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Background: About 99.7% of cervical dysplasia and cancer cases are caused by persistent genital high-risk human papillomavirus (hrHPV) infection. Most HPV infections are subclinical and self-limiting but may persists in about 5 to 10% of infected women, resulting in pre-cancerous lesions that can progress to invasive cancer years later. This study is aimed at detecting hrHPV among apparently healthy women of reproductive age in Kaduna State, thus providing more information for effective control of HPV and cervical cancer in Nigeria. Methodology: Cervical smears were taken from 515 randomly selected apparently healthy women across selected secondary and tertiary facilities from 3 Local Government Areas (LGAs) in each Senatorial Zone of Kaduna State, Nigeria. Liquid-based cytology (LBC) technique was used to collect cervical smears and prepare smears for cytology study, while the remaining samples were stored at -80oC for molecular studies. HPV DNA were extracted from the samples and amplified by convectional PCR using specific hrHPV (HPV 16,18,31 and 45) primer sets and a broad spectrum MY09/11 and GP5+/6+ primers for a wider range of HPV genotypes. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 23.0 and relationship between prevalence of hrHPV and socio-demographic factors such as age and marital status were determined using Chisquare or Fisher Exact test with p<0.05 considered statistically significant. Results: The prevalence of total HPV and hrHPV infections in the study population was 11.8% (61/515) and 9.3% (48/515) respectively. A total of 100 HPV genotypes were detected by PCR in the 61 positive smears, with 66 hrHPV types from 48 women, and 34 other HPV types from 13 women. The frequency of hrHPV genotypes detected was HPV 31 (5.8%, n=30), HPV 45 (4.1%, n=21), HPV 16 (1.7%, n=9), and HPV 18 (1.2%, n=6), with other HPV genotypes (6.6%, n=34). The frequency of cervical dysplasia was 6.4% (33/515), which was significantly associated with all HPV genotypes except HPV 16. Single HPV infection was seen in 31 (51.8%) women while multiple infections were seen in 30 (49.2%), with double infection in 21 (34.4%) and triple infections in 9 (14.7%). Conclusion: The prevalence of hrHPV infection was high among women in Kaduna State, Nigeria. DNA-based screening for hrHPV genotypes and production of new vaccine that will protect against the predominant hrHPV genotypes are thus recommended for the prevention of cervical cancer in Nigeria, Africa and beyond.
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PapillomaviridaeABSTRACT
Background & objectives: Human papillomavirus (HPV) infection is known to be the main cause of cervical cancer. This study aimed to determine the prevalence of high-risk HPV genotypes in smear specimens taken from women who had normal or abnormal cytology using a multiplex PCR method. Methods: The study included 270 women aged between 19 and 69 yr with or without suspicious cervical abnormalities. A Pap smear sample from each patient was cytologically examined, and HPV typing was performed using a multiplex fluorescent PCR method. Those who were high-risk HPV positive and had a normal or abnormal cytology were further evaluated by colposcopy and biopsy. Results: The total HPV positivity was 43 per cent (116/270). HPV positivity in the patients with an abnormal cytology was 77 per cent (33/43), whereas it was only 37 per cent (83/227) in women with normal cytology, which showed a significant difference (P<0.05). HPV positivity was also related to the age group when all the subjects were considered (P<0.05), and the highest prevalence of HPV infection was in the 30-39 yr age group. High-risk HPV types 16, 18, 31, 35, 51 and 56 were more common in the normal cytology patients, whereas high-risk HPV types 16, 31, 35, 45, 58 and 68 were commonly found in the abnormal cytology patients. Interpretation & conclusions: The determination of high-risk HPV genotypes in women with clinically suspicious cervical lesions should be conducted during an annual follow-up, irrespective of a normal or abnormal cytology by the age of 30 years or above.
