背景:陇南地区宫颈癌的死亡率高达39/10万,在中国排名第一。
方法:在2012年至2016年之间,有329例宫颈炎症,宫颈上皮内瘤变1至3级(CINI至III),收集浸润性鳞状细胞癌(SCC)。用23种不同HPV亚型的验证试剂盒检查HPV基因型。
结果:与宫颈炎相比,在CINI中,HPV阳性显著较高,CINII/III,和SCC(38.60%,74.60%,87.50%和89.05%,P<0.001),SCC的阳性率也高于CINI(P<0.01)。最常检测到的基因型是宫颈炎中的HPV16,CI和CINII/III中的HPV16、58和52,SCC组HPV16、58和18。宫颈炎症中HPV16阳性,CINI,CINII/III,SCC患者占45.46%,46.81%,60.32%和78.69%,分别。与宫颈炎和CINI相比,HPV16阳性患者SCC的比值比(OR)为2.96(95%置信区间[CI]:1.09-8.00,P<0.05)和4.20(95%置信区间[CI]:2.05-8.61,P<0.001),分别。此外,宫颈炎的多重感染,CINI,CINII/III和SCC组为9.09%,27.66%,26.98%和25.41%,HPV16+58是最常见的组合。
结论:这些发现强调了HPV16、58、52和18在陇南妇女CIN和SCC发展中的关键作用,充分意识到HPV基因型分布的区域差异是宫颈癌控制和预防的任务。
BACKGROUND: The mortality of cervical cancer in Longnan is as high as 39/10 million, ranking first in
China.
METHODS: Between 2012 to 2016, 329 samples with cervicitis, cervical intraepithelial neoplasia grade 1 to 3 (CINI to III), and invasive squamous cell carcinoma (SCC) were collected. HPV genotypes were examined with a validated kit for 23 different HPV subtypes.
RESULTS: Compared to cervicitis, the HPV positivity is significantly higher in CINI, CIN II/III, and SCC (38.60%, 74.60%, 87.50% and 89.05%, P < 0.001) and the positivity is also higher in SCC compared to CINI (P < 0.01). The most frequently detected genotypes were HPV16 in cervicitis, HPV16, 58 and 52 in CINI and CIN II/III, and HPV16, 58 and 18 in SCC groups. HPV16 positivity in cervicitis, CINI, CIN II/III, and SCC patients were 45.46%, 46.81%, 60.32% and 78.69%, respectively. Compared to cervicitis and CINI, the odds ratios (OR) for SCC in HPV16 positive patients were 2.96 (95% confidence interval [CI]: 1.09-8.00, P < 0.05) and 4.20 (95% confidence interval [CI]: 2.05-8.61, P < 0.001), respectively. In addition, the multiple infections in cervicitis, CINI, CINII/III and SCC group are 9.09%, 27.66%, 26.98% and 25.41% and HPV16 + 58 was the most common combinations.
CONCLUSIONS: These findings highlight the key role of HPV16, 58, 52 and 18 in the development of CIN and SCC in Longnan women and a fully aware of regional differences in HPV genotype distribution are tasks for cervical cancer control and prevention.