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Kong L, Xiao X, Xu T, Wan R, Chen F. Immediate histologic correlation in patients with different HPV genotypes and ages: a single center analysis in China. BMC Cancer 2023; 23:1211. [PMID: 38066444 PMCID: PMC10704629 DOI: 10.1186/s12885-023-11697-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) has been confirmed as a major causative factor for malignant transformation of cervical epithelial cells and for the development of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer. We carried out this study to investigate the association of different HPV genotypes and ages with immediate histological cervical lesions in opportunistic screening patients in a single center. METHODS A total of 1,661 samples with biopsy-confirmed histologic findings were collected from the gynecological clinic of our hospital between October 2017 and May 2020 for analysis. The distribution of single-type HPV genotypes in CIN of different severities and the age-dependent prevalence for single-type HPV infection were analyzed. RESULTS In both CIN2 and CIN3 group, HPV16, 58, 52, 33 and 31/18 were detected as top 5 high-risk human papillomavirus (hrHPV) types, which accounts for 89.25% and 88.54% of single HPV infection incidence respectively. Besides, not a single case of HPV45 was found in CIN2 and CIN3. HPV16 was the dominant genotype in both CIN2 and CIN3, accounted for 46.24% and 55.21%, respectively. The prevalence of HPV16 was the most frequent in all the age groups, except ≥ 65 years group in CIN3, and almost one in three HPV16-positive patients were diagnosed with high grade CIN. The peak of the incidence of CIN3 was observed at 25 ~ 34 years (33.68%), followed by 35 ~ 44 years (31.58%). CONCLUSION High grade CIN peak at 25 ~ 44 years, women of this age are recommended for normative screening if conditions permit. HPV16-positive patients should be given high priority in opportunistic screening, while the single-center data suggesting a low risk of CIN2/3 in HPV45-positive patients. For women ≥ 65 years old, patients infected with other HPV types should be also taken seriously. In general, HPV16, 58, 52, 33, 31 and 18 were the most common genotypes in CIN2/3, and a vaccine including these predominant genotypes might be of great significance for cervical cancer prevention in China.
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Affiliation(s)
- Linghua Kong
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, National Clinical Research Center for Obstetric & Gynecologic Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoping Xiao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, National Clinical Research Center for Obstetric & Gynecologic Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tao Xu
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ru Wan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, National Clinical Research Center for Obstetric & Gynecologic Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fei Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, National Clinical Research Center for Obstetric & Gynecologic Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Xie H, Rao X, Li J, Yao L, Ji Y, Zhang J, Wang H, Wang X, Li X. Diagnostic accuracy of extended HPV DNA genotyping and its application for risk-based cervical cancer screening strategy. Clin Chem Lab Med 2023; 61:2229-2236. [PMID: 37441737 DOI: 10.1515/cclm-2023-0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES To evaluate the consistency of 14 high-risk HPVs (hr-HPVs) detection between extended HPV DNA genotyping and a well-validated partial HPV genotyping kit, and to explore the diagnostic accuracy of risk stratification strategy based on extended HPV genotyping for cervical cancer (CC) screening. METHODS Baseline data from a clinical trial of recombinant HPV 9-valent vaccine in China was analyzed. All enrolled women aged 20-45 years received cervical cytology, HPV detection by extended and partial HPV genotyping kits. Those who met the indications would further receive colposcopy. The primary endpoints were cervical intraepithelial neoplasia 2/3 or worse (CIN2+/CIN3+). RESULTS A total of 8,000 women were enrolled between April 2020 and July 2020 and 83/33 cases were diagnosed as CIN2+/CIN3+. The overall agreement between the extended and partial HPV genotyping was 92.66 %. And the agreement further increased with the progression of lesions, which lead to similarly high sensitivity and negative predictive value of these kits. A stratified triage strategy of CC screening was constructed based on the immediate CIN2+/CIN3+ risk of specific HPV. Compared with the conventional HPV primary CC screening strategy, the risk-based strategy had higher specificity for CIN (CIN2+: 94.84 vs. 92.46 %, CIN3+: 96.05 vs. 91.92 %), and needed fewer colposcopies for detecting one cervical disease. CONCLUSIONS Extended HPV genotyping had good agreement with a well-validated partial HPV genotyping CC primary screening kit in hr-HPV detection. Extended HPV genotyping could facilitate risk-based stratified management strategy and improve the diagnostic accuracy of primary CC screening.
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Affiliation(s)
- Hongyu Xie
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Hangzhou, P.R. China
- Clinical Research Center, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Xuan Rao
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Hangzhou, P.R. China
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Junyan Li
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang, P.R. China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, Zhejiang, P.R. China
- Department of Gynecology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, P.R. China
| | - Lifang Yao
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang, P.R. China
- Department of Obstetrics and Gynecology, Shaoxing Maternal and Child Health Hospital, Shaoxing, Zhejiang, P.R. China
| | - Ying Ji
- Bovax Biotechnology Co., Ltd., Shanghai, P.R. China
| | - Juan Zhang
- Bovax Biotechnology Co., Ltd., Shanghai, P.R. China
| | - Hui Wang
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Hangzhou, P.R. China
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang, P.R. China
- Cancer Research Institute of Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Xinyu Wang
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang, P.R. China
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, P.R. China
| | - Xiao Li
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Hangzhou, P.R. China
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang, P.R. China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, Zhejiang, P.R. China
- Cancer Research Institute of Zhejiang University, Hangzhou, Zhejiang, P.R. China
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Fazlollahpour-Naghibi A, Bagheri K, Almukhtar M, Taha SR, Zadeh MS, Moghadam KB, Tadi MJ, Rouholamin S, Razavi M, Sepidarkish M, Rostami A. Trichomonas vaginalis infection and risk of cervical neoplasia: A systematic review and meta-analysis. PLoS One 2023; 18:e0288443. [PMID: 37437068 DOI: 10.1371/journal.pone.0288443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES The evidence in the literature regarding the relationship between Trichomonas vaginalis (TV) infection and cervical neoplasia is conflicting. The main aim of this study was to evaluate the magnitude of the risk of cervical neoplasia associated with TV infection. METHODS A meta-analysis of observational studies, which provided raw data on the association of TV infection with cervical neoplasia, was performed. For this aim, we searched scientific databases (PubMed/Medline, Scopus, the Web of Sciences, and Embase) from inception to March 15, 2023. A random-effects model was applied by Stata 17.0 to calculate the pooled and adjusted odds ratios (ORs) with 95% confidence intervals (CI), including subgroup, sensitivity, and cumulative analyses to explore sources of heterogeneity. RESULTS Of the 2584 records initially identified, 35 eligible studies contributed data for 67,856 women with cervical neoplasia, and 933,697 healthy controls from 14 countries were included. The pooled (2.15; 1.61-2.87; I2 = 87.7%) and adjusted (2.17; 1.82-2.60; I2 = 31.27%) ORs indicated a significant positive association between TV infection and the development of cervical neoplasia. There was no significant change in pooled and adjusted ORs by applying sensitivity and cumulative analyses, indicating the robustness of our findings. The pooled OR was significant in most sub-group analyses. There was no publication bias in the included studies. CONCLUSION Our findings indicated that women with a TV infection are at significantly greater risk of cervical neoplasia. Future research, particularly longitudinal and experimental studies, should be done to better understand the various aspects of this association.
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Affiliation(s)
- Andarz Fazlollahpour-Naghibi
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Kimia Bagheri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Seyed Reza Taha
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Kimia Behzad Moghadam
- Independent Researcher, Former University of California, San Francisco (UCSF), San Francisco, CA, United States of America
| | - Mehrdad Jafari Tadi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Safoura Rouholamin
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Razavi
- Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Lin X, Chen L, Zheng Y, Yan F, Li J, Zhang J, Yang H. Age-specific prevalence and genotype distribution of human papillomavirus in women from Northwest China. Cancer Med 2022; 11:4366-4373. [PMID: 35365956 DOI: 10.1002/cam4.4732] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/26/2022] [Accepted: 03/21/2022] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is the leading cause of cervical cancer with more than 200 genotypes. Different genotypes have different potentials in causing premalignant lesions and cervical cancers. In this study, we investigated the age-specific prevalence and genotype distribution of HPV genotypes in Northwest China. MATERIALS AND METHODS We recruited 145,918 unvaccinated women from Northwest China for population-based HPV DNA screening test during June 2015 to December 2020. And a lab-based test was performed for each volunteer by flow fluorescent technology to identify the genotypes of HPV. RESULTS The overall infection rate of HPV was 22.97%. With the participants divided into 12 groups according to age, a bimodal curve of infection rate was obtained. And the two peaks appeared in the younger than 20 group and 61-65 group, respectively. The five most common HPV genotypes included HPV 16, 58, 52, 53 and 61 in all participants, which were in descending order of frequency. Among women younger than 25 years old, HPV 6 and 11 were more common and even higher than some genotypes mentioned above. Among women older than 65 years old, HPV 18 and 66 were more common than or as high as the six most common genotypes in all populations. Additionally, the distribution of single and multiple infections in each age group was also different. CONCLUSION The baseline prevalence and genotype distribution of HPV in Northwest China was uncovered for the first time. Age was related to the epidemiology of different HPV genotypes. All the results would be of great significance for future healthcare services.
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Affiliation(s)
- Xiaohong Lin
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Liu Chen
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Yunyun Zheng
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Feng Yan
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Jia Li
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Jianfang Zhang
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Hong Yang
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
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Tang SY, Liao YQ, Hu Y, Shen HY, Wan YP, Wu YM. HPV Prevalence and Genotype Distribution Among Women From Hengyang District of Hunan Province, China. Front Public Health 2021; 9:710209. [PMID: 34805062 PMCID: PMC8602211 DOI: 10.3389/fpubh.2021.710209] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Most cervical cancers were closely associated with human papillomavirus (HPV) infections. Therefore, understanding the ecological diversity of HPV prevalence and genotype distribution among various populations in different geographical regions was essential for optimizing HPV vaccination and maximizing the vaccination effects. A total of 12,053 patient data from the three-level hospitals in Hengyang city were retrospectively analyzed. In this study, the HPV prevalence was 10.16% overall, and the multiple-type infection rate was 1.83%. The HR-HPV infection rate was 8.52%. The top six HPV genotypes were as follows in descending order: HPV16, HPV58, HPV52, HPV39, HPV51, and HPV53. The HPV prevalence in the group above 60 years old was the most, and their HR-HPV infection rate corresponded to the most too. The infection rates of HPV and HR-HPV among outpatients were both lower than those among the hospitalized-patients, respectively. Among the hospitalized-patients, the infection rates of HPV and HR-HPV among the 50–60 years group were the most in both. The HR-HPV ratio-in-positive among HPV-positive patients with the histopathologic examination was higher than that among those patients without. Among 52 HPV-positive patients with cervical squamous carcinoma, the ratio-in-positive of HPV16 was 61.54%. This study demonstrated that the HPV prevalence varied with age among women from Hengyang district of Hunan province in China and showed that HPV16, HPV58, HPV52, HPV39, HPV51, and HPV53 genotypes were more popularly distributed in this region, which could provide the experimental basis for Chinese public health measures on cervical cancer prevention.
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Affiliation(s)
- Shuang-Yang Tang
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Ya-Qi Liao
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Yu Hu
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Hai-Yan Shen
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Yan-Ping Wan
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Yi-Mou Wu
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
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Wang Y, Cai YB, James W, Zhou JL, Rezhake R, Zhang Q. Human papillomavirus distribution and cervical cancer epidemiological characteristics in rural population of Xinjiang, China. Chin Med J (Engl) 2021; 134:1838-1844. [PMID: 34267066 PMCID: PMC8367023 DOI: 10.1097/cm9.0000000000001441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cervical cancer remains a major public health issue for the Uyghur women and other women living mainly in rural areas of Xinjiang. This study aims to investigate the distribution of human papillomavirus (HPV) infection and cervical cancer in rural areas of Xinjiang, China. METHODS Cervical cancer screening was performed on rural women aged 35 to 64 years from Xinjiang, China in 2017 through gynecological examination, vaginal discharge smear microscopy, cytology, and HPV testing. If necessary, colposcopy and biopsy were performed on women with suspicious or abnormal screening results. RESULTS Of the 216,754 women screened, 15,518 received HPV testing. The HPV-positive rate was 6.75% (1047/15,518). Compared with the age 35-44 years group, the odds ratios (ORs) of HPV positivity in the age 45-54 years and 55-64 years groups were 1.18 (95% confidence interval [CI]: 1.02-1.37) and 1.84 (95% CI: 1.53-2.21), respectively. Compared with women with primary or lower education level, the ORs for HPV infection rates of women with high school and college education or above were 1.37 (95% CI: 1.09-1.72) and 1.62 (95% CI: 1.23-2.12), respectively. Uyghur women were less likely to have HPV infection than Han women, with an OR (95% CI) of 0.78 (0.61-0.99). The most prevalent HPV types among Xinjiang women were HPV 16 (24.00%), HPV 33 (12.70%), and HPV 52 (11.80%). The detection rate of cervical intraepithelial neoplasia (CIN)2+ was 0.14% and the early diagnosis rate of cervical cancer was 85.91%. The detection rates of vaginitis and cervicitis were 19.28% and 21.32%, respectively. CONCLUSIONS The HPV infection rate in Xinjiang is low, but the detection rate of cervical cancer and precancerous lesions is higher than the national average level. Cervical cancer is a prominent public health problem in Xinjiang, especially in southern Xinjiang.
