| ObjectivesTo investigate the HPV virus load and genotypes distribution in978women with cervical lesions in Gansu,and to explore the relationships between HPV virus load and genotypes with cervical lesions risk.Then to evaluate the effect of three methods of cervical cancer screening.MethodsFrom October of2009to December of2011, a hospital-based cervical cancer screening was conducted in Gansu Provincal maternity and child-care hospital,978cases aged20-85took part in the screening. Cervical cell change.HPV virus load and genotypes distribution in978cervical cell samples was detected with liquid-based ThinPrep cytology test (TCT) and Ⅱ Hybrid Capture (HC-Ⅱ) and Flow-Through Hybridization And Gene Chip (HybriMax);HC-Ⅱ was used to detect HPV virus load, HybriMax was used to detect distribution of HPV genotypes.426cases which TCT and/or HC-II and/or HybriMax test was positive (TCT≥ASCUS, HPV≥1RLU/CO, HybriMax test find positive HPV genotypes) were needed to colposcopy test and cervical biopsy to determine their cervical pathology.We analyzed the correlations between HPV virus load and genotypes with cervical lesions risk by Spearman correlation; Then to evaluate the effect of three methods of cervical cancer screening.Results1. In978cases of TCT text. a total of260cases were positive cytology (≥ASC), the positive rate was26.58%.Among those, ASC, LSIL. of HSIL, SCC were95cases (9.71%),76cases (7.77%),72cases (7.36%), SCC (1.74%) respectively. TCT-positive rate was rising with age, there was no statistical significance between TCT cytology diagnosis degree with different age groups.2. In978cases of HC-Ⅱ assay for HR-HPV, a total of298cases were positive, the positive rate was30.47%. The mean±standard deviation of HR-HPV load was (148.01±14.34) RLU/CO in different age group. The HR-HPV load tended to increase with age. But there was no significant difference between the HR-HPV load with different age groups. 3. In978cases of HybriMax assay for HPV genotypes, a total of268cases were positive, the positive rate was27.40%.All the21HPV genotypes were detected out for334times:There was no significant difference between HPV positive rate with different age groups. The proportion of single infection was77.99%,the6kinds of common sub-genotypes were:HPV16(39.70%),58(12.44%),52(11.00%),56(5.74%),53(3.83%) and18(3.83%); The proportion of multiple infections was22.01%. double-genotype infection was mainly93.22%(55/59) among multiple infections, the5kinds of common sub-genotypes were:HPV16+58(12.70%),16+18(7.27%),16+6(7.27%),16+52(5.45%) and16+53(5.45%); Only one case was triple infection(HPV18+31+51);3cases of quadruple infection were HPV16+18+33+35HPV16+68+CP8304+58, HPV35+39+43+52; There was not detected out five or over-five sub-genotypes HPV infection.4. Among the978cases. a total of426cases were conducted cervical biopsy due to TCT and/or HPV-positive, in which the normal cervical pathology, CIN1, CIN2,CIN3and squamous cell carcinoma were200cases (46.95%),96cases (22.54%),18cases (4.23%),70cases (16.43%) and42cases (9.86%) respectively; The other552cases did not need to conduct cervical biopsy because the TCT and HPV tests (HC-II and HybriMax technology) were negative.There was no significant differences between the cervical lesions with different age groups.5. The HC-Ⅱ HR-HPV virus load, HybriMax technology for HPV positive rate, high-grade cervical lesions (≥of CIN2) biopsy detection rate increased with cervical squamous cytological level of TCT.The mean number of HR-HPV virus load was (339.43±30.53)(RLU/CO) in different cervical lesions. HybriMax technology for HPV positive rate and high-grade cervical lesions (≥of CIN2) biopsy detection rate increased with HC-Ⅱ HR-HPV virus load. Single-genotype was the most common HPV infection, among the multiple genotype infections, especially HPV16/58co-infected.the majority of cervical lesions were normal and CIN1.Single-genotype infection was more common in cervical cancer (87.88%)(29/33).6. Evaluation of the effect of three methods of cervical cancer screening about TCT, HC-II HR-HPV test, HybriMax HPV test:The detection sensitivity of HC-Ⅱ HR-HPV test was up to 88.05%.TCT followed by80.97%. HybriMax detection technology was minimum of67.26%. The detection specificity of TCT was up to61.50%. HC-11HR-HPV test followed by50.50%. HybriMax detection technology was minimum of42.00%.ConclusionsThe positive rate of HC-Ⅱ assay for HR-HPV and HybriMax technology for HPV-genotypes increased with cervical squamous cytology of TCT and cervical lesion pathology-level; High-grade cervical lesions increased with the HR-HPV virus load and positively related to risk of cervical squamous cell lesion and cancer; The most common high-risk HPV types was16.58,52.56and53.18in978cases of Gansu women. The cervical vaccine should include the HPV-16and58genotype in Gansu Province:Among the HPV-positive infection with HybriMax detection technology, Single-genotype was the majority, multiple-genotype infection.especially HPV16/58co-infected was the majority in the normal cervical and CIN1; Single-genotype infection was more common in cervical cancer.The TCT test combine with HR-HPV viral load test and HPV genotyping detection can improve cervical cancer effect aim to early detection and treatment, and can be used as a monitoring and evaluation marker and prognostic indicators for CIN and cervical cancer. |
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