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Background: High-risk human papillomavirus (hrHPV) infection is linked with uterine cervix premalignant lesions and invasive carcinoma of the uterine cervix. Methods: Descriptive cross sectional study carried out among female kidney transplant (KTx) recipients in Kenyatta National Hospital, Nairobi-Kenya. We studied the risk factors for acquisition of hrHPV, examined cervical cytology and assayed for 14 hrHPV DNA using Cervista® HPV HR test and Cervista® MTA (Hologic®) automated platforms. Results: The 14-hrHPV genotypes assayed were 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 and the prevalence rate was 31.25 % (10/32). Abnormal cervical cytology was noted in 4/32 (12.5%) and included low-grade squamous intraepithelial lesion (2/32), atypical squamous cells of undetermined significance (1/32) and atypical glandular cells (1/32). The average age was 41.9years with mean age at first coitus being 20.4 years. Majority of the women 20(62.5%) were married while 8(25%) were single. About 18(56.3%) had only one sexual partner. About 20% of women were nulliparous and 4(12.5%) had a parity of five. Duration sincetransplantation ranged between 1-21 years. Conclusions: The burden of hrHPV and abnormal cervical cytology in our study seemed lower than that reported elsewhere and even in general population. This study may form basis for further studies about HPV infections and carcinoma of the uterine cervix among the kidney allograft recipients in our setting
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Humans , Female , Adult , Middle Aged , Uterine Cervical Neoplasms , Kidney Transplantation , Papillomavirus Infections , Transplant Recipients , AlphapapillomavirusABSTRACT
Objective:To explore the detection capability of p16/Ki-67 double staining technique in women with various abnormal thinprep cytologic test (TCT) results and its diagnostic value for cervical intraepithelial neoplasia Ⅱ+ grade (CIN2+).Methods:A total of 225 women with abnormal TCT results, i.e. the atypical squamous cells of undetermined significance(ASC-US), in the Tianjin Central Hospital of Gynecology Obstetrics, Nankai University Affiliated Maternity Hospital from December 2018 to December 2019 were enrolled. p16/Ki-67 double staining were detected and compared with the high risk human papillomavirus (HR-HPV) and pathological results.Results:The positive rates of p16/Ki-67 double staining increased with cytologic and pathologic categories. For diagnosis of CIN2+, p16/Ki-67double staining (90.1%) was less sensitive than HR-HPV testing (98.2%)( P<0.05), but the specificity of p16/Ki-67 double staining (58.8%) was significantly higher than HR-HPV(21.6%) ( P<0.001). Conclusions:Compared with HR-HPV, p16/Ki-67 double staining has better effect on diagnosing CIN2+. p16/Ki-67 double staining can be considered as triaging method for management of ASC-US and LSIL patients, significantly reduce the colposcopy referral rate (nearly 50%), which has high clinical application value.
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Objective To determine the association of asymptomatic sexually transmitted infections (STIs) with high-risk human papillomavirus (hrHPV) in cervical squamous intraepithelial lesions and neoplasms. Methods From July 2017 to July 2018, 320 hrHPV-positive and 160 hrHPV-negative women in The First Affiliated Hospital of Xi'an Jiaotong University were divided into normal+low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL)+ invasive cervical cancer (ICC) subgroups, respectively, based on their pathological cervical lesion grades. Cervical brush specimens including Ureaplasma urealyticum (UU) and its serotypes, Mycoplasma hominis (MH), Mycoplasma genitalium (MG), Chlamydia trachomatis (CT), and hrHPV were amplified and hybridized using PCR kits (Hybribio Biochemistry Co., Ltd.). The differences between groups were examined by the chi-squared test, continuity correction and Logistic regression. Results The overall infection (at least one of the non-hrHPV pathogens was positive) rates of the two groups were 62.5% and 59.4%, which were not significantly different. The prevalence of UU was the highest. The prevalence of UU serotype 14 (Uup14) and MH was associated with hrHPV (P=0.003, P=0.005, respectively), but not with certain hrHPV genotypes or with single or multiple genotypes. Compared with cases of normal+LSIL, cases of HSIL+ICC had significantly different Uup14 infection rates (OR: 12.579, 95% CI: 3.638-43.497, P<0.001) in the positive group. In hrHPV-negative cases, there were obvious differences in Uuu and Uup1 infections based on different cervical lesion types (OR: 11.646, 95% CI: 1.493-90.850, P=0.019; OR: 7.474, 95% CI: 1.140-49.015, P=0.036). Conclusion Asymptomatic STIs in female lower reproductive tract are widespread. Uup14 may increase the risk of HSIL+ICC when hrHPV is positive. Uuu and Uup1 cause an increased risk of HSIL+ICC without hrHPV.