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Affiliation(s)
- Yan Wang
- Affiliated Tumor Hospital of Xinjiang Medical University, Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, Xinjiang 830011, China
| | - Ying-Bin Cai
- Department of Gastroenterology, the Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
| | - William James
- Biological Sciences Collegiate Division, University of Chicago, Chicago, IL 60637, USA
| | - Jian-Lin Zhou
- Health and Family Planning Commission of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830011, China
| | - Remila Rezhake
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Qian Zhang
- Affiliated Tumor Hospital of Xinjiang Medical University, Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, Xinjiang 830011, China
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Mai Q, Yang X, Cheng H, Wu G, Wu Z. Prevalence and genotype distribution of human papillomavirus among women with cervical lesions in Shenzhen city, China. Hum Vaccin Immunother 2020; 17:965-971. [PMID: 32961080 DOI: 10.1080/21645515.2020.1805993] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
There is currently a lack of sufficient data on human papillomavirus (HPV)-attributable cervical carcinoma in China. Accordingly, we aimed to determine the prevalence and genotype distribution of HPV among women with cervical lesions in Shenzhen, in order to evaluate the potential benefit of HPV vaccination programs and inform cervical cancer control policies. We enrolled 5,255 patients who were admitted to the University of Chinese Academy of Sciences Shenzhen Hospital from January 2017 to December 2019. The HPV prevalence and genotype distribution were analyzed using the 21 HPV GenoArray diagnostic assay. A total of 937/5,255 patients showed HPV-positivity (prevalence rate 17.83%), of whom 85.81% (804/937) had high-risk HPV infection. HPV52 was the most prevalent genotype (4.72%, 248/5,255), followed by HPV58 (3.04%, 160/5,255), and HPV16 (2.72%, 143/5,255). The HPV prevalence rates among women with a normal cervix, low-grade intraepithelial lesions, high-grade intraepithelial lesions, invasive cervical cancer, and other characteristics were 15.63% (50/320), 58.65% (61/104), 80.00% (44/55), 88.57% (31/35), and 15.84% (751/4,741), respectively. HPV16, HPV18, and HPV52 accounted for the majority of cervical lesions, and the infection rates of HPV16 and HPV18 gradually increased with intraepithelial lesion progression (both P < .001). Our study found that HPV16, HPV52, and HPV18 played important roles in the occurrence and development of cervical lesions. This finding has the potential to guide the formulation of HPV screening and vaccination programs and preventive strategies for HPV-attributable cancer in this region.
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Affiliation(s)
- Qingfeng Mai
- Department of Clinical Laboratory, University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, People's Republic of China
| | - Xiaohan Yang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Huan Cheng
- Department of Clinical Laboratory, University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, People's Republic of China
| | - Genghang Wu
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Zikun Wu
- Department of Clinical Laboratory, University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, People's Republic of China
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Association between Trichomonas vaginalis infection and cervical lesions: a population-based, nested case-control study in Taiwan. Parasitol Res 2020; 119:2649-2657. [PMID: 32583161 DOI: 10.1007/s00436-020-06759-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/04/2020] [Indexed: 10/24/2022]
Abstract
Trichomonas vaginalis is the most common nonviral sexually transmitted infection. According to the 2019 WHO cancer report, cervical cancer is the fourth most frequent cancer in women. However, previous research, which has not included a large-scale study to date, has revealed that Trichomonas vaginalis increases cervical cancer risk. In this study, we investigated a group of Asian females in Taiwan to determine the association between trichomoniasis and the risk of developing cervical lesions, including cancer, neoplasm, and dysplasia. We conducted a nested case-control study by using the National Health Insurance (NHI) program database in Taiwan. The International Classification of Diseases, 9th Revision classifications (ICD-9-CM) was used to categorize all of the medical conditions for each patient in the case and control groups. The adjusted odds ratio (AOR) and 95% confidence interval (CI) for the association between trichomoniasis and cervical lesions were estimated using multivariable conditional logistic regression to adjust for all comorbidities and variables. In total, 54,003 individuals were enrolled in the case group and 216,012 were enrolled in the control group. Trichomonas vaginalis exposure had a significant association with cervical lesions (AOR 2.656, 95% CI = 1.411-5.353, p = 0.003), especially cervical cancer (AOR 3.684, 95% CI = 1.622-6.094, p = 0.001). In patients with both trichomoniasis and depression, the relative risk increased 7.480-fold compared to those without trichomoniasis or depression. In conclusion, female patients with Trichomonas vaginalis exposure had a significantly higher risk of developing cervical lesions (especially cervical cancer) than those without exposure.
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Liao G, Jiang X, She B, Tang H, Wang Z, Zhou H, Ma Y, Xu W, Xu H, Chen W, Ji J, Xi M, Chen T. Multi-Infection Patterns and Co-infection Preference of 27 Human Papillomavirus Types Among 137,943 Gynecological Outpatients Across China. Front Oncol 2020; 10:449. [PMID: 32318343 PMCID: PMC7154087 DOI: 10.3389/fonc.2020.00449] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 03/13/2020] [Indexed: 12/24/2022] Open
Abstract
Background: The epidemiological feature of human papillomavirus (HPV) infection is distinctive in China. We aimed to investigate the multi-infection patterns and co-infection preference of 27 HPV types among gynecological outpatients across China. Methods: Overall 137,943 gynecological outpatients were recruited from eight tertiary hospitals located in seven regions of China, between July 1st, 2014 and December 31st, 2016. The overall, region-specific, age-specific and type-specific prevalence of HPV infection were calculated, respectively. The pattern of HPV infection was also evaluated. Furthermore, rate ratio was calculated to evaluate the co-infection preference of any two HPV genotypes. Results: The overall prevalence of 27 HPVs' [17 high-risk (hr)/10 low-risk (lr)] infection was 23.5%. The age-specific HPV prevalence showed a “U-shaped” pattern. The most prevalent hrHPV genotypes were 16, 52, and 58. Multiple infections were detected in 25.8% of the HPV-positive women, in which dual infection was more prevalent. HPV 16/18 were likely to co-infected with HPV 31 but unlikely with HPV 52/58, i.e., the co-infection of HPV 16 with HPV 31 was high (3.5-fold), but low for HPV 58 (1.8-fold), and 52 (1.2-fold), while the co-infection of HPV 18 with HPV 31 was high (4.3-fold), but low for HPV 52 (1.9-fold), and 58 (1.7-fold). Conclusions: We found age-specific prevalence of HPV infection showed a “U-shaped” pattern for high and low risk HPV, suggesting the importance of screening among younger women and the necessary of detection among older women. We found a novel co-infection preference of HPV 16/18 with 31, 52, and 58, suggesting a need of developing and marketing prophylactic HPV vaccines that protect against more genotypes in China.
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Affiliation(s)
- Guangdong Liao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children Affiliated to the Ministry of Education, Sichuan University, Chengdu, China
| | - Xiyi Jiang
- Institute of Occupational Diseases, Hangzhou Medical College, Hangzhou, China
| | - Bin She
- Department of Academic Development, Tellgen Corporation, Shanghai, China
| | - Huijuan Tang
- Institute of Occupational Diseases, Hangzhou Medical College, Hangzhou, China
| | - Zhongyong Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Hongrong Zhou
- Department of Gynecology and Obstetrics, Changning Maternity and Infant Health Hospital, Shanghai, China
| | - Yan Ma
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Weidong Xu
- Department of Clinical Laboratory, Suzhou Municipal Hospital, Suzhou, China
| | - Hongxing Xu
- Department of Clinical Laboratory, Suzhou Municipal Hospital, Suzhou, China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianguang Ji
- Center for Primary Health Care Research, Lund University, Lund, Sweden
| | - Mingrong Xi
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children Affiliated to the Ministry of Education, Sichuan University, Chengdu, China
| | - Tianhui Chen
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences (CAS), Hangzhou, China.,Department of Cancer Prevention, Cancer Hospital of the University of CAS (Zhejiang Cancer Hospital), Hangzhou, China.,Zhejiang Provincial Office for Cancer Prevention and Control, Zhejiang Cancer Center, Hangzhou, China
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Li T, Wu Z, Jiang M, Zhao Y, Yu L, Qin Y, Liu B, Cui J, Li L, Pan Q, Zhang X, Liu D, Chen F, Qiao Y, Chen W. Clinical performance of Onclarity HPV assay and Cobas HPV test in detection of cervical precancer and cancer in Chinese women. Gynecol Oncol 2020; 157:202-208. [PMID: 31964506 DOI: 10.1016/j.ygyno.2020.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The Roche Cobas (Cobas) and BD Onclarity (Onclarity) human papillomavirus (HPV) assays are convenient, PCR-based, HPV DNA tests; currently, data on performance of Onclarity in Chinese women is limited. We aimed to evaluate the clinical performance of Onclarity for detecting cervical lesions in Chinese women. METHODS In total, 1122 women were enrolled into this study. Exfoliated cervical cells were collected in PreservCyt medium and were tested using Cobas and Onclarity. Cytology and histology were interpreted by senior cytologists and a panel of pathologists, respectively, at Cancer Hospital, Chinese Academy of Medical Sciences. RESULTS The assays showed excellent concordance for HPV16 (kappa = 0.91, 95% CI: 0.85-0.97) and for 12 other high-risk types (HPV31/33/35/39/45/51/52/56/58/59/66/68, kappa = 0.84, 95% CI: 0.78-0.90), and very good concordance for HPV18 (kappa = 0.75, 95% CI: 0.69-0.81). No difference for ≥CIN2 sensitivity was observed between Onclarity and Cobas (both 90.5%); and the <CIN2 specificity for detection was similar between Onclarity (84.2%, 95% CI: 81.6-86.4) and Cobas (80.4%, 95% CI: 77.6-82.8). When combined with cytology triage, the colposcopy referral rate point estimate was slightly lower for Onclarity (9.0%) than for Cobas (11.0%), with the same ≥CIN2 sensitivity of 75.0% (95% CI: 53.1-88.8) for Onclarity and Cobas. CONCLUSIONS Onclarity exhibited comparable screening performance and triage efficiency compared to Cobas in detection of cervical lesions in Chinese women.
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Affiliation(s)
- Tingyuan Li
- Office of Cancer Prevention and Treatment, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China; Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zeni Wu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Mingyue Jiang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yuqian Zhao
- Office of Cancer Prevention and Treatment, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China
| | - Lulu Yu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; RNA Biology Laboratory, Tumor Virus RNA Biology Section, Center for Cancer Research, National Cancer Institute, USA
| | - Yu Qin
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Bin Liu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jianfeng Cui
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Li Li
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Science and Education Office, The First Affiliated Hospital, Jinan University, 613 West Huangpu Ave, Guangzhou 510632, China
| | - Qinjing Pan
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xun Zhang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Daokuan Liu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Feng Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Youlin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wen Chen
- Office of Cancer Prevention and Treatment, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China; Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
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11
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Teng P, Hao M. A population-based study of age-related associations between vaginal pH and the development of cervical intraepithelial neoplasia. Cancer Med 2020; 9:1890-1902. [PMID: 31943830 PMCID: PMC7050087 DOI: 10.1002/cam4.2845] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 12/30/2019] [Accepted: 01/02/2020] [Indexed: 12/22/2022] Open
Abstract
The association between vaginal pH and the risk of cervical intraepithelial neoplasia (CIN) is unclear. We evaluated the dose‐response relationship between vaginal pH and CIN risk, as well as the combined influence of vaginal pH and high‐risk human papillomavirus (hrHPV) on the risk of CIN and the mediation effects of hrHPV infection on vaginal pH level and the development of CIN. We investigated 2304 women in Shanxi, China. The dose‐response relationship between vaginal pH and CIN risk was assessed using categoric and spline analyses. We established interaction and mediation models to determine the correlation between pH and hrHPV in the development of CIN. After adjusting covariates, a positive association was observed between hrHPV infection and the development of CIN [OR (95% CI) = 4.75 (3.52‐6.40) for CIN2+; OR (95% CI) = 7.30 (4.10‐13.00) for CIN3+], while a negative correlation was showed between vaginal pH level and CIN3+ [OR (95% CI) = 1.04 (0.59‐1.84); high vs low: OR (95% CI) = 0.32 (0.15‐0.69), P = .002]. The highest risk of CIN (5.24 of CIN2+ and 5.80 of CIN3+) were observed when hrHPV infection was combined with middle vaginal pH (4.6‐5.0). A significant mediation effect of hrHPV infection was observed in the association between vaginal pH level with CIN2+ (P = .002) and CIN3+ (P = .004). In conclusion, abnormal vaginal pH significantly induced the risk of high‐stage CIN in Chinese women infected with hrHPV. Therefore, maintaining normal vaginal pH levels may reduce the risk of CIN.
