| Objective:To study and analysis the application value and clinical significance of high-risk HPV typing in cervical cancer and precancerous lesions screening.Methods:Relying on the national major maternal and child health two cancer screening project,a total of 59,032 women of the appropriate age(35-64 years old)from 9 towns in Xishan District,Wuxi City from January 2015 to December 2016 were screened for free cervical cancer and precancerous lesions.All screeners were treated with illumina Hiseq2000 high-throughput sequencing technology for cervical HPV typing test for free screening.According to the TBS classification criteria,the cervical smear-based cytology(TCT)shunt examination of patients with positive cervical HPV test results;abnormal results of cervical TCT examination(?ASCUS)or suspicious individuals were taken under colposcopy for histopathological examination.Statistical analysis of high-risk HPV infection rate,specific classification,infection pattern,high-risk HPV infection in different age groups,distribution of high-risk HPV subtypes in cervical cancer and precancerous lesions.Result:A total of 6,170 high-risk HPV infections were detected in 59,032 screening patients.The infection rate was 10.45%(6170/59032),and the top five high-risk subtypes were 16,52,58,18,and 68,respectively 3795(6.43%),1883(3.19%),1549(2.62%),994(1.68%)and 969(1.64%).There were single infections and mixed infections,with a single infection.There were 4907 cases of single infection,accounting for 79.53%of positive cases,1018 cases of double infection,accounting for 16.50%;221 cases of triple infection,accounting for 3.58%;24 cases of quadruple infection,accounting for 0.39%.The high-risk HPV infection rate in the 60-64 age group was the highest,13.84%,followed by the 40-49 age group 10.56%,the difference was statistically significant(P<0.01).There was no significant difference in the infection rate between the 35-39 and 50-59 age groups(P>0.05).Cervical cancer and precancerous lesions were dominated by a single infection,with 220 cases of single-type high-risk HPV infection,accounting for 73.83%.Among them,the top three subtypes were 16,58,52 and 33,respectively,95 cases(31.88%),32 cases(10.74%)and 20 cases(6.71%),type 18 single infection ranked sixth,no type 59 infection.The most infections in the CINI lesions were quadruple infections,and the CINII lesions were mostly triple infections.Only one case of CINIII and cervical cancer was double-infected,and there were no multiple infections.Conclusion:?DHigh-risk HPV infection is relatively high in the age group of 60 years old or older,attention should be paid to cervical cancer screening and health education for elderly women in the region;?The first few subtypes of high-risk HPV infection in cervical lesions of all levels of cervical lesions were 16,58,52 and 33 in order,the detection rate of single HPV 16 gradually increased with the increase of cervical lesion level.?Cervical cancer and different levels of precancerous lesions were all mainly caused by single high-risk HPV infection,and with the severity of the lesions,single-type infections showed an upward trend.The double infection and multiple infection rates did not increase with the severity of cervical lesions,indicating that multiple infections did not promote the development of cervical lesions,the severity of the lesions are not related to the number of high-risk HPV infections;?To explore the characteristics of high-risk HPV typing and distribution in cervical cancer and precancerous lesions in this region is helpful for clinical grading and individualized management of patients,and provides data support for the optimization of primary prevention of cervical cancer and precancerous lesions in women and the development of regional or therapeutic HPV vaccine,which has important clinical significance. |
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