Relevant factors to female human papillomavirus infection in city and rural areas of Shenzhen / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the differences of relevant factors to human papillomavirus (HPV) infection between urban and rural women.</p><p><b>METHODS</b>10 000 sexually active women from Shenzhen city and rural areas were interviewed with questionnaire on risk factor to HPV infection and screened for cervical cancer, using 3 kinds of HPV test.</p><p><b>RESULTS</b>Average age of the study population was 38.9, with prevalence rates of HPV infection among the total population, people in SSEZ (Shenzhen Special Economic Zone), out of SSEZ, and rural areas were 33.3%, 35.8%, 30.2%, and 33.8% respectively. Relevant factors to HPV infection in SSEZ were those mainly having had history of abortion,having more sexual partners in lifetime and husbands who work outside the area. Relevant factors to HPV infection out of SSEZ were those mainly having had more episodes of abortion, more sexual partners in lifetime and using condom more than other contraceptives. Relevant factors to HPV infection in rural area were: having more abortions and smoking behavior.</p><p><b>CONCLUSION</b>There were some differences of relevant factors to HPV infection between urban and rural women. In urban area, having had more sexual partners in lifetime played a very important role in contracting HPV infection while condom use for contraception seemed to be a protective factor. In the rural areas, smoking was a risk factor for HPV infection, to some extent. Having had more episodes on abortion showed as a common risk factor to both urban and rural females, on HPV infection.</p>

Investigation on the prevalence of high risk human papillomavirus and cervical cancer among adult women, in Shenzhen / 中华流行病学杂志

Objective To investigate the prevalence of high risk human papillomavirus (HPV) genital infection and cervical cancer in adult women from Shenzhen.Methods Cluster sampling was used to investigate the prevalence of HPV infection and cervical cancer from women aged 20-59 years old living in Luohu,Futian,Nanshan,Longgang and Baoan districts in Shenzhen from April 2006 to April 2010.All women were detected for liquid-based cytology test (LCT) or Thinprep cytologic test (TCT)and high-risk HPV-DNA test with hybrid capture Ⅱ (HC-Ⅱ ).All women with ≥ASC-US by cytology and/or a positive HC- Ⅱ test were asked to return for colposcopy and four-quadrant biopsy.Endocervical curettage was performed.Pathological finding were used as the gold standard of the diagnosis of cervical intraepithelial neoplasia.Results 10 210 women were involved in the study and 10 017 of them having completed data.The overall positive rate of high-risk HPV-DNA was 16.29％.HPV positive rates in 20-,30-,35-,40-,45-,50-59 age groups were 17.37％,15.59％,16.33％,14.74％,17.16％ and 17.98％,respectively.The curve of HPV infection rates in different age groups appeared a ‘W' shape.HPV infection rates in the 25-years-olds and 50-59 year-olds groups were significantly higher than the other age groups (x2=4.50,P=0.03 ).The overall prevalence rate of cervical intraepithelial lesions (CIN) was 7.52％,of which the prevalence rates of low-grade cervical intraepithelial lesions (CIN Ⅰ) was 5.32％ high-grade cervical intraepithelial lesions (CIN Ⅱ/Ⅲ ) was 2.21％,cervical cancer was 0.12％.The prevalence of CIN Ⅰ was significantly higher than the CIN Ⅱ/Ⅲ (x2=134.15,P＜0.001 ).The prevalence of cervical cancer in 45- age group was 0.12％,the highest.HPV infection rates increased with the grades of cervical lesions including women without CIN as 44.31％,in CIN Ⅰ as 70.73％,in CIN Ⅱ as 86.73％,and in CIN Ⅲ as 96.75％ and in cancer as 100.00％.The HPV infection rates were different in districts (x2=17.81,P=0.03 ),with Futian and Luohu higher than those of Nanshan,Longgang and Baoan district.The prevalence rate of CIN in Baoan was lower than other districts.The CIN prevalence rates were not significantly different among the other districts of Shenzhen (x2=4.84,P=0.18).Conclusion The prevalence of cervical cancer was low in adult women living in Shenzhen,with cervical lesions still in the early stage.Prevention of HPV infection and treatment of CIN were the key points for the prevention of cervical cancer.