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Affiliation(s)
- Peng Teng
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Min Hao
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
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12
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Wong LP, Han L, Li H, Zhao J, Zhao Q, Zimet GD. Current issues facing the introduction of human papillomavirus vaccine in China and future prospects. Hum Vaccin Immunother 2019; 15:1533-1540. [PMID: 31017500 DOI: 10.1080/21645515.2019.1611157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The introduction of human papillomavirus (HPV) vaccination in China aims to prevent HPV infection in all women. The issues that China might face include high cost of vaccines made in other countries, shortage in HPV vaccine supply, negative events attributed to vaccination (whether justified or not) that jeopardizes the general public's confidence in the HPV vaccine, cultural and literacy barriers, and sensitivity to receiving a vaccine for a sexually transmitted disease. Ensuring the effective delivery of the HPV vaccine in China, a country with vast economic, geographical, and cultural complexities, will require a commitment of significant resources. In light of the high price of imported vaccines, the availability of locally manufactured HPV vaccines would greatly facilitate the national HPV vaccination program. New evidence supporting the efficacy of a two-dose regime in younger adolescents would also be advantageous in terms of affordability and logistical simplicity of vaccine administration. Furthermore, it would potentially enhance the compliance and uptake, especially for hard to reach women in remote regions.
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Affiliation(s)
- Li Ping Wong
- a Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia.,b Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo , Zhejiang , PR China
| | - Liyuan Han
- b Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo , Zhejiang , PR China
| | - Hui Li
- c Non-infectious Disease Prevention and Control Institute, Ningbo Municipal Center for Disease Control and Prevention , Ningbo , PR China
| | - Jinshun Zhao
- b Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo , Zhejiang , PR China
| | - Qinjian Zhao
- d State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University , Xiamen , Fujian PR China
| | - Gregory D Zimet
- e Department of Pediatrics, School of Medicine, Indiana University , Indianapolis , IN , USA
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13
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Ge Y, Zhong S, Ren M, Ge Y, Mao Y, Cao P. Prevalence of human papillomavirus infection of 65,613 women in East China. BMC Public Health 2019; 19:178. [PMID: 30744637 PMCID: PMC6371516 DOI: 10.1186/s12889-019-6487-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 01/25/2019] [Indexed: 02/09/2023] Open
Abstract
Background The infection with human papillomavirus (HPV) is the major cause of genital disease. This study assessed the prevalence and genotype of HPV among outpatient women and healthy women in Jiangsu, East China. Methods A total of 65,613 women aged 16–85 years were recruited from Nanjing Kingmed Diagnostics, including 45,736 outpatients and 19,877 healthy women. The cervico-vaginal cells were collected and then HPV types were detected using the Tellgenplex™ HPV DNA Test. Results The overall HPV prevalence was 17.7% for outpatients and 10.6% for healthy women. 13.7% outpatients were infected with a single HPV type and 4.0% were infected with multiple HPV types. Regarding healthy women, 8.5 and 2.1% were infected with single and multiple HPV types, respectively. The two most commonly detected HPV types were HPV 16 and 58 regardless of single- or multiple-type infection or source of the participants. HPV16 + 58 was the most commonly identified multiple genotype in outpatients, while HPV16 + 52 was frequently detected in healthy women. Highest prevalence rate was found in outpatients aged < 20 years and ≥ 60 years. Conclusions This study revealed the prevalence characteristics of HPV in both outpatient women and healthy women in Jiangsu province. Electronic supplementary material The online version of this article (10.1186/s12889-019-6487-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yanmei Ge
- Laboratory of gene amplification, Kingmed Diagnostics, Nanjing, 210043, China
| | - Shanliang Zhong
- Center of Clinical Laboratory Science, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.
| | - Meng Ren
- Institute of Tropical Medicine Third Military Medical University, Chongqing, 400037, China
| | - Yanping Ge
- School of Bioligical Science and Food Engineering, Chuzhou University, Chu zhou, 239000, China
| | - Yuan Mao
- Laboratory of gene amplification, Kingmed Diagnostics, Nanjing, 210043, China
| | - Peng Cao
- Laboratory of gene amplification, Kingmed Diagnostics, Nanjing, 210043, China
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Prevalence and Genotype Distribution of Human Papillomavirus in Invasive Cervical Cancer, Cervical Intraepithelial Neoplasia, and Asymptomatic Women in Southeast China. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2897937. [PMID: 30402468 PMCID: PMC6196990 DOI: 10.1155/2018/2897937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 02/14/2018] [Indexed: 01/12/2023]
Abstract
Cervical cancer is one of the leading causes of cancer-related deaths among women and it is caused by the human papillomavirus (HPV). High variation has been reported in the attribution of specific HPV genotypes to cervical neoplasia among various geographic regions. For effective control of cervical cancer through HPV vaccination, it is essential to estimate the cost-effectiveness of vaccination, to monitor the potential transition into other HPV genotypes, and to understand the distribution of specific HPV genotypes across a specific geographic region. In this study, the distribution of HPV genotypes was investigated in southeast China, from 2011 to 2016. The 12,816 cervical swabs collected from women (age 18–78 years, median 43.6 years) outpatients were analyzed. HPV prevalence among 12,816 cervical swabs analyzed was 22.3% (2,856/12,816). Among these positive cases, 2,216 had only one HPV genotype while 640 had multiple HPV genotypes. The cases with multiple types revealed 23 different HPV genotypes with the five most prevalent being HPV18 (18.2%), HPV52 (14.1%), HPV16 (11.9%), HPV58 (10.6%), and HPV33 (5.5%). The rates of HPV infection in patients with cervical inflammation, CIN-1, CIN-2, CIN-3, squamous carcinoma, and adenocarcinoma were 38.4%, 80.5%, 82.6%, 92.3%, 97.5%, and 93.4%, respectively. Four HPV genotypes, HPV18, HPV16, HPV52, and HPV58, were more prevalent in patients with CIN-2-CIN-3 and invasive cervical cancer. A comparison of HPV genotypes attribution to cervical cancer between southeast China and global incidences revealed distinct differences. Due to this unique prevalence, it is essential to streamline the vaccination development protocol prior to administering vaccines based on global data.
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15
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Yang S, Zhao W, Wang H, Wang Y, Li J, Wu X. Trichomonas vaginalis infection-associated risk of cervical cancer: A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2018; 228:166-173. [DOI: 10.1016/j.ejogrb.2018.06.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 06/07/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
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Wang Z, Li Z, Li J, Wang C, Wang W, Hao M, Zhao C. Prevalence and Distribution of HPV Genotypes in 1387 Women with Cervical Intraepithelial Neoplasia 2/3 in Shanxi Province, China. J Cancer 2018; 9:2802-2806. [PMID: 30123348 PMCID: PMC6096374 DOI: 10.7150/jca.25614] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/10/2018] [Indexed: 11/05/2022] Open
Abstract
Objective: The distribution of human papillomavirus (HPV) genotypes varies by countries and regions. Data regarding HPV genotype distribution for women with cervical intraepithelial neoplasia 2/3 (CIN2/3) are still limited. This study aimed to investigate the distribution of HPV genotypes for women with CIN2/3 in Shanxi province, China. Methods: Prior HPV testing/genotyping resulted from women with histologic diagnosis of CIN2/3 were retrospectively collected between August 2011 and August 2016. Results: A total of 1387 women with a diagnosis of CIN2/3 were included in this study. The average age of the women was 45.7 years and the average time period from HPV testing to histological diagnosis was 0.4 months. The overall high-risk HPV (hrHPV) positive rate was 91.6%. In all tested women, the most commonly detected hrHPV genotype was HPV16 (59.3%) followed by HPV58 (14.4%) and HPV33 (10.0%), while HPV18 was in the 6th position (6.0%). Conclusions: This is one of the largest studies of HPV genotyping for women with CIN2/3 in China. The prevalence and distribution of HPV genotypes in these Chinese women differed from those in women from Western countries. Our results provide important information for developing specific HPV vaccines for Chinese women.
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Affiliation(s)
- Zhilian Wang
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Zaibo Li
- Department of Pathology, Ohio State Wexner Medical Center, Columbus, OH 43210, USA
| | - Jing Li
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Chen Wang
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Wenhao Wang
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Min Hao
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Chengquan Zhao
- Department of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center. 300 Halket St, Pittsburgh, PA, 15213, USA
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Xiang F, Guan Q, Liu X, Xiao H, Xia Q, Liu X, Sun H, Song X, Zhong Y, Yuan CH, Xiang Y. Distribution characteristics of different human papillomavirus genotypes in women in Wuhan, China. J Clin Lab Anal 2018; 32:e22581. [PMID: 29862560 PMCID: PMC6220820 DOI: 10.1002/jcla.22581] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 05/08/2018] [Indexed: 01/07/2023] Open
Abstract
Background Human papillomaviruses (HPVs) are strongly associated with the development of cervical carcinoma, and the distribution of HPV genotypes varies regionally. Methods To investigate the distribution characteristics of different genotypes of HPV infection in women in Wuhan, China, a total of 13 775 patients were enrolled over 2 years. Results Of these, 2436 patients were infected with HPVs, and the total infection rate was 17.68%. The infection rate of high‐risk HPV (HR‐HPV) was significantly higher (13.96%) than that of single low‐risk HPV (LR‐HPV; 3.72%). Among the HR‐HPV infections, the most common genotype was HPV 52 with an infection rate of 4.23%, followed by HPVs 16, 58, 39, and 51. The most common LR‐HPV genotype was HPV 81, followed by HPVs 6, 11, and 44. Patients under the age of 25 years were found to have the highest HPV infection rate (P < .05). After the age range of 51‐55 years, a downward trend in total HPVs and HR‐HPVs was observed. The HPV infection rate for a single genotype was higher than that for multiple HPVs (P < .01), and the detection rates in summer and winter were significantly higher than those in spring and autumn. Conclusions The results demonstrate that the distribution characteristics of various HPV genotype infections are associated with region and age and may be related to season. These data could be the basis for further epidemiological analysis into the control and prevention of HPV infection in this region.
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Affiliation(s)
- Feiyan Xiang
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Guan
- Department of Laboratory Medicine, Xiangyang Central Hospital, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Xinwen Liu
- Department of Nursing, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Han Xiao
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Xia
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Xiuzhen Liu
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Sun
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojie Song
- Department of Gynecology and Obstetrics, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Zhong
- Department of Gynecology and Obstetrics, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Chun-Hui Yuan
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Xiang
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China.,The State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
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Prevalence of human papillomavirus genotypes and relative risk of cervical cancer in China: a systematic review and meta-analysis. Oncotarget 2018; 9:15386-15397. [PMID: 29632652 PMCID: PMC5880612 DOI: 10.18632/oncotarget.24169] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/06/2017] [Indexed: 11/25/2022] Open
Abstract
High-risk HPV (hrHPV) is related to cervical carcinogenesis, although clinical data comparing the natural history and carcinogenic potential of type-specific HPV remain limited. Furthermore, the nationwide prevalence rates of overall and type-specific HPV among women with cervical precancerous lesions and cancer have not been reported. Here, a meta-analysis was performed for type-specific HPV distribution among 30,165 HPV-positive women, including 12,094 invasive cervical cancers (ICCs), 10,026 cervical intraepithelial neoplasia grade 2/3 (CIN2/3), 3246 CIN1, and 4799 normal cervices from 45 PCR-based studies. We found that HPV16 was the most common hrHPV type involved in cervical disease. The HPV16 positivity rate varied little across normal (22.7%) and CIN1 individuals (23.6%) but increased through the CIN2 (37.6%) and CIN3 patients (51.9%) to 65.6% in ICC cases. HPV16, 18, 35, 39, 45, and 59 were more frequent in ICC than CIN3, with ICC:CIN3 ratios ranging from 2.3 for HPV18 to 1.1 for HPV35/45. HPV31, 33, 52, and 58 were more frequent in CIN3 compared with normal cervices but less common in ICC compared with CIN3 (ICC:CIN3 ratios ranging from 0.6 for HPV58 and 0.4 for HPV52). The ICC:normal ratios were particularly high for HPV18, 52 and 58 in West China (4.1, 3.9 and 2.9, respectively) and for HPV45 and 59 in North China (1.6 and 1.1, respectively). In summary, this study is the most comprehensive analysis of type-specific HPV distribution in cervical carcinogenesis and could be valuable for HPV-based cervical cancer screening strategies and vaccination policies in China.
