持续的人乳头瘤病毒(HPV)感染是宫颈癌发生发展的关键因素。我们试图通过宫颈细胞学检查确定类型特异性HPV患病率,并根据韩国高危持续性HPV感染评估疾病进展风险。
通过巴氏检查结果调查HPV患病率,截至2019年7月17日,我们检索了7个没有任何语言或日期限制的文献数据库.通过HPV类型评估疾病进展的风险,我们使用了韩国HPV队列研究数据.搜索内容包括“HPV”和“基因型”和“韩国”。“对韩国女性的研究,通过细胞学发现的类型特异性HPV分布,并包括检测试验的详细方法学描述。我们评估了686名HPV阳性女性的疾病进展风险,这些女性具有不确定意义的非典型鳞状细胞或来自韩国HPV队列研究的低度鳞状上皮内病变,这些女性与非单价疫苗相关的高危HPV类型和相关的持续性感染。类型特异性HPV患病率是在系统评价中检测该基因型的所有HPV阳性女性中特定HPV基因型阳性的女性比例。
我们纳入了23项研究。HPV-16是最普遍的,其次是HPV-58、-53、-70、-18和-68。在高度鳞状上皮内病变的女性中,包括癌症,HPV-16、-18和-58是最普遍的。在纵向队列研究中,在患有持续性HPV-58(风险增加:3.54~5.84)和HPV-16(2.64~5.04)感染的人群中,从意义不明确的非典型鳞状细胞到高度鳞状上皮内病变的疾病进展的校正风险比显著较高.
虽然HPV-16是最普遍的,HPV-16/58持续感染增加了疾病进展为高度鳞状上皮内病变的风险.因此,在韩国,HPV-16和-58的持续感染是宫颈疾病进展的关键危险因素.我们的结果表明,应同等关注HPV-58和-16感染,并为协助规划韩国国家免疫计划提供重要证据。
Persistent human papillomavirus (HPV) infection is a key factor for the development and progression of cervical cancer. We sought to identify the type-specific HPV prevalence by cervical cytology and assess disease progression risk based on high-risk persistent HPV infection in South Korea.
To investigate the HPV prevalence by Pap results, we searched seven literature databases without any language or date restrictions until July 17, 2019. To estimate the risk of disease progression by HPV type, we used the Korea HPV Cohort study data. The search included the terms \"HPV\" and \"Genotype\" and \"Korea.\" Studies on Korean women, type-specific HPV distribution by cytological findings, and detailed methodological description of the detection assay were included. We assessed the risk of disease progression according to the high-risk HPV type related to the nonavalent vaccine and associated persistent infections in 686 HPV-positive women with atypical squamous cells of uncertain significance or low-grade squamous intraepithelial lesions from the Korea HPV Cohort Study. Type-specific HPV prevalence was the proportion of women positive for a specific HPV genotype among all HPV-positive women tested for that genotype in the systematic
review.
We included 23 studies in our
review. HPV-16 was the most prevalent, followed by HPV-58, -53, -70, -18, and -68. In women with high-grade squamous intraepithelial lesions, including cancer, HPV-16, -18, and -58 were the most prevalent. In the longitudinal cohort study, the adjusted hazard ratio of disease progression from atypical squamous cells of uncertain significance to high-grade squamous intraepithelial lesions was significantly higher among those with persistent HPV-58 (increase in risk: 3.54-5.84) and HPV-16 (2.64-5.04) infections.
While HPV-16 was the most prevalent, persistent infections of HPV-16/58 increased the risk of disease progression to high-grade squamous intraepithelial lesions. Therefore, persistent infections of HPV-16 and -58 are critical risk factors for cervical disease progression in Korea. Our results suggest that equal attention should be paid to HPV-58 and -16 infections and provide important evidence to assist in planning the National Immunization Program in Korea.