The prevalence and role of human papillomavirus genotypes in primary cervical screening in the northeast of China

BMC Cancer, May 2012

Background Studies have shown that type-specific persistence of high-risk human papillomavirus (HPV) infection contributed significantly to cervical carcinogenesis. Methods In this population-based study (on 24041 women), we report on the prevalent genotypes of HPVs and the prevalent genotypes of HPV persistent infection in the northeast of China. Results Our results showed that in HPV infected women (45.6% in total), (95% CI, 44.97%–46.23%), 17.35% (95%CI, 16.87%–17.83%) suffered persistent infection. The most common high-risk HPV types in persistent positivity were HPV-16 (18.21%; 95%CI, 17.04%–19.38%), HPV-58 (13.2%; 95%CI, 12.17%–14.23%), HPV-18 (8.66%; 95%CI, 7.81%–9.51%), HPV-52 (7.06%; 95% CI, 6.28%–7.84%) and HPV-33 (6.78%; 95% CI, 6.02%–7.54%). The prevalence of persistent infections with HPV-16,–58, −18, −52 and 33 in cervicitis were lower compared to those in CIN (all P < 0.05). HPV-58, −33 and multiple HPV persistent positivity were significantly associated with older age (all P < 0.05). HPV-18 persistent positivity was significantly associated with adenocarcinoma and lymphatic metastasis (all P < 0.05). HPV-18 persistent positivity was associated with cervical cancer prognosis (P <0.0001). Multivariate analyses showed that HPV-18 persistent positivity, (RR = 1.704, 95%CI = 1.095–2.654, p = 0.028) and lymphatic metastasis (RR = 2.304, 95%CI = 1.354–3.254, P = 0.015) were independent predictors for 3-year survival in cervical cancer. Conclusions we provided extensive results of HPV genotype prevalence and distribution in the northeast of China. HPV genotyping is worthwhile to perform because of its independent prognostic value in cervical cancer

A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser.

Alternatively, you can download the file locally and open with any standalone PDF reader:

http://www.biomedcentral.com/content/pdf/1471-2407-12-160.pdf

The prevalence and role of human papillomavirus genotypes in primary cervical screening in the northeast of China

BMC Cancer The prevalence and role of human papillomavirus genotypes in primary cervical screening in the northeast of China Shizhuo Wang 0 Heng Wei 0 Ning Wang 0 Shulan Zhang 0 Yao Zhang 0 Qiang Ruan 2 Weiguo Jiang 1 Qian Xiao 0 Xiaomei Luan 0 Xiuyan Qian 0 Lili Zhang 0 Xiang Gao 0 Xiaowei Sun 3 0 Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University , Shenyang, Liaoning , China 1 Department of Pathology, Shengjing Hospital, China Medical University , Shenyang, Liaoning , China 2 Virus Laboratory, Shengjing Hospital, China Medical University , Shenyang, Liaoning , China 3 Division of Pediatric Neurology, Weill Cornell Medical College , New York, NY10065 , USA Background: Studies have shown that type-specific persistence of high-risk human papillomavirus (HPV) infection contributed significantly to cervical carcinogenesis. Methods: In this population-based study (on 24041 women), we report on the prevalent genotypes of HPVs and the prevalent genotypes of HPV persistent infection in the northeast of China. Results: Our results showed that in HPV infected women (45.6% in total), (95% CI, 44.97%-46.23%), 17.35% (95%CI, 16.87%-17.83%) suffered persistent infection. The most common high-risk HPV types in persistent positivity were HPV-16 (18.21%; 95%CI, 17.04%-19.38%), HPV-58 (13.2%; 95%CI, 12.17%-14.23%), HPV-18 (8.66%; 95%CI, 7.81%9.51%), HPV-52 (7.06%; 95% CI, 6.28%-7.84%) and HPV-33 (6.78%; 95% CI, 6.02%-7.54%). The prevalence of persistent infections with HPV-16,-58, 18, 52 and 33 in cervicitis were lower compared to those in CIN (all P < 0.05). HPV-58, 33 and multiple HPV persistent positivity were significantly associated with older age (all P < 0.05). HPV-18 persistent positivity was significantly associated with adenocarcinoma and lymphatic metastasis (all P < 0.05). HPV-18 persistent positivity was associated with cervical cancer prognosis (P <0.0001). Multivariate analyses showed that HPV-18 persistent positivity, (RR = 1.704, 95%CI = 1.095-2.654, p = 0.028) and lymphatic metastasis (RR = 2.304, 95% CI = 1.354-3.254, P = 0.015) were independent predictors for 3-year survival in cervical cancer. Conclusions: we provided extensive results of HPV genotype prevalence and distribution in the northeast of China. HPV genotyping is worthwhile to perform because of its independent prognostic value in cervical cancer Human papillomavirus genotype; Cervical screening; Cervical cancer; Prognosis - Background Human Papillomavirus (HPV) infection usually proceeds for the development of virtually all invasive cervical cancers, their associated precancerous lesions, and genital warts [1,2]. To date, more than 200 HPV genotypes have been identified, but the interest is focused only on genital HPVs (40 genotypes) that are associated with precancerous and cancerous lesions of the cervix [3,4]. Although high incidence and prevalence are found in females after the onset of sexual activity, most of HPV infection are transient and clear within 612 months. Studies showed that type-specific persistence of high-risk human papillomavirus (HPV) infection contributed significantly to cervical carcinogenesis [5-7]. It is expected that the next-generation approach of HPV vaccines may more efficiently prevent cervical cancer, however, efforts to implement and evaluate a vaccination strategy are dependent on our understanding of the behaviors of HPV type-specific infection. Meanwhile, the geographic variation in the prevalence and distribution of HPV genotypes had been reported in different countries, even different regions in the same country. Its necessary for us to study the prevalence and role of human papillomavirus genotypes in primary cervical screening in different geographic regions [8,9]. We have previously reported the prevalence of HPVs in 1444 Women in Liaoning Province, China [10]. However, no large epidemiologic data has been reported in the northeast of China. We performed a population-based study (24041 women) to investigate the prevalent high-risk genotypes of HPVs and the results in HPV infected women in the northeast of China. After they first visited, we randomly selected 15257 from those 24041 women, and followed them up to test their HPV persistence as well as their pathological changes, in order to study the association between the persistent HPV infections and cervical lesions. Methods Enrolled group From 2007 to 2010, 24041 women between the ages of 18 and 60 years who were permanent residents in the northeast of China were eligible to participate. All women were composed of healthy Chinese women who had underwent cervical cancer screening in our Health Check Center or at the Department of Obstetrics and Gynecology, Shengjing Afiliated Hospital of China Medical University. These women were not pregnant during their first visit and also had no intention to be pregnant during the first year of follow-up. Moreover, we excluded patients who had a history of hysterectomy, o (...truncated)


This is a preview of a remote PDF: http://www.biomedcentral.com/content/pdf/1471-2407-12-160.pdf

Shizhuo Wang, Heng Wei, Ning Wang, Shulan Zhang, Yao Zhang, Qiang Ruan, Weiguo Jiang, Qian Xiao, Xiaomei Luan, Xiuyan Qian, Lili Zhang, Xiang Gao, Xiaowei Sun. The prevalence and role of human papillomavirus genotypes in primary cervical screening in the northeast of China, BMC Cancer, 2012, pp. 160, 12, DOI: 10.1186/1471-2407-12-160