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Zhong TY, Zhou JC, Hu R, Fan XN, Xie XY, Liu ZX, Lin M, Chen YG, Hu XM, Wang WH, Li L, Xiao HP. Prevalence of human papillomavirus infection among 71,435 women in Jiangxi Province, China. J Infect Public Health 2017; 10:783-788. [PMID: 28214188 DOI: 10.1016/j.jiph.2017.01.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 08/16/2016] [Accepted: 09/10/2016] [Indexed: 02/05/2023] Open
Abstract
Cervical cancer is the third most common cancer in women worldwide. Human papillomavirus (HPV) has been identified as an etiological factor for cervical cancer. Data on the prevalence and subtype distribution of HPV infection in Jiangxi Province are incomplete. In this study, we investigated HPV subtype distribution and prevalence in Jiangxi Province between August 1, 2010, and December 31, 2015. A total of 71,435 individuals ranging in age from 16 to 77 years were recruited. Cervicovaginal swabs were collected from each participant, and HPV screening was performed. Our results showed that the HPV prevalence was 22.49% in Jiangxi Province. Overall, 14.99% of individuals were positive for a single HPV type, and 7.49% were positive for multiple types. The most frequently detected low-risk genotypes were HPV-6, and high-risk genotypes were HPV-16, -18, -33, -52, and -58. The prevalence and type distribution of HPV infection exhibits regional and age differences; Yingtan had the highest incidence for high-risk HPV infection (32.00%), and peaks in the frequencies of HPV infections were seen for patients under 20 and over 60 years of age. In conclusion, we present data showing that the HPV prevalence varies significantly with age and regions in Jiangxi Province. These results can serve as valuable reference to guide Jiangxi cervical cancer screening and HPV vaccination programs.
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Affiliation(s)
- Tian-Yu Zhong
- Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, People's Republic of China
| | - Ji-Chun Zhou
- Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, People's Republic of China
| | - Rong Hu
- Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, People's Republic of China
| | - Xiao-Na Fan
- Department of Scientific Research, Gannan Medical University, Ganzhou, Jiangxi 341000, People's Republic of China
| | - Xiao-Ying Xie
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, People's Republic of China
| | - Zhao-Xia Liu
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, People's Republic of China
| | - Min Lin
- Department of Histology and Embryology, Shantou University Medical College, Shantou, 515000 Guangdong, People's Republic of China
| | - Yi-Guo Chen
- Medical Laboratory, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi 330006, People's Republic of China
| | - Xiao-Mei Hu
- Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, People's Republic of China
| | - Wei-Hua Wang
- Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, People's Republic of China
| | - Long Li
- Department of Medical Laboratory, The Affiliated Hospital of Jinggangshan University, Ji'an, Jiangxi 343000, People's Republic of China
| | - Hua-Ping Xiao
- Department of Anesthesiology, Jiangxi Cancer Hospital, Nanchang, Jiangxi 330029, People's Republic of China.
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20
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Koliopoulos G, Nyaga VN, Santesso N, Bryant A, Martin‐Hirsch PPL, Mustafa RA, Schünemann H, Paraskevaidis E, Arbyn M. Cytology versus HPV testing for cervical cancer screening in the general population. Cochrane Database Syst Rev 2017; 8:CD008587. [PMID: 28796882 PMCID: PMC6483676 DOI: 10.1002/14651858.cd008587.pub2] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cervical cancer screening has traditionally been based on cervical cytology. Given the aetiological relationship between human papillomavirus (HPV) infection and cervical carcinogenesis, HPV testing has been proposed as an alternative screening test. OBJECTIVES To determine the diagnostic accuracy of HPV testing for detecting histologically confirmed cervical intraepithelial neoplasias (CIN) of grade 2 or worse (CIN 2+), including adenocarcinoma in situ, in women participating in primary cervical cancer screening; and how it compares to the accuracy of cytological testing (liquid-based and conventional) at various thresholds. SEARCH METHODS We performed a systematic literature search of articles in MEDLINE and Embase (1992 to November 2015) containing quantitative data and handsearched the reference lists of retrieved articles. SELECTION CRITERIA We included comparative test accuracy studies if all women received both HPV testing and cervical cytology followed by verification of the disease status with the reference standard, if positive for at least one screening test. The studies had to include women participating in a cervical cancer screening programme who were not being followed up for previous cytological abnormalities. DATA COLLECTION AND ANALYSIS We completed a 2 x 2 table with the number of true positives (TP), false positives (FP), true negatives (TN), and false negatives for each screening test (HPV test and cytology) used in each study. We calculated the absolute and relative sensitivities and the specificities of the tests for the detection of CIN 2+ and CIN 3+ at various thresholds and computed sensitivity (TP/(TP + TN) and specificity (TN/ (TN + FP) for each test separately. Relative sensitivity and specificity of one test compared to another test were defined as sensitivity of test-1 over sensitivity of test-2 and specificity of test-1 over specificity of test-2, respectively. To assess bias in the studies, we used the Quality Assessment of Diagnostic test Accuracy Studies (QUADAS) tool. We used a bivariate random-effects model for computing pooled accuracy estimates. This model takes into account the within- and between-study variability and the intrinsic correlation between sensitivity and specificity. MAIN RESULTS We included a total of 40 studies in the review, with more than 140,000 women aged between 20 and 70 years old. Many studies were at low risk of bias. There were a sufficient number of included studies with adequate methodology to perform the following test comparisons: hybrid capture 2 (HC2) (1 pg/mL threshold) versus conventional cytology (CC) (atypical squamous cells of undetermined significance (ASCUS)+ and low-grade squamous intraepithelial lesions (LSIL)+ thresholds) or liquid-based cytology (LBC) (ASCUS+ and LSIL+ thresholds), other high-risk HPV tests versus conventional cytology (ASCUS+ and LSIL+ thresholds) or LBC (ASCUS+ and LSIL+ thresholds). For CIN 2+, pooled sensitivity estimates for HC2, CC and LBC (ASCUS+) were 89.9%, 62.5% and 72.9%, respectively, and pooled specificity estimates were 89.9%, 96.6%, and 90.3%, respectively. The results did not differ by age of women (less than or greater than 30 years old), or in studies with verification bias. Accuracy of HC2 was, however, greater in European countries compared to other countries. The results for the sensitivity of the tests were heterogeneous ranging from 52% to 94% for LBC, and 61% to 100% for HC2. Overall, the quality of the evidence for the sensitivity of the tests was moderate, and high for the specificity.The relative sensitivity of HC2 versus CC for CIN 2+ was 1.52 (95% CI: 1.24 to 1.86) and the relative specificity 0.94 (95% CI: 0.92 to 0.96), and versus LBC for CIN 2+ was 1.18 (95% CI: 1.10 to 1.26) and the relative specificity 0.96 (95% CI: 0.95 to 0.97). The relative sensitivity of HC2 versus CC for CIN 3+ was 1.46 (95% CI: 1.12 to 1.91) and the relative specificity 0.95 (95% CI: 0.93 to 0.97). The relative sensitivity of HC2 versus LBC for CIN 3+ was 1.17 (95% CI: 1.07 to 1.28) and the relative specificity 0.96 (95% CI: 0.95 to 0.97). AUTHORS' CONCLUSIONS Whilst HPV tests are less likely to miss cases of CIN 2+ and CIN 3+, these tests do lead to more unnecessary referrals. However, a negative HPV test is more reassuring than a negative cytological test, as the cytological test has a greater chance of being falsely negative, which could lead to delays in receiving the appropriate treatment. Evidence from prospective longitudinal studies is needed to establish the relative clinical implications of these tests.
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Affiliation(s)
- George Koliopoulos
- Elena Venizelou Maternity HospitalDepartment of Obstetrics and Gynaecology1 Elena Venizelou SquareAthensGreece11521
| | - Victoria N Nyaga
- Scientific Institute of Public HealthUnit of Cancer EpidemiologyJuliette Wytsmanstraat 14BrusselsBelgium1050
| | - Nancy Santesso
- McMaster UniversityDepartment of Clinical Epidemiology and Biostatistics1200 Main Street WestHamiltonONCanadaL8N 3Z5
| | - Andrew Bryant
- Newcastle UniversityInstitute of Health & SocietyMedical School New BuildRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Pierre PL Martin‐Hirsch
- Royal Preston Hospital, Lancashire Teaching Hospital NHS TrustGynaecological Oncology UnitSharoe Green LaneFullwoodPrestonLancashireUKPR2 9HT
| | - Reem A Mustafa
- McMaster UniversityDepartment of Clinical Epidemiology and Biostatistics1200 Main Street WestHamiltonONCanadaL8N 3Z5
| | - Holger Schünemann
- McMaster UniversityDepartments of Health Research Methods, Evidence, and Impact and of Medicine1280 Main Street WestHamiltonONCanadaL8N 4K1
| | | | - Marc Arbyn
- SciensanoUnit of Cancer Epidemiology, Belgian Cancer CentreJuliette Wytsmanstreet 14BrusselsBelgiumB‐1050
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Zhao PY, Jiang HC, Li Y, Wang JB, Zhang TT, Liu CH, Song LW, Cheng JJ. Comparison of the cervista HPV HR test and luminex XMAP technology for the diagnosis of cervical intraepithelial neoplasia. Eur J Obstet Gynecol Reprod Biol 2017; 214:150-155. [DOI: 10.1016/j.ejogrb.2017.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 05/08/2017] [Accepted: 05/14/2017] [Indexed: 10/19/2022]
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Xu HH, Lin A, Chen YH, Dong SS, Shi WW, Yu JZ, Yan WH. Prevalence characteristics of cervical human papillomavirus (HPV) genotypes in the Taizhou area, China: a cross-sectional study of 37 967 women from the general population. BMJ Open 2017; 7:e014135. [PMID: 28601819 PMCID: PMC5577888 DOI: 10.1136/bmjopen-2016-014135] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES High-risk human papillomaviruses (hrHPVs) are highly prevalent worldwide, and HPV genotypes differ between geographical regions; however, sexually transmitted HPV may lead to cervical carcinogenesis. The objective of this cross-sectional study was to estimate the prevalence characteristics of cervical HPV genotypes in Taizhou, Southeast China. SETTING AND PARTICIPANTS A population-based sample of 37 967 eligible women (median age: 41.6; range: 15-90 years) visiting the Taizhou ENZE Medical Center in Taizhou (2012-2016) was analysed. HPV genotyping was performed on the collected specimens using a GP5+/bioGP6+-PCR/MPG assay by Luminex 200, which simultaneously identifies 27 different HPV genotypes and the β-globin gene (internal control). RESULTS The overall HPV infection rate was 22.8% in the Taizhou-based population, and the prevalence of high-risk HPV, low-risk HPV and mixed high-risk and low-risk HPV infection was 14.2%, 5.7% and 3.0%, respectively. The most prevalent genotypes were HPV52 (19.7%), 16 (11.9%), 58 (11.5%), 39 (7.2%), 18 (6.6%) and 56 (5.6%). The rate of multiple-type HPV infection was 5.7% in the whole population, and the HPV52+58, HPV16+52 and HPV16+18 mixed genotypes were most common in women with multiple infections. The age-specific HPV prevalence showed a bimodal curve, with a first peak below the age of 21 years (41.6%), followed by a second peak in the age group of 56-60 years (28.5%). Moreover, the HPV infection rate differed significantly between the outpatient and physical examination groups (24.0% vs 19.5%, p<0.0001). Further data comparisons showed that the distribution of HPV genotypes varied markedly between the two groups. CONCLUSIONS Data from this study could be valuable for HPV-based cervical cancer screening efforts in certain areas, support the local vaccination programme in the Taizhou region and facilitate future diagnosis and treatment of HPV diseases.
