important strides in understanding the virus have been made, particularly in the following areas: modes of transmission and risk factors associated with transmission; the oncogenic potential of specific viral types and the mechanism by which they cause cancer; and the spectrum of infection, ranging from asymptomatic carrier states to overt warts, preneoplastic lesions, and invasive cancer. Sophisticated new tests for the detection of HPV that hold great promise for improved screening for cervical cancer precursors and invasive cancer and for the triage of abnormal cervical cytology also have been developed. Understanding the immunology of HPV has allowed the development of new and more effective treatment modalities for HPV infection and the preliminary development of primary prevention modalities, including HPV vaccines.     

Human papillomavirus infection in the female population of Antwerp, Belgium: prevalence in healthy women, women with premalignant lesions and cervical cancer

Worldwide there is a strong relation between the presence of human papillomavirus (HPV) and the development of cervical cancer. This study investigated the prevalence and genotype of HPV in women with normal smears, women with premalignant lesions and women with cervical cancer in Antwerp, Belgium. Type-specific polymerase chain reaction (PCR) for HPV types 16 and 18 and general primer PCR (GP5+/6+) was performed on DNA extracted from paraffin-embedded tissue from women with lesions or fresh material from controls. HPV was detected in 11% of controls, 61% of women with atypia, 77% of women with CIN lesions and 88% of women with cervical carcinoma (chi2 trend, 273, p<0.001). The odds ratio for high-risk HPV types was 9.3 for atypia (95%CI. 4.3-19.8), 33.6 for CIN lesions (95%CI, 19.3-58.6) and 78.8 for cervical cancer (95%CI, 39.2-158.3). In total, 19 different HPV genotypes were detected, including five low risk HPV types. Seven of the 14 high-risk HPV types were detected in cervical cancer patients. Based on our study it is suggested that a prophylactic vaccine based on a cocktail of a limited number of high-risk HPV types should be considered in order to protect most women from developing cervical cancer.