Clinical Analysis Of7455Cases On HPV Genotyping

Cervical cancer ranks the third in incidence and the fourth in mortalityamong cancers women suffering from worldwide. More than85%cervicalcancer patients are found in the developing countries. In recent years, theincidence of cervical cancer is significantly increasing while it happens to theyoung more than ever. Cervical cancer does not only bring immense sufferingto the body of patients, but also seriously affect the quality of patients’ life.Many studies have shown that persistence of a human papillomavirus (HPV)infection is necessary, if not sufficient, to cause cervical cancer. Therefore,blocking HPV infection is an effective method to prevent the development ofcervical cancer. A study found that the effective rate of Gardasil (quadrivalentvaccine: prevention of HPV-6,11,16,18) and Cervarix (bivalent vaccine:prevention of HPV-16,18) reached more than90%for preventingcorresponding genotypes, with satisfactory results achieved. The infection rateand distribution of HPV genotypes are different in different countries. It’sworth applying HPV prophylactic vaccine in China with high incidence ofcervical cancer. Studies found that the prevalence of multiple HPVs infectionincreases year by year. Up to now, only a few studies have reported on therelationship between multiple HPVs infection and cervical lesions, and theirresults are not consistent. The aim of our study was to investigate thedistribution of HPV genotypes and explore the relationship between multipleHPVs infection and cervical lesions by analysis of HPV genotyping testresults of patients who visited the gynecology department of the SecondHospital of Hebei Medical University.Part1Distribution characteristics of7455cases HPV genotypesObjective: To analyze the distribution characteristics of HPV genotypes.Methods：Retrospectively analyzed the HPV genotyping results of7455patients who visited the gynecology department of the Second Hospital of Hebei Medical University from August2008to October2012.Results：3945cases of HPV positive samples were detected in7455cases, and the prevalence was52.92%.3945cases of positive samplesincluded2547cases of single HPV infection and1298cases of multiple HPVsinfection, the prevalence of which were34.16%and18.76%.2548cases wereinfected with high-risk HPV genotypes and the infection rate of high-risk HPVwas34.66%.658cases were infected with low-risk HPV genotypes and theinfection rate of low-risk HPV was8.83%.703cases were infected with bothhigh-risk and low-risk HPV genotypes mixed and the rate of it was9.43%.21genotypes were all found. The top six genotypes were HPV-16,6,58,52,11,18, whose infection rate were18.14%,8.97%,8.2%,7.97%,7.32%and4.02%respectively (multiple HPV infection according to genotypes repeat count).1571cases infected with HPV-16and/or HPV-18, accounted for39.82%inthe HPV-positive cases. While only71cases infected with HPV-16andHPV-18at the same time accounted for1.78%in the HPV-positive cases.2468cases infected with one or more genotypes among HPV-6,11,16,18,accounted for62.56%in HPV-positive cases. However no case was infectedwith the four genotypes at the same time. The7455cases were divided into6groups according to ages, whose positive rate were77.78%,56.04%,49.84%,50.80%and63.04%, respectively. The study showed a ‘‘U’’ shapeddistribution of age-specific prevalence of HPV with the first peak in the <20-year age group（X2=16.51，P<0.0001）and the second in the>59-yeargroup （X2=9.13，P=0.0025）. The infection rates of high-risk genotypes ofHPV infection were35.19%,27.63%,35.55%,38.33%,42.36%and38.41%,which didn’t show Significant changes. The infection rates of low-riskgenotypes of in the groups were14.81%,14.06%,8.06%,5.83%,3.29%and8.70%, showing a single peak distribution.Conclusions：The proportion of women, who visited in gynecologydepartment of the Second Hospital of Hebei Medical University, infected withone or more types among HPV-6,11,16,18is high in Shijiazhuang, soGardasil will be effective for Preventing cervical cancer. The top three genotypes were HPV-16,52,58among high risk HPV infection. The vaccinefor HPV-16,52,58will provide more protection for women. The studyshowed a ‘‘U’’ shaped distribution of age-specific prevalence of HPV.Part2Relationship between multiple HPV infection and cervical cancerObjective：To explore the relationship between multiple HPVs infectionand cervical lesions.Methods：1136cases in the first part who had undergone ThinPrepLiquid-based cytology test (TCT), colposcopy and biopsy, were enrolled inthis part.164cases with normal cytology were chosen as the control group.Others with abnormal cytology were divided into four group, which were theinflammation group (335cases), CIN1group (224cases), CIN2-3group (341cases) and cervical cancer group (72cases), according to the histopathologicalresults. We respectively counted up the prevalence of HPV, single HPV andmultiple HPVs infection, and then the chi-square test was applied to analyzethe data. We analyzed the distribution of multiple HPVs infection.Results： The prevalence of HPV infection were25.00%,62.69%,76.79%,85.63%and98.61%, respectively in different groups, showing anupward trend(P<0.05). The prevalence of single HPV infection were22.56%,33.73%,42.86%,56.01%,84.72%, also showing an upward trend (P<0.05).The prevalence of multiple HPV infection were2.44%,28.96%,33.93%,29.62%,13.89%and25.35%, respectively. As to the prevalence ofmultiple HPV infection, all cervical lesions groups were significantly higherthan tha of the control group (P<0.05); diferences in prevalence among theinflammation group, CIN1group and CIN2-3group were not statisticallysignificant (P>0.05), but that of the cervical cancer group was significantlylower than that of the other three groups (P<0.05). The most commongenotypes were HPV-16,58,52, which the infection rates of were38.38%,11.53%and10.12%, respectively.Conclusion：Multiple HPVs infection can lead to cervical lesions, but theseverity of the lesion dose not depend on the amount of HPV genotypes, buton the pathogenic ability of HPV genotypes. The most common is super-infection, among multiple HPVs infection. The most common genotypeis HPV-16, followed by HPV-58,52in the multiple HPVs infection.