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Affiliation(s)
- Hui hui Xu
- Laboratory of Gynecologic Oncology, Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Aifen Lin
- Human Tissue Bank, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Ya hong Chen
- Health Management Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Shan shan Dong
- Human Tissue Bank, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Wei wu Shi
- Laboratory of Gynecologic Oncology, Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Jia zheng Yu
- Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Wei hua Yan
- Laboratory of Gynecologic Oncology, Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
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Ma L, Cong X, Shi M, Wang XH, Liu HY, Bian ML. Distribution of human papillomavirus genotypes in cervical lesions. Exp Ther Med 2017; 13:535-541. [PMID: 28352328 PMCID: PMC5348701 DOI: 10.3892/etm.2016.4000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/06/2016] [Indexed: 01/05/2023] Open
Abstract
The aims of the present study were to investigate the distribution of human papillomavirus (HPV) genotypes in cervical lesions, and the association between different HPV genotypes and cervical lesions. Between January 2013 and June 2014, the HPV type determinations of nucleic acid by use of fluorescence polymerase chain reaction (PCR) method of 15,192 outpatients in China-Japan Friendship Hospital were performed and the infection status was analyzed. The results showed that: i) 2,366 Cases were HPV positive and 12,826 cases were HPV negative, the overall infection rate was 15.57% (2,366/15,192), in which a single genotype of HPV infection rate was 11.63% (1,767/15,192), and multiple genotypes of HPV infection rate was 3.94% (599/15,192); ii) HPV16, HPV52 and HPV58 infections were the most common HPV genotypes, the infection rates were 3.95% (600/15,192), 2.86% (435/15,192) and 2.67% (406/15,192), respectively; and iii) According to the gold standard of histopathological analysis via hematoxylin-eosin staining, HPV16, HPV52 and HPV58 accounted for 58.80% (154/267) of all CIN2 or above squamous epithelial lesions. Furthermore, three cases with pathological changes of the cervical severe glandular epithelium were all HPV18 infection. The difference was statistically significant (χ2=60.74, P<0.001). Single HPV subtype infection was primarily associated with HPV16, HPV52 and HPV58. In conclusion, HPV type detection had a may be important in screening of cervical lesions as a difference in pathogenic ability was noted among different HPV genotypes. As cervical cancer is an infectious disease, HPV testing may help detect more precancerous lesions, thus reducing the morbidity and mortality of cervical cancer. HPV16, HPV52 and HPV58 were associated with severe cervical squamous epithelial lesions; HPV18 was associated with cervical severe glandular cell pathological changes, although it was not the most common HPV genotype in China. When positive, a clinical cervical examination should be conducted, including colposcopy and biopsy.
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Affiliation(s)
- Li Ma
- Department of Gynecology and Obstetrics, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Xiao Cong
- Department of Gynecology and Obstetrics, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Mai Shi
- Department of Gynecology and Obstetrics, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Xiu-Hong Wang
- Department of Gynecology and Obstetrics, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Hai-Yan Liu
- Department of Gynecology and Obstetrics, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Mei-Lu Bian
- Department of Gynecology and Obstetrics, China-Japan Friendship Hospital, Beijing 100029, P.R. China
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Wang Z, Wang J, Fan J, Zhao W, Yang X, Wu L, Li D, Ding L, Wang W, Xu J, Stram M, Zhao C, Hao M. Risk factors for cervical intraepithelial neoplasia and cervical cancer in Chinese women: large study in Jiexiu, Shanxi Province, China. J Cancer 2017; 8:924-932. [PMID: 28529603 PMCID: PMC5436243 DOI: 10.7150/jca.17416] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/22/2016] [Indexed: 12/18/2022] Open
Abstract
We aimed to investigate the risk factors for cervical intraepithelial neoplasia (CIN) in Jiexiu, Shanxi Province, China. Twenty thousand eligible married women (age: 18-65 years) were administered with a questionnaire on potential risk factors for CIN and underwent liquid based Pap test. All women with abnormal cytological results underwent colposcopy with biopsy. Based on the biopsy pathology results, women were then assigned to either study group (with CIN) or control group (negative for histological results and volunteered to participate in the follow up study). The women in both study group and control group underwent vaginal microflora detection and dietary survey. The potential risk factors were analyzed by using ordinal logistic regression. Among the 20,000 women ne 1,438 women (7.19%) had cytologic abnormalities and 410 (2.05%) women were diagnosed histologically with CIN lesions, including 317 (1.58%) with CIN1, 93 (0.50%) with CIN2/3and 11 (55/100,000) with squamous cell carcinoma (SCC). The average daily dietary folate intake was significantly lower in the study group (344.61±153.07μg) than in the control group (371.50±166.58μg; P<0.001). Multivariate analysis demonstrated that age of 56-65 years, farming as the husband's occupation, unwashing the vulva after sexual intercourse, and low self-reported folate intake were positively associated with CIN development and might have contribution to the increased CIN incidence in this population. These findings may provide help to develop the strategies to reduce the risk of cervical cancer in China.
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Affiliation(s)
- Zhilian Wang
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jintao Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jinrong Fan
- Jiexiu Family Planning/Women and Children Health Service Center, Jinzhong, China
| | - Weihong Zhao
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xin Yang
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Lingmei Wu
- Jiexiu Family Planning/Women and Children Health Service Center, Jinzhong, China
| | - Dongyan Li
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Ling Ding
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Wei Wang
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Junjie Xu
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Michelle Stram
- Department of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center. 300 Halket St, Pittsburgh, PA, 15213, USA
| | - Chengquan Zhao
- Department of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center. 300 Halket St, Pittsburgh, PA, 15213, USA
| | - Min Hao
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
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Prevalence and risk factors for human papillomavirus infection among Chinese ethnic women in southern of Yunnan, China. Braz J Infect Dis 2017; 21:325-332. [PMID: 28284657 PMCID: PMC9427817 DOI: 10.1016/j.bjid.2017.01.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/19/2017] [Accepted: 01/23/2017] [Indexed: 11/22/2022] Open
Abstract
Background Dai is a major Chinese ethnic minority group residing in rural areas of the southern part of Yunnan. However, no data exist on the Human Papillomavirus (HPV) prevalence and genotype distribution among Dai women. Method A total of 793 participants (Dai = 324, Han = 251, other ethnic = 218) were included in this study. PCR was performed to detect the HPV-positive samples, and genotyping was performed with an HPV Geno-Array. Result The overall HPV prevalence was very low among Dai women compared to the others. The prevalence of high-risk-HPV infections was significantly higher (p = 0.001) among other ethnic women (22.0%) than that among Han (13.1%) and Dai women (7.1%). The overall HPV, high-risk-HPV, single and multiple infection prevalence among rural women were 12.9%, 12.1%, 12.3%, and 0.5%, respectively. HPV-16 (5.5%) was shown to be the most prevalent genotype, followed by HPV-52 (2.6%) and HPV-58 (2.4%). Urban women had relatively higher rates of overall HPV (16.0%), high-risk-HPV (14.1%), single genotype (11.9%), and multiple genotype (4.1%) infections. In urban women, HPV-52 (3.6%) was the most prevalent genotype, followed by HPV-39 (2.7%) and HPV-16 (1.2%). In the urban area, HPV prevalence was highest in women aged <29 years, but declined with increasing age. However, in rural women, the highest HPV prevalence was observed among women at older age (>50 years). Education and smoking habit were significantly associated with HPV infection among both rural and urban area women (p < 0.001). Conclusion The prevalence and genotype distribution of HPV varied among ethnic women in urban and rural area of Yunnan Province.
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Zhang L, Bi Q, Deng H, Xu J, Chen J, Zhang M, Mu X. Human papillomavirus infections among women with cervical lesions and cervical cancer in Eastern China: genotype-specific prevalence and attribution. BMC Infect Dis 2017; 17:107. [PMID: 28143439 PMCID: PMC5282745 DOI: 10.1186/s12879-017-2223-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/25/2017] [Indexed: 11/26/2022] Open
Abstract
Background Cervical cancer and its precursor, high-grade cervical intraepithelial neoplasia (CIN2/3), are associated with persistent high-risk human papillomavirus (HPV) infection. HPV genotype prevalence varies with severity of cervical lesions, patient age and geographical location. The aim of this study was to investigate HPV genotypes prevalence and attribution according to the severity of cervical lesions among Chinese women. Method A 4-year surveillance study was performed. A total of 1664 female patients were included and their cervical histological diagnosis consisted of cervical intraepithelial neoplasia grade 1 (CIN1, 376 cases), grade 2 (CIN2, 408 cases), grade 3 (CIN3, 336 cases) and invasive cervical cancers (ICC, 544 cases). HPV genotypes prevalence and attribution to cervical lesions were calculated and analyzed. The 95% confidence interval (CI) for proportion was also calculated. Results HPV positivity rates increased directly with cervical lesions severity (72.4% for CIN1, 81.4% for CIN2, 88.1% for CIN3 and 90.4% for ICC). Infections with multiple HPV types were inversely related to cervical lesions severity. HPV16, 52, 31, 33 and 58 were the most prevalent genotypes in ICC. 49.1% of squamous cell carcinoma, 65.1% of adenocarcinoma and 12.0–43.3% of cervical intraepithelial neoplasia could be attributed to vaccine-covered high-risk genotypes (HPV16/18). Inclusion of HPV52 and HPV31 in future vaccines would provide the highest marginal benefit in protection for individuals residing in this region. Conclusions These findings provide information about HPV genotypes in this region which may be important to target with future vaccination and screening programs. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2223-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lei Zhang
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042, China
| | - Qingqing Bi
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042, China
| | - Hua Deng
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042, China
| | - Jing Xu
- Department of Pathology, Qingdao Central Hospital, Qingdao, China
| | - Juan Chen
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042, China
| | - Meilian Zhang
- Clinical Laboratory, Qingdao Cancer Hospital, Qingdao, China
| | - Xiaofeng Mu
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042, China.
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Menon S, Broeck DV, Rossi R, Ogbe E, Harmon S, Mabeya H. Associations Between Vaginal Infections and Potential High-risk and High-risk Human Papillomavirus Genotypes in Female Sex Workers in Western Kenya. Clin Ther 2016; 38:2567-2577. [PMID: 27836494 DOI: 10.1016/j.clinthera.2016.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 10/06/2016] [Accepted: 10/10/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE Infection with and persistence of high-risk human papillomavirus (HR HPV) are the strongest risk factors for cervical cancer. Little is known about the prevalence and role of concurrent sexually transmitted infections (STIs) found in HPV-infected female sex workers (FSW) in Africa. This study purports to test our a priori hypotheses that STIs are associated with genotypes pertaining to the α-group species 9. The objectives were to determine the prevalence of bacterial vaginosis (BV), Trichomonas vaginalis, and Candida spp in FSW, the association between these STIs and the prevalence of any potential HR and HR HPV genotypes in FSWs. METHODS A cross-sectional study design of 616 FSW from Western Kenya aged between 18 and 61 years during 2009-2015 using a peer recruitment sampling strategy. Inclusion criteria for the study entailed female sex and >18 years of age and having engaged in transactional sex in exchange for money, goods, services, or drugs in the last 3 months. Women were excluded if they were pregnant, <18 years of age, had a history of cervical dysplasia or cancer, had current abnormal bleeding, or had a hysterectomy. FINDINGS Of the FSW, 33.3% had HIV and 57.7% harbored a potential HR and HR HPV genotype. The 2 most prevalent potential HR and HR genotypes were HPV 16 (16.10%) and HPV 59 (12.20%). BV was the most common infection (48.3%), followed by Trichomonas vaginalis (31.4%) and Candida spp (19.9%). A multivariate regression revealed significant associations with both α-group 9 and 6; BV and HPV 58 (adjusted odds ratio [aOR] = 2.3; 95% CI, 1.0-5.2; P = 0.05), Trichomonas vaginalis and HPV 31 and HPV 35 (aOR = 2.0; 95% CI, 1.0-3.8; P = 0.04 and aOR = 1.8; 95% CI, 1.0-3.3, P = 0.05 respectively); and between Candida spp and HPV 53 (aOR = 2.0; 95% CI, 1.1-4.0; P = 0.03) and 16 (aOR = 1.9; 95% CI, 1.1-3.3; P = 0.03). IMPLICATIONS Snowball sampling may have inadvertently excluded FSW less likely to benefit from a social network. Significant associations between BV and HPV 58 and between Candida spp and HPV 16 and 53 suggest the need for sexually transmitted disease management within a cervical cancer prevention program. The probable synergistic effects of the vaginal microbiota should be elucidated, especially within this vulnerable population. Given the potential for FSW to transmit STIs, robust epidemiologic sampling methods are urgently required that account for the heterogeneity of the FSW population.