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Objective: To systematically evaluate the effectiveness of Kushen Gel in the treatment of cervical high-risk human papillomavirus (HR-HPV) infection. Methods: The Cochrane Library, PubMed, Embase, Medline, Wanfang, VIP, CNKI, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on Kushen Gel in the treatment of the cervical high-risk HPV infection from their inception to December 2019. Two researchers screened the articles, extracted the data, assessed the risk of bias of the eligble studies independently, and performed Meta-analysis with RevMan 5.3. Results: A total of 583 cases were included in five RCTs. The Meta-analysis showed that HR-HPV negative rate [RR = 1.38, 95% CI(1.20, 1.58), P 0.05). Conclusion: The therapeutic effect of applying Kushen Gel can increase the rate of clearance of HPV, reduce HPV-DNA load, and reduce postoperative complication. There is no evidence that the use of Kushen Gel after LEEP can reduce the recurrence rate of CIN2/CIN3. Due to the limitation of the quantity and quality of the included studies, the results need to be further verified and updated by more high-quality RCTs.
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OBJECTIVE: To investigate the effect of HR-HPV positive,HR-HPV load and SCC-Ag positive on the recurrence of cervical cancer after radical resection.METHODS: The clinical data of cervical cancer patients who underwent radical resection of cervical cancer in People's Hospital of Zengcheng District from January 2010 to January2019 were retrospectively collected.The patients were followed up regularly,and the preoperative HR-HPV positive,loading,the amount of SCC-Ag expression were determined;the recurrence and metastasis of cervical cancer were analyzed,and the value of HR-HPV positive,HR-HPV loading and SCC-Ag in predicting the recurrence and metastasis of cervical cancer were analyzed.RESULTS: A total of 438 patients with cervical cancer were included.There was no significant difference in pathological type,or postoperative Meigs-Brunschwig pathological staging between the recurrence group(n=42)and the non-recurrence group(n=396)(P>0.05).The difference in the proportion of HRHPV positive(40/42 vs. 144/396),HR-HPV loading and SCC-Ag positive(34/42 vs. 64/396)was statistically significant between non-recurrence group and recurrence group(P0.05).Multivariate logistic regression analysis showed that distant metastasis,FIGO staging of cervical cancer,HR-HPV positive,and SCC-Ag were independent factors affecting cervical cancer recurrence(P<0.05).When predicting by individual indicator,the specificity and positive predictive value of HR-HPV positive for predicting cervical cancer recurrence were 99.18% and 95.23% at the highest,and the negative predictive value of HR-HPV was87.37% at the highest.When SCC-Ag was used to predict cervical cancer recurrence,the sensitivity was up to 33.33%.The sensitivity of combined prediction was 64.51%,the specificity was 99.46%,the positive predictive value was97.41%,and the negative predictive value was 94.44%.CONCLUSION: Distant metastasis,FIGO staging,HR-HPV positive,and SCC-Ag are independent factors affecting cervical cancer recurrence.The combination of HR-HPV positive,HR-HPV loading and SCC-Ag has certain value for predicting recurrence of cervical cancer,and the prediction value is the highest.
