Investigation of human papilloma virus infection and virus genotyping in patients with cervical lesions in Shanghai / 第二军医大学学报

ABSTRACT

Objective To understand the genotypic infection status of human papilloma virus (HPV) in patients with gynecological diseases in Shanghai, and to analyze the diagnostic value of HPV genotyping in cervical disease, so as to provide reference for rational application of screening methods. Methods We analyzed the examination results of 12 670 patients with various gynecological diseases who voluntarily receivedthe HPV genotyping test in Tongren Hospital Affiliated to Shanghti Jiaotong University School of Medicine in 2016, and statistically analyzed the infection status of different genotypes of HPV. Among them, 504 cases with clinical symptoms or HPV infection received ThinPrep cytologic test (TCT) and colposcopy histopathological examination. The relationship between high-risk HPV infection and cervical lesion was analyzed according to the pathological diagnosis of cervical lesions. Results The overall HPV infection rate was 23.66% (2 998/12 670), of which 84.09% (2 521/2 998) were infected with high-risk type HPV; the overall infection rate of high-riskHPV was 19.90% (2 521/12 670), and the overall infection rate of low-risk HPV was 3.76% (477/12 670). Among the patients infected with HPV, the rate of single type infection was 71.21% (2 135/2 998), the rate of double infection was 16.94% (508/2 998), and the remaining were infectedwith more than two types. There were no significant differences in low-risk HPV infections between different age groups, while the patients in low-age group had high infection rate of high-risk HPV (P<10.01). In the high-risk HPV infection, the five subtypes of the highest infection rate were HPV52, HPV16, HPV53, HPV58, and HPV51. In the low-risk HPV infection, the top three infection types were HPV81, HPV43, and HPV42. With the escalation of cervicai lesions levei, the infection rate of high-risk HPV was increased. HPV genotyping was more sensitive than TCT in screening cervicai disease, and its negative predictive value was higher, which had great significance for ruling out cervicai cancer. HPV infections in cervicai cancer cases were HPV16, HPV18 and HPV52. Conclusion HPV genotyping has high accuracy and clear genotype, and is more effective in screening cervicai lesions when combined with TCT and histology, contributing tothe prevention and treatment of cervicai cancer. HPV genotyping has high sensitive and negative predictive value in screening cervicai lesions, indicating that it can replace TCT or combine with TCT in initiai cervicai cancer screening.