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Affiliation(s)
- Sonia Menon
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium; CDC Foundation, Atlanta, Georgia.
| | - Davy Vanden Broeck
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium; Faculty of Medicine and Health Sciences, Laboratory of Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
| | - Rodolfo Rossi
- AMBIOR (Applied Molecular Biology Research Group), University of Antwerp, Antwerp, Belgium
| | - Emilomo Ogbe
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | | | - Hillary Mabeya
- Moi University and Gynocare Fistula Centre, Eldoret, Kenya
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Li WJ, Xu HX, Chen ZH, Xu WD, Wu YJ. Characteristics of carcinogenic human papillomavirus infection in Suzhou: Epidemiology, vaccine evaluation, and associated diseases. J Med Virol 2016; 89:895-901. [PMID: 27696465 DOI: 10.1002/jmv.24700] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2016] [Indexed: 11/06/2022]
Abstract
Human papillomavirus infection is a major health problem and caused substantial benign and malignancy diseases among female and male worldwide. We aim to investigate the epidemiology of high-risk human papillomavirus (HR-HPV) and related diseases in Suzhou population. As well as evaluating the potential benefit of a nine-valent HPV vaccine (regardless of HPV-6 and -11) in Suzhou. A total of 40,108 people aged 13-89 years were retrospectively examined by database retrieval from 2010 to 2015. Thirteen genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 66) of HR-HPV were detected using Tellgenplex™ xMAP™ HPV DNA Test assay. The overall prevalence of HR-HPV was 21.1%, the female and male account for 96.4% and 3.6%, respectively. The infection rate among male (25.6%, 367/1,432) was significantly higher than that among female (20.9%, 8,100/38,676), X2 = 17.341 (P < 0.001), with OR = 1.293, 95% CI (1.146-1.460). The five most frequent HR-HPV genotypes were HPV-16 (5.12%), -52 (5.07%), -58 (3.02%), -39 (2.00%), and -18 (1.74%). HR-HPV infection rate was peak in person aged <20 years, and second higher in person aged 51-60 years. Infection modes as HPV-16, -18, -31, -33, -45, -52, -58 alone or mixed accounted for 63.2%. The top three prevalent diseases in HR-HPV infected women were cervicitis, vaginitis, and cervical lesions, and in men were verruca, urethritis, and balanitis, respectively. This is the first study to demonstrate HPV infection status in Suzhou population. Both women and men had a large burden of HPV infection. The nine-valent HPV prophylactic vaccines may potentially prevent 63.2% HR-HPV infection in Suzhou. J. Med. Virol. 89:895-901, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Wen Jing Li
- Department of Clinical Laboratory, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou, China
| | - Hong Xing Xu
- Department of Clinical Laboratory, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou, China
| | - Zhao Hua Chen
- Department of Clinical Laboratory, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou, China
| | - Wei Dong Xu
- Department of Clinical Laboratory, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou, China
| | - Yuan Jian Wu
- Department of Clinical Laboratory, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou, China
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Analysis of Human Papillomavirus Infection in 16,320 Patients From a Gynecology Clinic in Central South China. J Low Genit Tract Dis 2016; 20:327-31. [DOI: 10.1097/lgt.0000000000000243] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Prevalence of human papillomavirus infection among women presenting for cervical cancer screening in Chile, 2014-2015. Med Microbiol Immunol 2016; 205:585-594. [PMID: 27539577 DOI: 10.1007/s00430-016-0473-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/18/2016] [Indexed: 12/18/2022]
Abstract
Cervical cancer is the fourth most common malignancy in women worldwide. In Chile, cervical cancer is the second leading cause of death among women of reproductive age, causing more than 600 deaths annually. This study was carried out to determine the burden and confirm the predominant human papillomavirus (HPV) genotypes among women presenting for cervical cancer screening in public health services in Chile. Women aged 18-64 years residing in the north and central areas covered by six primary care centers of Santiago, Chile, were invited to participate from March 2014 to August 2015. Cervical swabs were examined both HPV genotyping by PCR and Reverse Line Blot, and cervical cytology by Pap testing. A total of 1738 women were included in this study: 11.1 % were HPV positive, 9.7 % were high-risk types positive, 3.2 % were low-risk types positive, 1.4 % were Pap positive and 0.9 % were positive by both tests. The four most predominant genotypes were 16, 66, 51 and 59, with prevalence of 2.8, 1.4, 1.2 and 1.2 %, respectively. Multiple HPV infections were detected among 3.8 % participants. Age-specific prevalence of HPV showed a peak in HPV infection at younger ages (≤30 years), declining to a plateau in middle age. Among women with normal cytology, the 9.4 % were HPV positive, while 58.3 % of women with abnormal cytology were HPV positive. These findings show new epidemiological data confirming HPV 16 and 66 as the most predominant genotypes in Chile. These data are important for design successful strategies for prevention of cervical cancer in Chile.
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Baloch Z, Yuan T, Yindi S, Feng Y, Tai W, Liu Y, Liu L, Zhang A, Wang B, Wu X, Xia X. Prevalence of genital human papillomavirus among rural and urban populations in southern Yunnan province, China. ACTA ACUST UNITED AC 2016; 49:e5254. [PMID: 27254662 PMCID: PMC4932820 DOI: 10.1590/1414-431x20165254] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/11/2016] [Indexed: 11/22/2022]
Abstract
This study was designed to investigate and compare the HPV prevalence, genotypes distribution and associated risk factors in rural and urban women living in Xishuang Banna district, in the province of Yunnan. A total of 177 and 190 women from rural and urban areas were engaged, respectively. HPV DNA was amplified using the L1 consensus primers system (MY09/11 and GP5/6) and HPV GenoArray test was conducted for genotyping. Proportions were compared by chi-square test, and logistic regression was used to evaluate risk factors. A total of 54 women were positive for HPV DNA. Among rural women, 23 women were positive for HPV infection, of which 21 showed a single infection and 2 had a multiple infection. HPV-16 (10/23) was the most prevalent genotype followed by HPV-52 (5/23), and HPV-58 (5/23). Urban women had a higher infection rate for overall HPV (31/54) and for multiple genotype infection (8/31). HPV-52 (9/31) was the most prevalent genotype followed by HPV-39 (7/31) and HPV-68 (5/31). The age-specific HPV prevalence was also different between rural and urban women. In urban area, women with age <35 years had the highest HPV prevalence, which declined thereafter as age advanced. However, in rural women the highest HPV prevalence was observed in an older age group (>56 years). Ethnicity, smoking and parity were significantly associated with HPV infection among urban women. Our study demonstrates that HPV prevalence and genotype distribution varies among women from rural and urban areas in the south of Yunnan.
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Affiliation(s)
- Z Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - T Yuan
- Yunnan Province, Kunming, China
| | - S Yindi
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Y Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - W Tai
- The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Y Liu
- Yunnan Province, Kunming, China
| | - L Liu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - A Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - B Wang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - X Wu
- Yunnan Province, Kunming, China
| | - X Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
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Xiao M, Xu Q, Li H, Gao H, Bie Y, Zhang Z. Prevalence of Human Papillomavirus Genotypes Among Women With High-Grade Cervical Lesions in Beijing, China. Medicine (Baltimore) 2016; 95:e2555. [PMID: 26817906 PMCID: PMC4998280 DOI: 10.1097/md.0000000000002555] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The aim of the study is to investigate the prevalence of high-risk human papillomavirus (hr-HPV) genotypes among Han women with high-grade cervical lesions in Beijing, China.Cervical cell specimens from patients with histopathologically confirmed cervical lesions at 7 hospitals in Beijing were examined with a validated HPV kit for 13 hr-HPV genotypes during the study period. The patients were divided into a low-grade cervical lesions group (cervical intraepithelial neoplasia grade 1, CIN1) and a high-grade cervical lesions group (CIN2+, including cervical intraepithelial neoplasia grade 2, CIN2; cervical intraepithelial neoplasia grade 3, CIN3; squamous cervical cancer, SCC; and adenocarcinoma of the cervix, ACC) based on the histopathology results.A total of 2817 eligible patients were enrolled, including 610 cases identified as CIN1 and 2207 as CIN2+. The hr-HPV positive rates in the CIN1 and CIN2+ groups were 78.2% (477/610) and 93.3% (2060/2207), respectively. The most frequently detected genotypes were HPV16, 58, 52 and18 in the CIN1 group and HPV16, 58, 33, and 52 in the CIN2+ group, in descending order of prevalence. In addition, the prevalence of HPV18 among the patients with ACC was 28.6% (14/49), significantly >7.2% (54/752) prevalence among the SCC patients (P < 0.001). Additionally, significantly more women in the CIN2+ group had multiple infections compared with those in the CIN1 group (38.1% and 24.9%, respectively; P < 0.001). However, as the cervical lesion grade increased, the prevalence of multiple hr-HPV infections gradually deceased to 44.2% in the CIN2 patients, 36.7% in the CIN3 patients, and 35.3% in the cervical cancer (CC) patients, which included SCC and ACC patients. In cases of multiple hr-HPV infections in the CIN2+ group, double infections accounted for ∼76.6%, and HPV16+58, HPV16+52, and HPV16+18 were the most common combinations, in descending order. The most frequent combination for triple infections was HPV16+58+31, with a rate of 4.2%. The highest positive rate occurred in the ≤24 year-old group for all types of cervical lesions.The prevalence of HPV genotypes in the targeted population with high-grade cervical lesions differs from that of other countries. This information could be helpful for the prevention of CC in Beijing, China.
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Affiliation(s)
- Meizhu Xiao
- From the Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University (MX, QX, HG, YB, ZZ); and Department of Obstetrics and Gynecology, the General Hospital of the People's Liberation Army, Beijing, China (HL)
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Chen X, Wallin KL, Duan M, Gharizadeh B, Zheng B, Qu P. Prevalence and genotype distribution of cervical human papillomavirus (HPV) among women in urban Tianjin, China. J Med Virol 2015; 87:1966-72. [PMID: 26073652 DOI: 10.1002/jmv.24248] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2015] [Indexed: 11/11/2022]
Abstract
To investigate the prevalence and genotype distribution of human papillomavirus (HPV) infection among women in urban Tianjin, China. A cervical cancer screening program for 2,000 women aged 21-65 years old was performed in urban Tianjin from April to October in 2013. The program included ThinPrep cytologic tests (TCT), HPV DNA detection and genotyping using nested polymerase chain reaction (PCR) combined with Pyrosequencing technology. Colposcopy examination and biopsy were needed if TCT reported greater or equal atypical cells of undetermined significance (ASCUS). One thousand nine hundred seventy-eight women were enrolled in the final study, 14.71% (291/1,978) of women were tested HPV positive. Of HPV-positive specimens, 248 (85.22%) and 43 (14.78%) were infected with high- and low-risk HPV genotypes, respectively. Twenty-eight types of HPV were detected in all, the most frequently detected types were HPV16, 58, 18, and 66 orderly. The single infection rate was 92.28% among HPV-positive samples while the multiple infection rate was 7.72%. Among multiple infection models, HPV16 was the most common type co-infection with other types. This study is, to our knowledge, the first population-based survey to provide data on HPV infection and genotype distribution among women in urban Tianjin, China. There was a high prevalence of HPV infection in this area, and HPV16, 58, 18, 66 were the most frequently detected genotypes. Our study provide important information regarding the necessity of early cervical cancer screenings and prophylactic HPV vaccinations, and the knowledge of HPV distribution can also inform us about the HPV ecological change after the vaccination.
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Affiliation(s)
- Xiujie Chen
- Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China
| | - Keng-Ling Wallin
- Department of Oncology-Pathology, Cancer Center Karolinska (CCK), Karolinska University Hospital-Solna, Stockholm, Sweden
| | - Meng Duan
- Tianjin Medical University, Tianjin, China
| | - Baback Gharizadeh
- Stanford Genome Technology Center, Stanford University, Palo Alto, California
| | - Biying Zheng
- Department of Clinical Microbiology, Institute of Laboratory Medicine of Guangdong Medical College, Zhanjiang, Guangdong Province, China
| | - Pengpeng Qu
- Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China
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Abstract
Trichomonas vaginalis is the most common nonviral sexually transmitted infection (STI) in the world. It was once thought to be a nuisance STI, but it is now being recognized as an important source of reproductive morbidity and a facilitator of HIV transmission and acquisition, and thus it is an important public health problem. The prevalence of T. vaginalis varies greatly by geography and risk group, but is more common among persons of African descent and appears to increase with age, though this may be a screening phenomenon. Wet mount and culture are simple diagnostics, but have lower sensitivity than nucleic acid amplification techniques presently approved for women only. Single dose (2 g) metronidazole (MTZ) for both the index patient and their sexual partners is the preferred treatment. High rates of retest positivity are found after single-dose treatment which are likely due to clinical resistance rather than re-infection and/or drug resistance.