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Objective To detect the methylation status of SALL3 gene promoter region in normal cervical tissues,cervical cancer tissues,and cervical cancer cell lines and thus explore the relationship between methylation status and the expression of SALL3 gene.Methods The DNA methylation statuses of SALL3 gene in normal cervical,cervical cancer tissues and cervical cancer cell lines were analyzed by methylation-specific PCR(MS-PCR).The expressions of SALL3 mRNA in cervical cancer cell lines,cervical cancer tissues,and normal cervical tissues were detected by RT-PCR.Results In cervical cancer and matched peri-carcinomatous samples,the methylation levels of SALL3 were up-regulated(CCa .CCap:=0.046;CCa .NC =0.039)and the protein expressions were down-regulated(CCa .CCap:=0.012;CCa .NC =0.000)when compared with normal cervix samples.The mRNA levels of SALL3 in HeLa and SiHa cells treated with 5-Azacytidine were elevated in a dose-dependent manner(HeLa:=0.001;SiHa:=0.002).The methylation level of SALL3 was higher in high risk human papillomavirus(HPV)-positive cervical samples than in HPV-negative cervical samples(=0.014),which also resulted in a descending SALL3 expression in HPV-positive samples(=0.021).Conclusions The hypermethylation of SALL3 in promoter regions inhibits the expression of SALL3 in cervical cancer tissue samples.Infection with high-risk HPV serotypes may increase the methylation of SALL3 promoter region,silence its expression,and thus promote the development of cervical cancer.
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Female , Humans , Cell Line, Tumor , DNA Methylation , Gene Expression Regulation, Neoplastic , HeLa Cells , Homeodomain Proteins , Genetics , Papillomavirus Infections , Genetics , Promoter Regions, Genetic , RNA, Messenger , Genetics , Transcription Factors , Genetics , Uterine Cervical Neoplasms , GeneticsABSTRACT
Persistently high risk human papillomavirus (HPV) infection is one of the indispensable factors of cervical cancer, which is the secondly most common cancer of women in developing countries. Nowadays HPV DNA detection has been more frequently used in cervical cancer initial screening. However, the specificity and sensitivity of HPV DNA detection are low and the triage of HPV positive women is necessary to identify the authentically high-risk population, and avoid the waste of health care resource and excessive treatment. There are different advantages and disadvantages in triage methods including the cytology, HPV DNA genotype, HPV mRNA detection and biological markers such as p16/Ki-67, respectively. Here we briefly describe and evaluate each triage method.
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Objective • To investigate the diagnostic value of combined detection of cervical cytology and high-risk human papillomavirus (HPV) in cervical adenocarcinoma. Methods • The clinical data of patients diagnosed as cervical adenocarcinoma in the International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine from January 2006 to December 2017 were retrospectively collected and analyzed. A comparison among cytology detection, high-risk HPV test, and combined detection of both methods was performed. Results • A total of 2 291 cases of cervical cancer were collected, of which 480 cases were cervical adenocarcinoma patients. Finally, 409 cases of cervical adenocarcinoma were analyzed. The average age of all included patients was (46.8±11.4) years old. The proportion of the patients aged 35-55 was 59.2%. All the patients were divided into three groups, i.e., group A (cytology detection, n=208), group B (high-risk HPV test, n=103), and group C (cytology and high-risk HPV combined test, n=98). There were 142 (68.3%), 85 (82.5%), and 93 (94.9%) positive cases in group A, B, and C, respectively. There was a statistically significant difference among the three groups (P=0.000). In the patients with cervical in situ adenocarcinoma, the positive detection rates in group A, B and C were 70.6%, 100.0% and 100.0%, respectively (P=0.000). And in the patients with cervical invasive adenocarcinoma, the positive detection rates in group A, B, and C were 67.9%, 75.8% and 91.8%, respectively (P=0.000). Conclusion • Cervical cytology combined with high-risk HPV detection can significantly increase the positive detection rate of cervical adenocarcinoma.
