人乳头瘤病毒基因分型检测在绝经后妇女HPV感染中的应用价值

目前筛查是预防和控制宫颈癌的主要手段.随着人乳头瘤病毒(HPV)-DNA检查的普及,年轻患者已逐步实现早期发现,早期治疗[1].本研究对绝经期妇女进行脱落细胞学及人乳头瘤病毒基因型别进行分析,探讨绝经期妇女HPV感染情况及与宫颈病变的相关性.     

人乳头瘤病毒基因型在宫颈细胞病变中的分布

目的探讨人乳头瘤病毒(HPV)感染在宫颈病变中的分布及其与宫颈病变之间的关系。方法用刷拭子法对1591例门诊就诊妇女采集宫颈细胞,用PCR-膜斑点杂交法进行HPV分型,薄层液基细胞学检查(TCT)观察宫颈细胞病理变化。结果在338例TCT检出宫颈病变的女性中,HPV和HR-HPV感染率分别高达68.64%和63.02%,HPV和HR-HPV感染率均随着宫颈病变级别递增而升高,差异有统计学意义(P<0.05)。除HPV51外,其它HR-HPV基因型和HPVCP8304在不同宫颈疾病组中具有极显著差异(P<0.01)。年龄≤40岁妇女HR-HPV和LR-HPV感染的机率显著高于年龄>40岁妇女(P<0.05);年龄>40岁妇女HPV感染罹患宫颈相关疾病的机会显著高于年龄≤40岁妇女(P<0.01)。结论 HR-HPV与宫颈病变关系密切,适龄妇女作HPV筛查对预防宫颈癌具有重要意义。     

人乳头瘤病毒感染对中老年妇女宫颈病变早期筛查的意义

目的通过人乳头瘤病毒(HPV)感染状况的检测,对中老年妇女宫颈病变患者进行早期筛查,为宫颈癌的防治提供理论依据。方法采用导流杂交技术对宫颈脱落细胞进行HPV感染状况检测,并对HPV阳性标本进行细胞病理学诊断分析。结果 2 260例宫颈脱落细胞中385例感染HPV,检测到6种高危型HPV(包括HPV16、18、58、52、31及33)和2种低危型HPV(包括HPV6及11),高危型以HPV16、18和58三型别感染为主,并且宫颈病变程度随HPV感染的阳性率增加而加重。结论高危型HPV感染可能是中老年妇女宫颈病变的主要病原因子。     

人乳头瘤病毒检测在宫颈癌前病变及宫颈癌筛查中的应用

目的探讨人乳头瘤病毒（HPV）检测在宫颈癌前病变及宫颈癌筛查中的应用价值。方法对363例患者进行薄层液基细胞学检查、人乳头瘤病毒检测及阴道镜检查。结果 363例标本中,HPV感染阳性191例,占52.6%。宫颈炎组HPV感染率为27.2%,宫颈上皮内瘤变（CIN）Ⅰ级为66.2%,CINⅡ级为71.0%,CINⅢ级为86.0%,宫颈癌组感染率为100%,HPV感染阳性率随宫颈病变程度加重而明显升高（P=0.000）。在191例感染者中,HPV的主要基因型依次为HPV-16、HPV-58、HPV-33、HPV-18、HPV-31和HPV-11。CIN组的多重感染率明显高于宫颈炎组（P=0.001）。结论 HPV感染及多重HPV感染与宫颈病变的严重程度密切相关,HPV检测在宫颈癌前病变及宫颈癌的筛查中有重要的临床价值。     

上海奉贤地区部分妇女宫颈HPV阳性感染特征分析

目的探讨上海奉贤地区部分妇女宫颈HPV感染特征。方法对在妇科门诊就诊,并自愿接受生殖系统HPV检查的7 569例妇女进行回顾性分析。结果 7 569例妇女中,HPV阳性1 391例,HPV感染率为18.38%,<25岁阳性率最高(22.3%)。高危型HPV感染率为15.27%(1 156/7 569例),低危型HPV感染率为1.80%(136/7 569),高危及低危合并感染1.31%(99/7 569)。结论奉贤地区HPV感染率较高,应制定出适合奉贤地区妇女HPV感染的规范划管理模式。     

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。     

宜昌地区HPV分型调查

目的:调查2011-01-01-2013-01-24三峡大学人民医院人乳头状瘤病毒(HPV)分型感染状况,分析HPV分型与诊断、年龄分布、单一与多重感染、患者孕产流及外伤等状况。方法:以我院LIS系统和病案室为资料来源,收集患者HPV分型感染、年龄分布、单一与多重感染、患者孕产流及外伤等资料。应用SPSS19.0分析不同年龄组、宫颈病变组间的分布差异。结果:宜昌地区妇女感染以HPV16为主(52.22%)。其次为HPV18、HPV52等;HPV感染总数在CINⅠ、CINⅡ、CINⅢ,宫颈癌Ⅰ、Ⅱ、Ⅲ期中差异有统计学意义(P0.01);40~49岁感染人数最多,为43例(47.78%);HPV感染阳性率在各年龄组间差异有统计学意义(P0.05);单一感染占77.78%,双重感染占18.89%,三重感染占3.33%;感染者中有3次孕史和1次生产史的最常见;43.9%的患者有外伤史,其中以结扎手术为主。结论:宜昌地区妇女HPV感染亚型以HPV16为主;HPV感染在病理程度、年龄中差异有统计学意义;感染者大多有多孕、多产和流产、外伤史。     