Prevalence of high-risk human papillomavirus and incidence of cervical intraepithelial neoplasia in female populations in Shenzhen, Guangdong Province / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the prevalence of high-risk human papillomavirus (HPV) and incidence of cervical intraepithelial neoplasia (CIN) in female populations in Shenzhen, Guangdong Province, China.</p><p><b>METHODS</b>Totally 1137 women aged 15-59 from Shahe Community, Nanshan District, Shenzhen were investigated for cervical cancer during an population-based epidemiological screening from November 2004 to December 2004. Visual inspection with acetic acid (VIA), colposcopy, liquid-based cytology test (LCT), and hybrid capture 2 (HC-) were performed to detect the high-risk HPV types in cervical secretions. Biopsy under colposcope was performed in women who were HPV-positive with LCT >or= atypical squamous cells of undetermined sign (ASCUS) or HPV-negative with LCT >or= low grade squamous intraepithelial lesion (LSIL), with the pathological results as the golden standards.</p><p><b>RESULTS</b>The detection rate of high-risk HPV-DNA was 14.0%. HPV detection rates in 15-24, 25-29, 30-34, 35-39, 40-44, 45-49, and 50-59 age groups were 15.5%, 17.7%, 12.6%, 8.8%, 10.2%, 15.3%, and 21.0%, respectively (P < 0.05). HPV detection rates in 25-29 years group and 50-59 years group were significantly higher than those in other groups (P < 0.05) and 35-39 group had the lowest detection rate. The curve of HPV infection rates in all groups was 'V' type. The overall incidence of CIN was 4.4%. The incidences of CIN , CIN , and CIN were 3.2%, 1.0%, and 0.3%, respectively, in which the incidence of CIN was significantly higher than those of CIN and . HPV detection rates increased with cervical lesion grades, which in >or=CIN groups and normal group were 100.0% and 8.3%, respectively. No cervical cancer was identified in this research. The sensitivities of VIA, colposcopy, LCT, and HC-II for high-risk HPV screening were 35.7%, 50.0%, 92.9%,and 100%, respectively, in detecting high-grade squamous intraepithelial lesion (HSIL), the specificities of these four methods were 96.0%, 87.2%, 88.4%, and 86.9%, respectively. Satisfactory negative predictive values were obtained for all methods.</p><p><b>CONCLUSIONS</b>HPV infection is the main risk factor for CIN. Cervical cancer among female populations in Shenzhen is still in early stages. Prevention of HPV infection and treatment of CIN are key for the prevention of cervical cancer.</p>

Amplification and clinical significance of hTERC gene in the cervical exfoliated cells from natural population in Shenzhen / 中华流行病学杂志

the severity of cytological and histological grade. The evidence of hTERC, with or without amplification, might serve as a prognostic indicator to measure the grade of lesion.

Role of cytological test for cervices to identify human papillomavirus in the screening program on serious cervical lesion / 中华流行病学杂志

Objective To evaluate the value of cervical cytology and hybrid capture Ⅱ (HC-Ⅱ) human papillomavarus (HPV) test for screening cervical lesion. Methods Conventional papanicolaou (Pap) smear by improved take-samples, liquid-based cytology test (LCT) and HC-Ⅱ human papillomavarus test were performed in 425 women in Shang Mei-lin community of Futian region in Shenzhen city, from December 2007 to March 2008 and the above methods were performed in 75 women in Shenzhen Hospital of Peking University at the same time. Age stratified sampling was used. Samples of Pap were taken a broom-type sampling device (take-samples used for LCT) with split-sampling method. Those women with HPV-positive, Pap≥atypical squamous cells of undetermined sign (ASCUS) or LCT≥ASCUS received multi-spot biopsy and endocervical curettage under colposcopy. Final diagnosis would depend on pathological findings as well, to evaluate the values of Pap, LCT, HC-Ⅱ HPV, Pap-HPV parallel test, LCT-HPV parallel test, Pap-HPV serial test and LCT-HPV serial test for the screening program on cervical cancer. Results (1) In this study, 7 women bad cervical intraepithelial neoplasia (CIN) Ⅱ, another 7 had CIN Ⅲ, 1 had cervical cancer in the community; 9 had CIN Ⅱ, 11 had CIN Ⅲ, 3 had cervical cancer in the hospital, respectively. (2) The sensitivity of HC-Ⅱ HPV and cytology-HPV parallel test for detecting≥CIN Ⅱ was >95.0% while negative pre-value were nearly 100.0%. (3) There were no significant differences of screening effectiveness and unsatisfactory rates between Pap of improved take-samples and LCT. (4) The cost-effectiveness ratio of Pap-HPV parallel test was higher than LCT-HPV parallel test. Conclusion It was suggested that the first choice for screening of cervical serious lesion were HC-Ⅱ HPV and cytology-HPV parallel test while Pap-HPV parallel test was the best method for screening purposes.