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Objective To compare the synchronous changes of high risk human papillomavirus load(HPV-DNA)and CD4+CD25+Foxp3+regulatory T cells(Treg)in local microenvironment of cervix,and investigate the ef-fects of HPV virus replication and progression of cervical lesions on Treg cells. Methods 304 cases of HR-HPV infection with cervical lesions were divided into 5 groups,cervical intraepithelial neoplasia(CIN)I,CINII,CINIII, cervical cancer and chronic cervicitis.The HPV-DNA of cervical secretion was detected by PCR fluorescence,and the relative Treg cells numbers from cervical brush samples were determined by flow cytometry with CD4+CD25+Foxp3+gating,and the data were statistically analyzed. Results(1)There was significant difference of cervical Treg cells in different degrees of cervical lesion and different copy numbers by variance comparison(F = 24.93, 109.86,P < 0.05),and a further pairwise comparison showed that there was no significant difference of Treg cell between chronic cervicitis and CINI and low load(HPV DNA 104~105copies/mL)and medium load(HPV DNA 105~106copies/mL)(P>0.05).There was a significant difference between the other groups(P<0.05);(2)Treg cells as variable,interaction effect of cervical lesions and viral load factors were significant different(F=3.39,P<0.05). The effect of different cervical lesions and HR-HPV viral load on the expression of Treg cells was differen-tial. An overall showing with the degree of cervical lesions increased,HR-HPV virus copy number increased, Treg cells expression increased gradually;(3)CD4+CD25+Foxp3+Treg cells were highly expressed in cervical cancer patients,but the expression level fluctuated widely and the numerical distribution was the most dispersedly. Conclusion The immune suppression function of local CD4+CD25+Foxp3+Treg cells with different cervical lesions and different HR-HPV DNA may bilaterally regulate the prognosis of cervical lesions,as a whole,between Treg cells and HR-HPV load and cervical lesions were the consistent progress trend.
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Objective To investigate clinicopathological significance of atypical squamous epithelium cells which cannot exclude high grade squamous intraepithelial lesions (ASC-H) in the diagnosis of cervical diseases. Methods The results of age, high-risk human papillomavirus DNA (hrHPV DNA) and cervical biopsy in 496 patients with ASC-H from March 2012 to December 2015 in Shanxi Dayi Hospital were analyzed. Results Among 496 ASC-H cases, the proportion of the patients between 40 and 49 years old was the highest [30.8 ％ (153/496)]. HrHPV DNA was detected in 154 cases, and the positive rate was 79.2 ％(122/154), and the positive rate of patients at the age of 18 to 29 years old was the highest [84.2 ％ (16/19)]. The detection rate of cervical intraepithelial neoplasia (CIN) Ⅱand above lesions in 124 cases with cervical biopsy was 66.9 ％ (83/124), including 100 cases with hrHPV DNA positive (80.6 ％) and 24 cases with hrHPV DNA negative (19.4 ％). There were 71 cases (71.0 ％) of CINⅡ, CIN Ⅲ, early squamous carcinoma and squamous cell carcinomas in 100 hrHPV DNA positive patients with cervical biopsy. There were 12 cases (50.0 ％) of CINⅡ/Ⅲ changes in 24 hrHPV DNA negative patients with cervical biopsy, but none in early squamous carcinoma and squamous cell carcinomas was detected, and there was a significant difference between hrHPV DNA positive and negative patients (χ2=3.857, P< 0.05). The positive predictive value, negative predictive value, sensitivity and specificity of hrHPV DNA detection for diagnosis of CINⅡand above lesions were 85.5 ％, 29.3 ％, 71.0 ％ and 50.0 ％, respectively. Conclusions ASC-H strongly predicts CINⅡand above lesions in cervical cytology. The detection of hrHPV DNA has a high positive predictive value for CINⅡand above lesions.