河南省宫颈病变人乳头瘤病毒感染分布及基因分型

目的 探讨河南省宫颈病变人乳头瘤病毒(HPV)感染分布及其基因分型.方法 采用核酸分子导流杂交法检测河南省肿瘤医院2009年3月至2010年10月2 273例就诊患者HPV DNA,并对其亚型感染分布情况进行比较.结果 2 273例女性患者共检出HPV阳性951例,阳性率为41.84%(951/2 273);HPV-16阳性率29.17%(663/2 273),感染类型在各年龄组间呈单峰分布,感染率与宫颈病变的危险度呈正比.结论 河南省HPV感染亚型主要是HPV 16型,高危型HPV感染率随着宫颈病变的级别增高呈上升趋势,在25～50岁间呈高感染率.     

安徽省阜阳地区人感染HPV的基因型分布调查北大核心CSCD

目的调查人感染人乳头瘤病毒(HPV)的基因型分布。方法2016年1月-2019年12月在本院妇科做宫颈癌筛查的患者2467例,采集棉试子标本,检测宫颈细胞中的23种HPV病毒,分析病毒基因型分布情况。结果2476例患者中HPV阳性545例,感染率22.09%。其中高危型感染392例(占71.93%),多重感染166例(占30.46%)。常见感染的6种基因型分别为HPV-52、HPV-16、HPV-58、HPV-18、HPV-61和HPV-66,且无论是在单一基因型感染还是多重HPV基因型感染中,HPV-52、HPV-16、HPV-58和HPV-18均是常见基因型;不同年龄组HPV感染人群中,中年组(39~58岁)HPV感染率显著高于其他年龄组(P<0.05,但不同HPV基因型感染的年龄分布差异无统计学意义(P>0.05)。结论HPV的流行和分布存在地域差异,本地区以HPV-16、52、58、18为常见基因型。     

粤西地区50314例成年女性HPV感染状况调查

目的 探讨粤西地区成年女性人乳头状瘤病毒(human papillomavirus, HPV)感染情况及其与宫颈鳞状上皮病变的关系。方法 选择2014年1月-2020年10月在广东医科大学附属医院妇科门诊接受HPV筛查的50 314例成年女性为对象,采用凯普HPV分型检测试剂盒(PCR+膜杂交法)进行HPV分型检测,其中的14454例作宫颈脱落细胞液基细胞学(thinprep cytologic test, TCT)检查。采用SPSS软件对HPV感染率及亚型占比、感染者的年龄分布、不同亚型HPV感染与宫颈病变程度的关系等进行统计学分析。结果 PCR检测宫颈癌筛查患者HPV感染率为19.67%(9897/50314)。按年龄分组计算的HPV感染率呈“V”型分布,≤25岁(28.86%,732/2536)和>65岁组患者感染率较高(30.62%,218/712),36～45岁感染率较低(17.65%,3253/18428),各年龄组患者间感染率差异具有统计学意义(χ²=363.89,P<0.01)。检出的HPV分为21种亚型,高危型HPV感染率居前5位的是...     

Multiple Human Papilloma Virus (HPV) Infections Are Associated with HSIL and Persistent HPV Infection Status in Korean Patients

Infections with multiple human papilloma virus (HPV) types have been reported, but their role in cervical carcinogenesis has not been fully elucidated. In this study, 236 cases with multiple HPV infection were examined and compared to 180 cases with single HPV infection. HPV genotyping was performed with cervico-vaginal swab specimens using multiplex (real-time) polymerase chain reaction (PCR). In multiple HPV infection, the most prevalent HPV genotype was HPV 53, followed by HPV 16, 58, 52, and 68. HPV 33, 35, 39, 51, 52, 53, 58, and 68 were high-risk-HPV (HR-HPV) genotypes that were more frequently detected in multiple HPV infection compared to that in single HPV infection. The association between multiple HPV infection and high-grade SIL (HSIL) was significantly stronger compared to that of single HPV infection and HSIL (p = 0.002). Patients with multiple HPV infection displayed persistent and longer duration of the HPV infection compared to patients with single HPV infection. Multiple HPV infections have distinct clinicopathologic characteristics. Since it is associated with persistent HPV infection, HSIL, and different HR-HPV strains in contrast to single HPV infection, the presence of multiple HPV infection should be reported; close follow up is warranted.     