Human papillomavirus infection and cervical intraepithelial neoplasia morbidity of women from different occupations in Shenzhen city, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) morbidity of women from different occupations in Shenzhen city.</p><p><b>METHODS</b>2045 women of five kinds of occupation in Shenzhen city, including 130 teachers, 385 workers, 316 service women, 199 poverish women, 420 doctors or nurses and 595 general residents were included. We screened these women by methods of detecting high risk HPV of hc2 combing with LCT. Women with screening positive results were diagnosed CIN by colposcopic biopsy.</p><p><b>RESULTS</b>(1) High risk factors on HPV infection rate in different occupations were different with the highest in service occupation (19.3%) while the lowest appeared in medical workers (11.9%). (2) In those 2045 women, we found 199 cervical lesions including pathological HPV infection, CIN1, 2, 3 and cervical cancers, with morbidity rates as 4.11%, 3.28%, 1.67%, 0.54% and 0.15% respectively. Along with the progress of the cervical lesions, the morbidity decreased. (3) The morbidity rates of CIN in different occupations were different, with the highest of HSIL in service occupation and the lowest in teachers.</p><p><b>CONCLUSION</b>Women of different occupations in Shenzhen city had different high risk HPV infection rates and CIN morbidity. The HPV infection rate and HSIL morbidity were highest among women having service related jobs.</p>

Retrospective analysis of 15,393 cases of liquid-based cervical cytology, with histologic correlation / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the rate of concordance between positive cervical cytologic interpretation based on liquid-based preparations and subsequent histologic diagnosis.</p><p><b>METHODS</b>Liquid-based cervical cytology (SurePath) was carried out in 15,393 patients. Cases with the cytologic diagnosis of epithelial cell abnormality were further investigated by human papillomavirus (HPV) DNA testing (Hybrid Capture II) for the high-risk HPV DNA, colposcopic examination and multiple cervical biopsies. The 2001 version of The Bethesda System for reporting gynecologic cytology was applied. Positive cytologic diagnosis included atypical squamous cells of undetermined significance (ASC-US) or above. Histologic correlation was available in some of the patients. The rate of concordance between positive cytologic interpretation and subsequent histologic diagnosis was calculated.</p><p><b>RESULTS</b>Amongst the 15,393 liquid-based cytology cases studied, the cytologic diagnosis of 7 cases squamous cell carcinoma were all concordance with histologic diagnosis, while the rates for high-grade and low-grade squamous intraepithelial lesions were 93.6% (103/110) and 82.0% (443/540), respectively. A positive correlation was also demonstrated between detection of high-risk HPV DNA, positive cytologic interpretation and positive histologic diagnosis.</p><p><b>CONCLUSION</b>Liquid-based cytologic preparation, when coupled with standardized reporting using the Bethesda System 2001, can achieve a high diagnostic accuracy of cervical epithelial abnormalities.</p>

Distribution of human papillomavirus types in Shenzhen women / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the status of genital infection as well as distribution of types of human papillomavirus (HPV) in women in Shenzhen and provide population data for the future vaccine intervention on cervical cancer.</p><p><b>METHODS</b>Women with age between 15 and 59 years were selected in cluster stratified sampling from Huaqiaocheng community, Nanshan district, Shenzhen and received a population-based cervical cancer screening. After consent, every woman was interviewed by using questionnaire and tested by liquid-based cytology and HPV DNA (hybrid capture 2 and gene chips typing) separately.</p><p><b>RESULTS</b>Totally 1 137 women were screened. The rate of high risk HPV of hybrid capture 2 test (14. 0% ) was higher than gene chips typing test (9. 8%) (chi(2) = 27. 198, P < 0. 001) ; the consistency of the two tests was acceptable ( kappa = 0. 498, P < 0. 001). The rates of low risk HPV types and other types of gene chips typing test in this population were 1. 9% and 0. 2% respectively. The percentages of HPV 16, 18 and 58 in HPV positive women were 29. 7% , 18. 9% and 18. 9%. The rates of different age group of low risk HPV were 1. 4% (17-34), 1. 7% (35-44) and 3. 2% (45-59) , respectively.</p><p><b>CONCLUSIONS</b>HPV 16, 18, and 58 are the most popular types in the study population. The differences of infection rates of high risk HPV are due primarily to the variation of HPV16 distribution among age-specific population. The chances of being affected by low risk HPV will increase with age.</p>