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Objective To evaluate the effects of polycyclic aromatic hydrocarbons (PAHs) and high risk human papillomavirus (HR-HPV) infection and their interaction on the progression of cervical intraepithelial neoplasia.Methods A total of 486 patients,including 208 women with normal cervix (NC),154 patients with low-grade cervical intraepithelial neoplasm (CIN Ⅰ),124 patients with high-grade cervical intraepithelial neoplasm (CIN Ⅱ/Ⅲ),were selected from the cervical lesions cohort from June to December,2014.HR-HPV was detected by using flow-through hybridization technology and the urine concentration of 1-hydroxypyrene (1-OHP) was detected with high performance liquid chromatography.By using software SPSS 22.0,the x2 test,trend x2 test,Kruskal-Wallis H test,Nemenyi rank test and Spearman rank correlation analysis were performed.And the interaction effects were evaluated by additive model.Results The HR-HPV infection rates in NC,CIN Ⅰ and CIN Ⅱ/Ⅲ groups were 27.9％,37.0％ and 58.9％,respectively.The urine concentrations of 1-OHP (pmol/molCr) were 0.07 ± 0.09,0.11 ± 0.10 and 0.17 ± 0.15,respectively.With increasing severity of the cervical lesions,the HR-HPV infection rate gradually increased (trend x2=29.89,P＜0.001) and the high exposure rate of PAHs gradually increased (trendx2 =27.94,P＜0.001).HR-HPV infection was positively correlated with 1-OHP exposure (r=0.680,P＜0.001).There was a positive additive interaction between HPV infection and PAHs exposure in CIN Ⅱ/Ⅲ group,but it was not found in CIN Ⅰ group.Conclusion Both HR-HPV infection and high exposure of PAHs might increase the risk of cervical intraepithelial neoplasm,and might have a synergistic effect on the progression of high-grade cervical intraepithelial neoplasia.
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Objective To evaluate the effects of polycyclic aromatic hydrocarbons (PAHs) and high risk human papillomavirus (HR-HPV) infection and their interaction on the progression of cervical intraepithelial neoplasia.Methods A total of 486 patients,including 208 women with normal cervix (NC),154 patients with low-grade cervical intraepithelial neoplasm (CIN Ⅰ),124 patients with high-grade cervical intraepithelial neoplasm (CIN Ⅱ/Ⅲ),were selected from the cervical lesions cohort from June to December,2014.HR-HPV was detected by using flow-through hybridization technology and the urine concentration of 1-hydroxypyrene (1-OHP) was detected with high performance liquid chromatography.By using software SPSS 22.0,the x2 test,trend x2 test,Kruskal-Wallis H test,Nemenyi rank test and Spearman rank correlation analysis were performed.And the interaction effects were evaluated by additive model.Results The HR-HPV infection rates in NC,CIN Ⅰ and CIN Ⅱ/Ⅲ groups were 27.9％,37.0％ and 58.9％,respectively.The urine concentrations of 1-OHP (pmol/molCr) were 0.07 ± 0.09,0.11 ± 0.10 and 0.17 ± 0.15,respectively.With increasing severity of the cervical lesions,the HR-HPV infection rate gradually increased (trend x2=29.89,P＜0.001) and the high exposure rate of PAHs gradually increased (trendx2 =27.94,P＜0.001).HR-HPV infection was positively correlated with 1-OHP exposure (r=0.680,P＜0.001).There was a positive additive interaction between HPV infection and PAHs exposure in CIN Ⅱ/Ⅲ group,but it was not found in CIN Ⅰ group.Conclusion Both HR-HPV infection and high exposure of PAHs might increase the risk of cervical intraepithelial neoplasm,and might have a synergistic effect on the progression of high-grade cervical intraepithelial neoplasia.
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Objective The aims of this study were to compare the different expression between high-risk human papilloma-virus load(HR-HPV DNA)and Th1/Th2 type cytokines in local different microenvironments of cervix,and to explore the possibility and significance of predicting cervical cancer. Methods A total of 339 patients with persistent HR-HPV infection were divided into cervical intraepithelial neoplasia(CIN)and cervical cancer. Forty patients with HPV-negative and cytological examination of normal cervix were used as controls. PCR fluorescence assay and double antibody sandwich were used. ELISA assay were used to detect HPV-DNA and Th1 type cytokines including IL-2,IFN-γ,TNF-ɑ and Th2 type cytokines including IL-4,IL-6 and IL-10 from cervical secretion. The ratio of TNF-ɑ/IL-10 was used as an index to measure the immune balance of Th1/Th2. Univariate and multivariate logistic regression were performed to analyze the data and then to screen the predicting indicators of cervical cancer. Results Univariate analysis showed that HR-HPV DNA,IL-2,IL-4,IL-6,IL-10,IFN-γ,TNF-ɑ and TNF-ɑ/IL-10 were significantly different between CIN and cervical cancer groups(P<0. 05),which could be used as a risk factor for predicting cervical cancer. Multivariate logistic regression analysis showed that IL-10,IFN-γ,TNF-ɑ,TNF-ɑ/IL-10 were the influencing factors of cervical cancer. The regression model fitted goodness test was Nagelkerke(R2= 0. 982),the pre-judgment rate for CIN was 99. 5% ,the pre-judgment rate of cervical cancer was 100% ,and the total positive rate was 99. 7% ,suggesting good fitting effect was good and the prediction accuracy was high. Conclusion CINⅠand CINⅡhave abnormal expression of Th cytokine,but they do not affect Th1/Th2 balance. Th1/Th2 imbalance in CINⅢ stage and Th2 dominant expression promote the occurrence of cervical cancer. Based on the regression model for predicting cervical carcinogenesis,cervical immunity caused inhibitory microenvironment by local immune imbalance is the key link in HR-HPV persistent infection and cervical cancer,and has nothing to do with HR-HPV DNA.