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Affiliation(s)
- Patricia Kissinger
- School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street SL-18, New Orleans, LA, 70112, USA,
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Tang X, Gao Z, Li Y, Yu J, Li X. Efficacy and safety of focused ultrasound versus microwave therapy for cervical ectopy: a meta-analysis. J Evid Based Med 2015; 8:61-74. [PMID: 25954850 DOI: 10.1111/jebm.12150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/24/2014] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To assess the efficacy and safety of focused ultrasound therapy (FU) and microwave therapy (MW) for cervical ectopy (CE). METHODS We searched PubMed, EMbase, the Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journals Database (VIP), China Academic Journals Full-text Database (CNKI), and WanFang Data for randomized controlled trials (RCTs) comparing FU with MW for women with symptomatic CE from inception to 30 August 2014. Two review authors (Tang XL and Gao Z) independently screened for eligible studies according to the inclusion and exclusion criteria, extracted data and assessed risk of bias of included RCTs. Then, meta-analysis was performed using the RevMan 5.2 software. Funnel plots were used to evaluate publication bias. RESULTS A total of 33 RCTs with 11,759 participants were included. All studies had high risk of bias. The results of meta-analysis indicated that compared to MW, FU significantly reduced the risk of vaginal bleeding (RR = 0.09, 95%CI 0.05 to 0.17, P < 0.00001) and vaginal discharge (RR = 0.10, 95%CI 0.04 to 0.24, P < 0.00001), increased the cure rate (RR = 1.10, 95%CI 1.05 to 1.15, P < 0.0001) and the total effectiveness rate (RR = 1.04, 95%CI 1.02 to 1.06, P = 0.0005), and decreased the recurrence rate (RR = 0.13, 95%CI 0.02 to 1.00, P = 0.05); however, this last difference was not statistically significant. CONCLUSION Current available evidence suggests that FU is safer and more effective than MW for treating CE. However, some limitations will reduce the reliability of our results. Further well-designed clinical trials are needed to provide further clarification.
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Affiliation(s)
- Xueli Tang
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhan Gao
- Mianyang 404 Hospital, Mianyang, China
| | - Youping Li
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiajie Yu
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xianglian Li
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Xue H, Lin X, Li T, Yan X, Guo K, Zhang Y. Prevalence and genotype distribution of human papillomavirus infection in asymptomatic women in Liaoning province, China. J Med Virol 2015; 87:1248-53. [PMID: 25880913 DOI: 10.1002/jmv.24029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Hui Xue
- Department of Gynecology; First Affiliated Hospital of China Medical University; Shenyang China
| | - Xuyong Lin
- Department of Pathology; First Affiliated Hospital and College of Basic Medical Sciences of China Medical University; Shenyang China
| | - Tianren Li
- Department of Gynecology; First Affiliated Hospital of China Medical University; Shenyang China
| | - Xiaoxia Yan
- Department of Pathology; First Affiliated Hospital and College of Basic Medical Sciences of China Medical University; Shenyang China
| | - Kejun Guo
- Department of Gynecology; First Affiliated Hospital of China Medical University; Shenyang China
| | - Yi Zhang
- Department of Gynecology; First Affiliated Hospital of China Medical University; Shenyang China
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Xu QX, Zhang ZY. High-risk Human Papillomavirus Genotypes in Cervical Lesions and Vaccination Challenges in China. Asian Pac J Cancer Prev 2015; 16:2193-7. [DOI: 10.7314/apjcp.2015.16.6.2193] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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38
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Wang L, Wu B, Li J, Chen L. Prevalence of human papillomavirus and its genotype among 1336 invasive cervical cancer patients in Hunan province, central south China. J Med Virol 2014; 87:516-21. [PMID: 25604457 DOI: 10.1002/jmv.24094] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Linqian Wang
- Department of Medical Laboratory; Hunan Cancer Hospital; the Affiliated Cancer Hospital of Xiangya School of Medicine; Central South University; Changsha Hunan Province China
| | - Baiping Wu
- Department of Medical Laboratory; Hunan Cancer Hospital; the Affiliated Cancer Hospital of Xiangya School of Medicine; Central South University; Changsha Hunan Province China
| | - Junjun Li
- Department of Pathology; Hunan Cancer Hospital; the Affiliated Cancer Hospital of Xiangya School of Medicine; Central South University; Changsha Hunan Province China
| | - Liyu Chen
- Department of Microbiology; Xiangya School of Medicine; Central South University; Changsha Hunan Province China
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Lu S, Cong X, Li M, Chang F, Ma L, Cao YT. Distribution of high-risk human papillomavirus genotypes in HPV-infected women in Beijing, China. J Med Virol 2014; 87:504-7. [PMID: 25331595 DOI: 10.1002/jmv.24075] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2014] [Indexed: 11/10/2022]
Abstract
To investigate the distribution of high-risk human papillomavirus (HPV) genotypes in infected women from Beijing, China, samples were obtained during routine gynecologic examinations and DNA was extracted from the samples, and PCR was performed to distinguish the 13 high-risk HPV subtypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68). Samples were obtained from 1160 women (20-75 years old), and 470 cases of high-risk HPV infection were diagnosed. HPV 52, HPV 16, HPV 58, HPV 51, and HPV 39 were the most common genotypes accounting for 22.8%, 22.3%, 20.0%, 14.3%, and 13.6% of cases, respectively. The highest infection rates were found in 20-30 year-old patients (35.1%). HPV 16 infection was the highest in the 31-40 year-old group, and HPV 52, HPV 58, and HPV 39 infections were highest in the 20-30 year-old group. Some patients were infected with multiple high-risk HPV subtypes. Of the 470 patients with positive HPV tests, 65.7% of women were infected with a single high-risk HPV subtype, 23.2%, of women were infected with two high-risk HPV subtypes, 7.7% were infected with three subtypes, and 3.4% of women were infected with more than three high-risk HPV subtypes. In this study, HPV 16 and HPV 52 were the most common subtypes found in patients with cervical lesions.
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Affiliation(s)
- Shuang Lu
- Molecular Diagnostics Center, Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
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Ding X, Liu Z, Su J, Yan D, Sun W, Zeng Z. Human papillomavirus type-specific prevalence in women referred for colposcopic examination in Beijing. J Med Virol 2014; 86:1937-43. [PMID: 25132373 DOI: 10.1002/jmv.24044] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2014] [Indexed: 11/11/2022]
Abstract
Human papillomavirus (HPV) is associated with several disorders of the genital tract, skin, and oropharynx. This study investigated the prevalence of infection by 37 HPV genotypes among women of the Beijing area in China. Cervical specimens from 1,082 patients and 165 healthy controls were tested for HPV genotypes using a chip hybridization assay. Based on the local pathology, patients were divided into cervicitis and cervical lesion groups. Overall HPV infection rates were 30.5% for the cervicitis group and 78.4% for the cervical lesion group; whereas infection rates for high-risk HPV types (i.e., those associated with cervical cancers) were 24.0% and 73.4%, respectively. The most common HPV genotypes were HPV 52, 16, 81, 58, and 18 in healthy controls, HPV 52, 61, 55, 16, and 53 in those with cervicitis, HPV 52, 16, 33, 39, and 58 in cervical intraepithelial neoplasia grade 1, HPV 16, 58, 31, 52, and 33 in cervical intraepithelial neoplasia grade 2 or grade 3, and HPV 16, 33, 18, 52, and 58 in cervical cancer. Established high-risk HPV showed two peaks, in patients aged 30-34 and 55-79 years. In Beijing, HPV 16, 52, 58, and 33 are the most prevalent HPV types in women with cervical lesions, which should affect development of a cervical cancer vaccination for local use.
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Affiliation(s)
- Xiurong Ding
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Evaluation of microbial enzymes in normal and abnormal cervicovaginal fluids of cervical dysplasia: a case control study. BIOMED RESEARCH INTERNATIONAL 2014; 2014:716346. [PMID: 24967392 PMCID: PMC4054614 DOI: 10.1155/2014/716346] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 04/07/2014] [Accepted: 05/01/2014] [Indexed: 11/17/2022]
Abstract
The aim of the present study was to evaluate the role of microbial enzymes in normal and abnormal cervicovaginal fluids of cervical dysplasia. The cervicovaginal infections were evaluated through the estimation of microbial enzymes in patients with and without abnormal cervical cytology like bacterial and fungal infections. The patients were categorized based on infection caused by organism and stages of dysplasia. The pH, Whiff test, and Pap smear tests were conducted for normal and abnormal cervical swabs based on standard protocols. Microbial enzymes include mucinase, sialidases, and proteases of the cervical swabs and are estimated according to standard methods. The results of abnormal cervical cytological smears showed increased pH and the presence of amines with different levels of Pap smear test. Increased levels of microbial enzymes were observed in patients with abnormal cytology than normal cytology. Three microbial enzymes mucinase, sialidase, and protease were significantly (P < 0.01) more elevated in patients with bacterial infections (8.97 ± 0.64, 10.39 ± 0.28, 8.12 ± 0.64) than without dysplasia (2.02 ± 0.8, 1.98 ± 0.3, 1.96 ± 0.8). The results reinforce that the microbial infection seems to be more prone to cervical dysplasia and may act as risk-factor for the development of cervical cancer along with HPV infection.
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Zhang R, Velicer C, Chen W, Liaw KL, Wu EQ, Liu B, Cui JF, Belinson JL, Zhang X, Shen GH, Chen F, Qiao YL. Human papillomavirus genotype distribution in cervical intraepithelial neoplasia grades 1 or worse among 4215 Chinese women in a population-based study. Cancer Epidemiol 2013; 37:939-45. [PMID: 24210584 DOI: 10.1016/j.canep.2013.10.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 09/27/2013] [Accepted: 10/02/2013] [Indexed: 01/06/2023]
Abstract
PURPOSE To estimate the burden of human papillomavirus (HPV) infection and cervical disease among sexually active women in a sample of Chinese women. METHODS A multicenter, population-based study was conducted between May 2006 and April 2007. A total of 4215 sexually active women aged 17-54 years were surveyed from five geographical sites representing both urban and rural areas: Beijing, Shanghai, Shanxi, Henan and Xinjiang. Women were referred for colposcopy on the basis of results of Pap testing and HPV screening. HPV genotyping of the CIN1+ specimens was performed with INNO-LiPA. Attribution of HPV types to lesions was estimated using a fractional contribution approach. RESULTS 13.3% of the women (559/4215) were referred for colposcopy; 4.3% (183/4215) of these were diagnosed with CIN1+. Of the latter, 88.5% (162/183) were typed and 94.4% (153/162) were HPV-positive. HPV16 was the most prevalent type in lesions in both urban and rural settings. Combined, HPV16 and 18 were attributable to 71.4% of HPV-positive CIN2+ lesions. In addition, HPV31, 33, 52 and 58 were prevalent in CIN1+ lesions, with HPV33, 52, and 58 combined accounting for 24.1% CIN2+ lesions. Though prevalent, HPV31 always occurred as a co-infection with another HPV type and therefore was attributed minimal causality. CONCLUSIONS HPV16 and 18 are associated with the majority of cervical lesions in Chinese women from which this population-based sample was drawn. In addition, other HPV types, such as 33, 52, and 58, also play an important role in cervical disease.
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Affiliation(s)
- Rong Zhang
- Department of Cancer Epidemiology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wu YM, Wang T, He Y, Song F, Wang Y, Zhu L, Kong WM, Duan W, Zhang WY. Clinical management of cervical intraepithelial neoplasia in pregnant and postpartum women. Arch Gynecol Obstet 2013; 289:1071-7. [DOI: 10.1007/s00404-013-3076-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 10/24/2013] [Indexed: 10/26/2022]
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44
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Li J, Huang R, Schmidt JE, Qiao YL. Epidemiological Features of Human Papillomavirus (HPV) Infection among Women Living in Mainland China. Asian Pac J Cancer Prev 2013; 14:4015-23. [DOI: 10.7314/apjcp.2013.14.7.4015] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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45
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Yang MJ, Luo L, Nie K, Wang M, Zhang C, Li J, Ma XJ. Genotyping of 11 human papillomaviruses by multiplex PCR with a GeXP analyzer. J Med Virol 2012; 84:957-63. [PMID: 22499019 DOI: 10.1002/jmv.23275] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A new, rapid, and high-throughput method was developed for simultaneous detection of 11 human papillomavirus (HPV) genotypes including nine high-risk types (HPV16, 18, 31, 33, 35, 39, 52, 58, and 66) and two low-risk types (HPV6 and 11) in a single tube by multiplex PCR based on a GenomeLab Gene Expression Profiler (GeXP) analyzer (GeXP-PCR). Eleven sets of chimeric primers were used to initiate the PCR, and one pair of universal primers was used for the subsequent cycles of the PCR. The specificity of GeXP-PCR for each HPV type was examined with clinical samples of single type HPV infection tested previously. The sensitivity of GeXP-PCR was evaluated by performing the assay on serial 10-fold dilutions of cloned PCR products. The GeXP-PCR achieved a sensitivity of 100 copies when all of the 11 pre-mixed plasmids containing HPV targets were present. Analyses of 124 clinical specimens using the GeXP-PCR demonstrated that the GeXP-PCR assay had comparable sensitivity and specificity to those of reported multiple PCR assay and an increased detection of HPV 11 in samples with mixed infections. In conclusion, the GeXP-PCR is a fast, sensitive, and high throughput method for the detection of multiple HPV infections.
