人乳头瘤病毒(HPV)16/18基因分型是在宫颈癌的初次hrHPV筛查中对高危(hr)HPV阳性女性进行分诊的有效方法。本研究旨在评估与其他hrHPV类型共感染是否会影响HPV16/18阳性女性宫颈癌发生的风险。
中国共有313,704名年龄≥30岁的女性进行了筛查。其中,4,933名HPV16/18阳性参与者接受阴道镜引导活检。使用CobasHPV基因分型系统鉴定HPV基因型。使用多项逻辑回归对不同的HPV16/18感染模式进行建模。
hrHPV和HPV16/18的总患病率分别为7.85%(24,456/311,382)和1.95%(6,086/311,382)。在HPV16/18阳性个体中,33.24%(2,023/6,086)与多种类型共感染。在4933名接受阴道镜检查的女性中,他们的HPV16/18感染模式如下:52.38%(2,584/4,933)仅HVP16,23.54%(1,161/4,933)HPV16+其他hrHPV,14.98%(739/4,933)仅HPV18,6.83%(337/4,933)HPV18+其他hrHPV,1.13%(56/4,933)HPV16+18,1.13%(56/4,933)HPV16+18+其他hrHPV。在调整辅因子后,与单一HPV16感染相比,在HPV16+其他hrHPV组中,发生宫颈上皮内瘤变(CIN)3级或以上(CIN3+)的风险显著较低(比值比[OR]=0.637,95%置信区间[CI]=0.493~0.822).
HPV16/18与其他hrHPV共感染是一种常见现象。不同HPV16/18感染模式可能影响宫颈癌发生的风险。在≥30岁的女性中,与其他hrHPV共感染的HPV16似乎具有较低的CIN3+相关风险。
Human papillomavirus (HPV) 16/18 genotyping is an effective method for triage of high-risk (hr) HPV-positive women in primary hrHPV screening for cervical cancer. The present
study aimed to evaluate whether co-infected with other hrHPV types will affect the risk of cervical carcinogenesis in
HPV16/18 positive women.
A total of 313,704 women aged ≥30 years were screened in China. Among them, 4,933
HPV16/18-positive participants underwent colposcopy-directed biopsy. The HPV genotypes were identified using the Cobas HPV genotyping system. Multinomial logistic regression was used to model different HPV16/18 infection patterns.
The overall prevalence rates of hrHPV and HPV16/18 were 7.85% (24,456/311,382) and 1.95% (6,086/311,382) respectively. Among HPV16/18 positive individuals, 33.24% (2,023/6,086) were co-infection with multiple types. Of the 4933 women who underwent colposcopy, their HPV16/18 infection patterns were as follows: 52.38% (2,584/4,933) HVP16 only, 23.54% (1,161/4,933) HPV16 + other hrHPVs, 14.98% (739/4,933) HPV18 only, 6.83% (337/4,933) HPV18 + other hrHPVs, 1.13% (56/4,933)
HPV16 + 18, 1.13% (56/4,933)
HPV16 + 18+other hrHPVs. After adjusting for cofactors, compared with single HPV16 infection, the risk of developing cervical intraepithelial neoplasia (CIN) grade 3 or greater (CIN3+) was significantly lower in HPV16 + other hrHPVs group (odds ratio [OR] = 0.637, 95% confidence interval [CI] = 0.493-0.822).
HPV16/18 co-infection with other hrHPVs is a common phenomenon. Different HPV16/18 infection patterns may influence the risk of cervical carcinogenesis. HPV16 co-infected with other hrHPVs appears to have a lower associated risk of CIN3+ in ≥30 years old women.