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Objective@#To explore the epidemiologic characterization of high-risk human papillomavirus (HR-HPV) infection and genotype distribution of HR-HPV among women in rural areas of China.@*Methods@#This study used multiple layers of stratified cluster random sampling method. During January to December in 2014, 117 counties of 27 provinces were selected as the HPV test screening pilot project counties. The women aged 35-64 years with rural areas Hukou in these project counties were selected as the study subjects. A total 457 799 women received HPV DNA test. Among them, 118 237 women from 32 counties in 11 provinces received qualified HPV DNA test by fluorescent PCR to detect HPV genotypes.@*Results@#Among 118 237 rural women, the overall HR-HPV positive infection rate was 7.8% (9 249/118 237). The infection rate increased with age and reached an infection peak at the 60-64 age groups (9.9%, 831/8 394). The HR-HPV positive infection rate in western regions (6.9%, 2 144/31 130) was statistical significantly lower than in central regions (8.2%, 1 894/23 023) and eastern regions (8.1%, 5 211/64 084) (χ2=51.46, P<0.001). Among 9 249 women with specific genotypes of HR-HPV, 6 496 (97.6%) cases were infected with single HR-HPV type, and 163 cases (2.4% ) were infected with multiple types. HR-HPV type 52, 16 and 58 were the most common infection types in rural areas of China. The single infection rates were 20.9% (1 355/6 496), 18.7% (1 215/6 496), and 11.2% (725/6 496), respectively. The multiple infection rates were 47.2% (77/163), 17.8% (29/163), and 18.4% (30/163), respectively.@*Conclusion@#The HR-HPV positive infection rate in rural areas of Chinese woman was 7.8%, western region has lower infection rate compared with central and eastern regions. HPV 52 was first of the most common genotypes in rural areas of China.
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Objective To investigate the clinical characteristics of postmenopausal patients with cervical intraepithelial neoplasia ( CIN) gradeⅡ/Ⅲand cervical cancer . Methods A retrospective analysis was made on the clinical characteristics of 57 cases of postmenopausal patients who were diagnosed as CIN grade Ⅱor above from January 2014 to September 2015.Their age ranged from 49 to 77 (58.2 ±5.6) years old, and the time of menopause ranged from 1 to 36 (9.4 ±6.9) years. Results ①In postmenopausal women with CIN Ⅱ/Ⅲ and cervical cancer, only about 1/5 (11/57, 19.3%) had clinical complaints, and nearly 2/3 (36/57, 63.2%) had smooth cervical appearance .②There were 36 cases of high-risk human papillomavirus ( HPV) (36/39, 92.3%), 20 cases of single HPV16 infection (20/36, 55.6%), 7 cases of HPV16 type and other high-risk HPV infection (7/36, 19.4%), and 9 cases of other types of high-risk HPV infection (9/36, 25.0%).③The positive rate of high-risk HPV was 92.3%(36/39) and the HPV16 positive rate was 69.2% (27/39).TCT examination showed a positive rate of high grade squamous intraepithelial lesion (HSIL) of only 29.6% (16/54), with significant difference (χ2 =6.686 and 14.286, P =0.010 and 0.000, respectively). Conclusions Postmenopausal women with cervical lesions usually have no obvious clinical symptoms . Gynecological examination alone is difficult to judge whether the cervical lesions exist .Strict cervical lesions screening is particularly important .