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Affiliation(s)
- Meng-Jie Yang
- State Key Laboratory for Molecular Virology and Genetic Engineering, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Rodriguez-Cerdeira C, Sanchez-Blanco E, Alba A. Evaluation of Association between Vaginal Infections and High-Risk Human Papillomavirus Types in Female Sex Workers in Spain. ISRN OBSTETRICS AND GYNECOLOGY 2012; 2012:240190. [PMID: 22900198 PMCID: PMC3415090 DOI: 10.5402/2012/240190] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 06/13/2012] [Indexed: 01/26/2023]
Abstract
Background. Infection with and persistence of high-risk human papillomavirus (HR-HPV) are the strongest risk factors for cervical cancer. In addition, other genital microorganisms may also be involved in the progression of HPV-associated lesions. Objetive. To evaluate the association of the vaginal microbiota (Candida spp., Trichomonas vaginalis, and bacterial vaginosis) with HR-HPV infection in Spanish female sex workers (FSWs). Methods. This cross-sectional study involved 208 (FSWs; age, 18-49 years) who visited a sexually transmitted infection (STI) information and prevention center (SERGAS) between January 2010 and December 2011. Face-to-face interviews were carried out. Cervical and vaginal samples were examined for human papillomavirus (HPV), Trichomonas vaginalis, Candida spp., and microorganisms related to bacterial vaginosis (BV). Results. HR-HPV was found to be significantly associated with BV in FSWs with positive results for HPV16-related types (31, 33, 35, and 52). T. vaginalis was isolated in FSWs with the following HR-HPVs: 18, 45, 66, and 68. Candida spp. were isolated only in FSWs with HPV 18-positive infection. Conclusion. We demonstrate a significant prevalence of HR-HPVs in FSWs with disturbances in the vaginal microbiota.
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Zhao FH, Lewkowitz AK, Hu SY, Chen F, Li LY, Zhang QM, Wu RF, Li CQ, Wei LH, Xu AD, Zhang WH, Pan QJ, Zhang X, Belinson JL, Sellors JW, Smith JS, Qiao YL, Franceschi S. Prevalence of human papillomavirus and cervical intraepithelial neoplasia in China: a pooled analysis of 17 population-based studies. Int J Cancer 2012; 131:2929-38. [PMID: 22488743 DOI: 10.1002/ijc.27571] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 03/20/2012] [Indexed: 01/06/2023]
Abstract
High-risk (HR) human papillomavirus (HPV) prevalence has been shown to correlate well with cervical cancer incidence rates. Our study aimed to estimate the prevalence of HR-HPV and cervical intraepithelial neoplasia (CIN) in China and indirectly informs on the cervical cancer burden in the country. A total of 30,207 women from 17 population-based studies throughout China were included. All women received HPV DNA testing (HC2, Qiagen, Gaithersburg, MD), visual inspection with acetic acid and liquid-based cytology. Women positive for any test received colposcopy-directed or four-quadrant biopsies. A total of 29,579 women had HR-HPV testing results, of whom 28,761 had biopsy confirmed (9,019, 31.4%) or assumed (19,742, 68.6%) final diagnosis. Overall crude HR-HPV prevalence was 17.7%. HR-HPV prevalence was similar in rural and urban areas but showed dips in different age groups: at age 25-29 (11.3%) in rural and at age 35-39 (11.3%) in urban women. In rural and urban women, age-standardized CIN2 prevalence was 1.5% [95% confidence interval (CI): 1.4-1.6%] and 0.7% (95% CI: 0.7-0.8%) and CIN3+ prevalence was 1.2% (95% CI: 1.2-1.3%) and 0.6% (95% CI: 0.5-0.7%), respectively. Prevalence of CIN3+ as a percentage of either all women or HR-HPV-positive women steadily increased with age, peaking in 45- to 49-year-old women. High prevalence of HR-HPV and CIN3+ was detected in both rural and urban China. The steady rise of CIN3+ up to the age group of 45-49 is attributable to lack of lesion removal through screening. Our findings document the inadequacy of current screening in China while indirectly raising the possibility that the cervical cancer burden in China is underreported.
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Affiliation(s)
- Fang-Hui Zhao
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wang X, Qi M, Yu X, Yuan Y, Zhao W. Type-specific interaction between human papillomavirus type 58 E2 protein and E7 protein inhibits E7-mediated oncogenicity. J Gen Virol 2012; 93:1563-1572. [PMID: 22442110 DOI: 10.1099/vir.0.039354-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Human papillomavirus type 58 (HPV-58) is a very common HPV type in eastern Asia. Little is known about its biology and tumorigenesis. In this study, HPV-58 E2 protein (58E2) was found to interact with E7 protein (58E7), and the hinge domain of 58E2 was shown to be responsible for binding to the 58E7 protein. Interestingly, the E2-E7 interaction appears to be HPV type-specific, as we found that the HPV-16 E2 could not bind to the 58E7 protein, and neither did 58E2 interact with HPV-16 E7. The biological consequence(s) of the E2-E7 interaction in HPV-58, especially in viral tumorigenesis, was investigated. Results showed that, through interacting with 58E7, 58E2 prevented E7-induced retinoblastoma protein (pRb) degradation and prolonged the half-life of pRb in cells. Additionally, 58E2 abrogated 58E7-induced cell proliferation. These observations collectively suggest that direct interaction with 58E7 is another mechanism for 58E2 to inhibit 58E7-associated carcinogenesis in addition to regulating expression of the 58E7 gene.
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Affiliation(s)
- Xin Wang
- Department of Microbiology, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104, USA.,Department of Microbiology, Shandong University School of Medicine, Jinan, Shandong, 250012, PR China
| | - Mei Qi
- Department of Microbiology, Shandong University School of Medicine, Jinan, Shandong, 250012, PR China
| | - Xiuping Yu
- Department of Microbiology, Shandong University School of Medicine, Jinan, Shandong, 250012, PR China
| | - Yan Yuan
- Department of Microbiology, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104, USA
| | - Weiming Zhao
- Department of Microbiology, Shandong University School of Medicine, Jinan, Shandong, 250012, PR China
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Chen Q, Xie LX, Qing ZR, Li LJ, Luo ZY, Lin M, Zhang SM, Chen WZ, Lin BZ, Lin QL, Li H, Chen WP, Zheng PY, Mao LZ, Chen CY, Yang C, Zhan YZ, Liu XZ, Zheng JK, Yang LY. Epidemiologic characterization of human papillomavirus infection in rural Chaozhou, eastern Guangdong Province of China. PLoS One 2012; 7:e32149. [PMID: 22384160 PMCID: PMC3286448 DOI: 10.1371/journal.pone.0032149] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 01/24/2012] [Indexed: 12/04/2022] Open
Abstract
Background Human papilloma virus (HPV) infection was the main cause of cervical cancer. There were only a few reports and detailed data about epidemiological research of HPV infection in rural population of China. Materials and Methods The cervical cells of rural Chaozhou women were collected, and multiplex real time PCR was firstly performed to detect high-risk HPV (HR-HPV) infection, which could detect 13 types of HR-HPV (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68). Then, HPV-positive samples were typed by HPV GenoArray test. Results HR-HPV DNA was detected by multiplex real time-PCR in 3830 of 48559 cases (7.89%). There was a peak incidence in age of 55–60 years group, and a lower incidence in who lived in plain group compared with suburban, mountain and seashore group. 3380 cases of HPV positive sample were genotyped, 11.01% (372/3380) cases could not be classified, among the typed 3008 cases, 101 cases were identified without HR-HPV type infection, 2907 cases were infected with one HR-HPV type at least, the 6 most common HR-HPV types in descending order of infection, were type 52 (33.4%, 16 (20.95%), 58 (15.93%), 33 (9.94%), 68 (9.22%) and 18 (8.36%). The combined prevalence of HPV types 16 and 18 accounted for 28.52% of total infection. However, type 52 plus 58 presented 48.23% of total infection. 2209/2907 cases were infected with a single HPV type and 698/2907 cases were infected with multiple types, and multiple infection constituent ratio increased with age, with a peak incidence in age 55–60 years group. Conclusions Our findings showed low prevalence of HPV vaccine types (16 and 18) and relatively high prevalence of HPV-52 and -58, support the hypothesis that the second-generation HPV vaccines including HPV-52 and -58 may offer higher protection for women in rural Guangdong Province.
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Affiliation(s)
- Qiang Chen
- Central Lab, Chaozhou Central Hospital, Chaozhou, Guangdong Province, China
- Department of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Long-Xu Xie
- Chaozhou Hybribio Limited Corporation, Chaozhou, Guangdong Province, China
| | - Zhi-Rong Qing
- Chaozhou Hybribio Limited Corporation, Chaozhou, Guangdong Province, China
| | - Lie-Jun Li
- Chaozhou Hybribio Limited Corporation, Chaozhou, Guangdong Province, China
| | - Zhao-Yun Luo
- Central Lab, Chaozhou Central Hospital, Chaozhou, Guangdong Province, China
| | - Min Lin
- Central Lab, Chaozhou Central Hospital, Chaozhou, Guangdong Province, China
| | - Shi-Ming Zhang
- Chaozhou Health Bureau, Chaozhou, Guangdong Province, China
| | - Wen-Zhou Chen
- Chaozhou Health Bureau, Chaozhou, Guangdong Province, China
| | - Bing-Zhong Lin
- Raoping County People's Hospital, Raoping County, Guangdong Province, China
| | - Qi-Li Lin
- Department of Gynecology and Obstetrics, Chaozhou People's Hospital, Chaozhou, Guangdong Province, China
| | - Hui Li
- Department of Gynecology and Obstetrics, Chaozhou Gynecological and Pediatric Hospital, Chaozhou, Guangdong Province, China
| | - Wei-Pian Chen
- Chao'an County Gynecological and Pediatric Hospital, Chao'an County, Guangdong Province, China
| | - Pei-Yao Zheng
- Fengxi People's Hospital, Chaozhou, Guangdong Province, China
| | - Ling-Zhi Mao
- Department of Obstetrics and Gynecology, Guangdong Provincial Women and Children's Hospital, Guangzhou, China
| | - Chan-Yu Chen
- Department of Gynecology, Chaozhou Central Hospital, Chaozhou, Guangdong Province, China
| | - Chun Yang
- Department of Gynecology, Chaozhou Central Hospital, Chaozhou, Guangdong Province, China
| | - Yong-Zhong Zhan
- Central Lab, Chaozhou Central Hospital, Chaozhou, Guangdong Province, China
| | - Xiang-Zhi Liu
- Central Lab, Chaozhou Central Hospital, Chaozhou, Guangdong Province, China
| | - Jia-Kun Zheng
- Central Lab, Chaozhou Central Hospital, Chaozhou, Guangdong Province, China
| | - Li-Ye Yang
- Central Lab, Chaozhou Central Hospital, Chaozhou, Guangdong Province, China
- * E-mail:
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Abstract
ObjectivePlants belonging to the genus Celastrus exhibit antitumor activity and the ability to reverse multidrug resistance in tumor cells; however, it remains unclear whether the compound oleanen from Celastrus hypoleucus also exhibits antitumor activity. The objective of this study was to explore the inhibitory effect of 12-oleanene-3β, 6α-diol (oleanen) on the proliferation of cervical cancer HeLa cells in vitro, as well as its relative mechanism.MethodsHeLa cells were treated with different concentrations of oleanen for different times. Cell proliferation was determined by 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di-phenytetrazoliumromide assay. Cell apoptosis was evaluated by flow cytometry and caspases activities assay. The expression of several proapoptotic proteins belonging to the Bcl-2 family, such as Bax, Bim, and Bad, was detected by Western blot.ResultsOleanen mainly inhibited the proliferation of HeLa cells at the G0 to G1 and G2 to M phases, and the IC50 of oleanen for cells was significantly higher at 24 hours compared to 48 hours (17.45 ± 3.71 vs 9.02 ± 0.83 μg/mL, respectively; P < 0.05). The significant increase in activity of caspase 3/7, caspase 6 in oleanen-treated HeLa cells indicated that oleanen promoted the apoptosis of HeLa cells. The activity of caspase 9 representing the endogenous apoptotic pathways also increased obviously in oleanen treatment. Furthermore, the increase in the expression of Bim was the most significant among the Bcl-2 family after oleanen treatment.ConclusionOleanen up-regulates the expression of Bim and other proapoptotic molecules to activate the endogenous apoptosis pathway, thus promoting apoptosis and inhibiting proliferation of human cervical cancer HeLa cells in vitro.
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