Circulation of human papillomavirus (HPV) genotypes in women from Córdoba, Argentina, with squamous intraepithelial lesions

Human papillomavirus (HPV) can induce a wide spectrum of squamous intraepithelial lesions (SIL) of varying severity. The aim of the present study was to establish the frequency of HPV infection and identify the genotypes circulating in women from Córdoba, Argentina, in relation to age and cytology. A total of 186 women, between 18 and 65 years old, with antecedents of SIL, underwent a pelvic examination and had cervical cells collected for cytology and HPV DNA detection. Ninety-six samples (51.6%) were positive for HPV detection, and sixty-three (65.6%) of them showed the presence of at least one HR-HPV. Low- and high-grade SIL showed significant association in patients younger than 35 years of age. We found 18 different genotypes, with a greater presence of HR-HPV. Genotypes 16 and 6 were the most frequent. Seven (7.3%) multiple infections, 85.7% of which had at least one HR-HPV, were detected. The detection of a large number of different HPV genotypes is a warning sign. It is thus necessary to strengthen the monitoring of the circulation of high-risk genotypes, currently less prevalent in intraepithelial lesions, as a control measure for the possible impact of the implementation of vaccines against genotypes 16 and 18.     

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.     

Hybrid capture as a tool for cervical lesions screening in HIV-infected women: insights from a Brazilian cohort

Introduction

Cervical cancer remains an important burden for HIV-infected women in the era of combination antiretroviral therapy. Recommendations for cervical screening in these women diverge and may include high-risk HPV (HRHPV) testing. We aimed to evaluate the clinical usefulness of a single HRHPV testing for cervical screening of HIV-infected women.

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.     

High risk of human papillomavirus type 16 infections and of development of cervical squamous intraepithelial lesions in systemic lupus erythematosus patients

OBJECTIVE: To determine rates of human papillomavirus (HPV) infections, abnormal cervical smears, and squamous intraepithelial lesions (SIL) among women with systemic lupus erythematosus (SLE). METHODS: We investigated 30 women with SLE, 67 with abnormal smears from colposcopy clinics, and 15 community subjects with normal smears. Polymerase chain reaction results for viral DNA and HPV-16 sequencing data were correlated to cytology and colposcopic findings. RESULTS: SLE and colposcopy patients were more likely (P < 0.05) to be HPV positive (15 [54%] and 37 [67%] patients, respectively) and HPV-16 DNA positive (16 [57%] and 17 [31%] patients, respectively) than community subjects (0% HPV DNA positive and 1 [6%] HPV-16 DNA positive). SLE patients were also more likely to be HPV-16 DNA positive than colposcopy patients (P < 0.05). SLE patients with a high HPV-16 viral load more frequently had SIL (n = 6) than those with a low HPV-16 viral load (n = 1; P < 0.05). HPV and HPV-16 DNA positivity were not associated with previous or current drug therapy for SLE patients. All HPV-16 DNA sequences from 6 SLE and 5 colposcopy patients were the European-type variant. Eighteen (60%) SLE patients had a previous or current cervical abnormality. At the time of study, 5 (17%) SLE patients had an abnormal cervical smear and 8 (27%) had SIL. For those diagnosed with SLE for >10 years, the rate of SIL was 44% lower than those with SLE for <5 years (odds ratio 0.56, 95% confidence interval 0.1-3.5). CONCLUSION: UK women with a recent SLE diagnosis had disturbingly elevated levels of HPV infections (particularly with European HPV-16 variants at a high viral load), abnormal cervical cytology, and SIL.     

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。     

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。     

Screening for human papillomavirus,cervical cytological abnormalities and associated risk factors in HIV‐positive and HIV‐negative women in Rwanda

Objectives

Cervical cancer is the major cause of death from cancer in Africa. We wanted to assess the prevalence of human papillomavirus (HPV) infections and associated risk factors and to determine whether HPV testing could serve as a screening method for squamous intraepithelial lesions (SILs) in Rwanda. We also wanted to obtain a broader understanding of the underlying risk factors for the establishment of HPV infection in Rwanda.

Methods

A total of 206 HIV‐positive women, 172 HIV‐negative women and 22 women with unknown HIV status were recruited at the University Teaching Hospitals of Kigali (UTHK) and of Butare (UTHB) in Rwanda. Participants underwent an interview, cervical sampling for a Thinprep Pap test and a screening test analysing 37 HPV strains.

Results

Only 27% of HIV‐positive women and 7% of HIV‐negative women had been screened for cervical cancer before. HPV16 and HPV52 were the most common HPV strains. HIV‐positive women were more commonly infected with high‐risk (HR) HPV and multitype HPV than HIV‐negative women. The sensitivity was 78% and the specificity 87% to detect high‐grade SIL (HSIL) with HPV screening. Among HIV‐negative women, being divorced was positively associated with HR‐HPV infection, while hepatitis B, Trichomonas vaginalis infection and HR‐HPV infection were factors positively associated with SILs. Ever having had gonorrhoea was positively associated with HR‐HPV infection among HIV‐positive women. HR‐HPV infection and the number of live births were positively associated with SILs.

Conclusions

The currently used quadrivalent vaccine may be insufficient to give satisfactory HPV coverage in Rwanda. HPV Screening may be effective to identify women at risk of developing cervical cancer, particularly if provided to high‐risk patients.