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Objective · To investigate the relationship between the results of thin prep cytologic test (TCT), high-risk human papillomavirus (Hr-HPV) detection and vaginalintraepithelial neoplasia (VAIN) after hysterectomy. Methods · A retrospective study was conducted of 56 patients with VAIN after hysterectomy. The analysis included TCT and Hr-HPV examination, clinical data and the relationship between Hr-HPV examinenation and histopathological examination of colposcopy. Results · Postoperative follow-up of TCT and Hr-HPV parallel pathological examination showed that 56 patients had vaginal stump lesions, including cervical factor hysterectomy accounted for 5.81% (45/775) and non cervical factor hysterectomy accounted for 0.19% (11/5933). The difference was statistically significant (P=0.000). In 56 cases of patients with vaginal stump lesions, Hr-HPV infection were 40 cases (accounting for 71.43%), uninfected patients were 16 cases (accounting for 28.57%). The Hr-HPV infection rates of cervical hysterectomy and non cervical factor hysterectomy patients were 80.00% (36/45) and 36.36% (4/11) respectively, and the difference was statistically significant (χ2= 6.248, P=0.012). TCT results showed that the incidence of squamous intraepithelial lesions were 42.22% (19/45) and 9.09% (1/11) respectively. Conclusion · The Hr-HPV infection rate and the morbidity of VAIN of the patients undergone hysterectomy due to the cervical lesionfactors is higher than those who had none cervical lesion factors. In order to identify VAIN early, patients who have the history of hysterectomy should undergo careful evaluation of cervical and vaginal circumstance before surgery and the routine examinations of TCT and Hr-HPV in the follow-up.
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Objective To analyze the application value of high risk human papillomavirus (HR HPV) DNA and thinprep cytolo-gy test(TCT ) detection in screening cervical cancer and to evaluate the clinical significance of their combined detection .Methods A total of 402 cases conducting cervical cancer screening in our hospital from March to May 2016 were selected and performed the HR HPV DNA and TCT detection .Those of suspected cervical lesions were performed the histopathological examination .Then the effects of HR HPV DNA and TCT combined detection were compared according to the pathological results .Results The detection positive rate of female HR HPV DNA was 27 .1% (109/402);abnormal and benign inflammation reaction were detected out in 46 cases of female TCT ,the positive rate was 11 .4% (46/402);in 123 cases of suspected cervical malignant lesion ,32 .5% females(40/123) appeared CIN Ⅰgrade or more lesions by histopathological examination ;the sensitivity of HR HPV DNA and TCT combined detection was higher than that of single detection ,the difference was statistically significant (P0 .05) .Conclusion The detection of HR HPV DNA and TCT is a good method for screening of cervical cancer ,the combined detection of HR HPV DNA and TCT can improve the detection rate of cervical precancerous lesion .
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Objective To analyze the clinical efficacy of LEEP combined with Tremella Shu in the treatment of cervical cancerous lesions complicated with high-risk human papillomavirus (HPV) infection. Methods From March 2013 to May 2017, 88 patients with cervical precancerous lesions complicated with HPV infection selected from March 2013 to May 2017 in Beichen Hospital of Tianjin were randomly divided into experimental group and control group,44 cases in each group. The control group were treated with LEEP, the experimental group was treated with LEEP combined with Tremella Shu,The HPV viral load, clinical efficacy and quality of life score were compared between the two groups. Results The cure rate was 95.45％ in the experimental group higher than that in the control group(81.81％),the difference was statistically significant (P<0.05). The quality of life score of the experimental group was better than that of the control group,the difference was statistically significant(P<0.05). The HPV viral load in the experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion LEEP treatment combined with Tremella Shu on cervical precancerous lesions with HPV infection of clinical efficacy is significant, can effectively improve the quality of life of patients, reduce HPV viral load, worthy of clinical application.