| Cervical cancer is one of the most common malignant tumors among women worldwide.Human papillomavirus(HPV)infection is the most important cause of cervical cancer.Studies show that high risk HPV(HR-HPV)nucleic acids can be detected in more than 90%of the cervical cancer specimens.At present,there is no epidemiological survey of HPV on a national scale in China.Data from HPV epidemilogogical survey on smaller scale has shown that the distribution of HPV types has depended obviously on region and race.Therefore,to provide reference for HPV screening and vaccine selection,it is necessary to clarify the infection status of HPV,especially HR-HPV on nationwide scale in China.In this study,a total of 19,018 specimens from female outpatients in the Chinese PLA General Hospital were collected.They had been detected by High-risk HPV Genotyping Real time PCRand analyzed by thinprep cytology test(TCT)for cervical pathologic diagnosis.HR-HPV prevalence,age-specific prevalence,single and multiple infection,and odds ratio(OR)of each type of HPV in cytology abnormal were analyzed.Overall,19.1%of the total 19018 individuals were positive for HPV infection.In the 3623 HPV positive individuals,78.2%-were positive for a single HPV type,and 21.8%were positive for multiple types.In the detection of the thirteen HR-HPVs,the most prevalent type was HPV52(4.4%),followed by HPV16,58,39,51,56,18,59,35,68,31,33 and 45,the corresponding infection rate were 3.7%,3.4%,2.7%,2.0%,1.8%,1.3%,1.1%,0.9%,0.9%,0.8%,0.7%and 0.4%.The difference in distribution of HR-HPV infection in different age groups is statistically significant,the highest infection rate is in 21-25 years old group,lowest is in 61 years old and above group,there are two peaks of infection in 21-25years old group and 56-60years old group;eight(HPV16,39,51,52,56,58,59 and 68)types of the thirteen HR-HPVs infection in each age group had significant differences,and the distribution trend of which are different too.In terms of the correlation of disease progression,according to the cytology test,HPV infection of the four groups of normal,atypical squamous cells of undetermined significance(ASC-US),low-grade squamous intraepithelial lesion(LSIL)and high-grade squamous intraepithelial lesion(HSIL)were analyzed,and the corresponding infection rate were 16.6%,48.6%,78.5%and 78.4%.As shown,HR-HPV infection rate is correlated with the aggravation of the cytological grade.Also,the HPV single infection rate increased with the increase of cytological grade,but the HR-HPV multiple infection rate was the highest in the LSIL group,and was significantly higher than other groups.In addition,further analysis of OR showed that,the OR ofsingle infection gradually increased with the increase of cytological grade,the OR of HPV multiple infectionwas the highest in the LSIL group,and was significantly higher than ASC-US and HSIL groups.On the other hand,OR of single infection in partial species or types were higher than that of multiple infection,which refers to several types of A9(ASC-US and HSIL groups of HPV16,LSIL group of HPV31 and HSIL group of HPV33),all of the rest OR of multiple infections was greater than that of single infection;in the dual infections-.the OR of LSIL group were all higher than each of the two single infection types respectively,the OR of HSIL groups of A7+A9 and A9+A9 was higher than each of the two single infection types.In the case of cervical cancer and high grade precancerous lesions,there are always HPV negative cases,the reason is not clear.Whether these cases contain uncommon HPV infection or not is not clear.HPV detection approach is mainly based on the amplification of.MY09/11 region(which located in the L1 gene region and contained GP5+/6+ and SPF10 amplification region).Existing data has shown that the sensitivity of MY09/11 detection for different HPV types can differ up to 100 times.Recently,rare types of HPV were found in the lower genital tract specimens by next-generation sequencing.Besides,rare types of HPV were also found in the HPV infection of the male genital tract,these provide a basis for the existence of rare HPV types in the lower genital tract.Thisstudy defines HPV types which cannot be detected by MY spectrumto in Alpha genus as rare HPV types.The distribution of these rare types of HPV in the lower genital tract requires further study.Based on the above analysis,this study investigated the distribution of the rare type HPV in the specimens from three technical approaches.(1)Based on HPV30 prevalence in Thailand and HIV positive population,this study discussed the distribution of HPV30 in China.(2)Ten HPV types were successfully screened out by the cloning and sequencing of PCR products using FAP and SK general primers outside the MY09/11 region in the HPV negative specimens(by MY spectrum to).HPV 90 and 91 were selected as rare types from the ten screened types.(3)Re-analysis of HPV data in the vaginal specimens of human microbiome project(HMP),HPV34 was identified as the type to be screened.Infection of the rare HPV type in the lower genital tract clinical sample was confirmed by polymerase chain reaction(PCR).Results showed:the infection rate of HPV30 in the clinical specimens of the lower genital tract was 0.5%,HPV34 was 0.2%,HPV90 was 0.7%and HPV91 was 0.7%.Conclusion:(1)The HPV prevalence in the outpatients was 19.1%,and the most predominant HPV types were HPV52,16 and 58.Multiple infections were 21.8%(790/3623)of all the positive women,and women with multiple infections were more likely to have abnormal cytology.(2)Infection of rare HPV types of HPV30,34,90 and 91 in the lower genital tract was confirmed. |
PDF Full Text Request