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Sultana S, Nishan MDNH, Akter A, Rahman D, Yasmin F, Hawlader MDH. Knowledge and willingness towards human Papillomavirus vaccination among the parents and school teachers of eligible girls in Dhaka, Bangladesh: A school-based cross-sectional study. J Virus Erad 2025; 11:100590. [PMID: 40129691 PMCID: PMC11932650 DOI: 10.1016/j.jve.2025.100590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2025] [Revised: 03/05/2025] [Accepted: 03/05/2025] [Indexed: 03/26/2025] Open
Abstract
Background Cervical cancer ranks as the common prevalent cancer, among women worldwide especially impacting low-resource countries. In Bangladesh, this accounts for 12 % of all cancer cases. The development of cancer is closely linked to Human Papillomavirus (HPV) infection. Despite the availability of HPV vaccines, their uptake remains limited in Bangladesh. Thus, this research aims to assess the knowledge and willingness of parents and school teachers regarding HPV vaccination for eligible girls in Bangladesh. Methodology This study involved 406 parents and school teachers of girls aged 9-14 years from Dhaka city. A cross-sectional study design was used. Data collection was done through a questionnaire administered by interviewers after pre-testing and refinement for clarity and reliability. Analysis was carried out using Stata 17 software. Chi-square tests and logistic regression were used to uncover associations and predictors related to knowledge levels and willingness. Results Findings revealed that a majority of participants (64.04 %) exhibited an understanding of HPV and cervical cancer yet a high percentage (98.28 %) expressed willingness to engage in HPV vaccination initiatives. participants with primary (AOR = 3.306, p < 0.005), secondary (AOR = 8.806, p < 0.001), and higher education (AOR = 5.059, p < 0.001), as well as those from upper-middle-income groups (AOR = 3.038, p < 0.001), had significantly higher knowledge of HPV and cervical cancer. Conclusion The research emphasizes lack of knowledge regarding HPV and its vaccination among parents and educators in Bangladesh despite a willingness to vaccinate. These results emphasize the importance of tailored initiatives and better access, to health information to increase HPV vaccine acceptance and lower the incidence of cervical cancer.
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Affiliation(s)
- Samina Sultana
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | | | - Aklima Akter
- Department of Obstetrics & Gynecology, Dhaka Medical College Hospital, Dhaka, 1000, Bangladesh
| | - Dalia Rahman
- Department of Obstetrics & Gynecology, Dhaka Medical College Hospital, Dhaka, 1000, Bangladesh
| | - Fowzia Yasmin
- Department of Obstetrics & Gynecology, Dhaka Medical College Hospital, Dhaka, 1000, Bangladesh
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Sultana S, Nishan MDNH, Akter A, Rahman D, Yasmin F, Hawlader MDH. Knowledge and willingness towards human Papillomavirus vaccination among the parents and school teachers of eligible girls in Dhaka, Bangladesh: A school-based cross-sectional study. J Virus Erad 2025; 11:100590. [DOI: sultana s, nishan nh, akter a, rahman d, yasmin f, hawlader mdh.knowledge and willingness towards human papillomavirus vaccination among the parents and school teachers of eligible girls in dhaka, bangladesh: a school-based cross-sectional study.journal of virus eradication.2025:100590.doi: 10.1016/j.jve.2025.100590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2025] Open
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Zu YE, Wang SF, Peng XX, Wen YC, Shen XX, Wang XL, Liao WB, Jia D, Liu JY, Peng XW. New cheaper human papilloma virus mass screening strategy reduces cervical cancer incidence in Changsha city: A clinical trial. World J Clin Oncol 2024; 15:1491-1500. [PMID: 39720646 PMCID: PMC11514368 DOI: 10.5306/wjco.v15.i12.1491] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/05/2024] [Accepted: 10/14/2024] [Indexed: 10/22/2024] Open
Abstract
BACKGROUND Cervical cancer is the second leading cause of death in women worldwide, second only to breast cancer. Around 80% of women have been infected with human papillomavirus (HPV) in their lifetime. Early screening and treatment are effective means of preventing cervical cancer, but due to economic reasons, many parts of the world do not have free screening programs to protect women's health. AIM To increase HPV cervical cancer screening in Changsha and reduce the incidence of cervical cancer. METHODS Cervical cancer screening included gynecological examination, vaginal secretion examination and HPV high-risk typing testing. Cervical cytology examination (ThinPrep cytology test) was performed for individuals who test positive for HPV types other than 16 and 18. Vaginal colposcopy examination was performed for HPV16 and 18 positive individuals, as well as for those who were positive for ThinPrep cytology test. If the results of vaginal colposcopy examination were abnormal, histopathological examination was performed. We conducted a cost-benefit analysis after 4 years. RESULTS From 2019 to 2022, 523437 women aged 35-64 years in Changsha city were screened and 73313 were positive, with a 14% positive rate. The detection rate of precancerous lesions of cervical cancer was 0.6% and the detection rate of cervical cancer was 0.037%. Among 311212 patients who underwent two cancers examinations, the incidence rate was reduced by more than half in the second examination. The average screening cost per woman was 120 RMB. The average cost of detecting early cases was 10619 RMB, with an early detection cost coefficient of 0.083. CONCLUSION Our screening strategy was effective and cost-effective, making it valuable for early diagnosis and treatment of cervical cancer. It is worth promoting in economically limited areas.
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Affiliation(s)
- Yue-E Zu
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care, Hunan Normal University, Changsha 410001, Hunan Province, China
| | - Si-Feng Wang
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care, Hunan Normal University, Changsha 410001, Hunan Province, China
| | - Xing-Xing Peng
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care, Hunan Normal University, Changsha 410001, Hunan Province, China
| | - Yong-Chun Wen
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care, Hunan Normal University, Changsha 410001, Hunan Province, China
| | - Xue-Xiang Shen
- Changsha Hospital for Maternal & Child Health Care Affiliated, Hunan Normal University, Changsha 410001, Hunan Province, China
| | - Xiao-Lan Wang
- Changsha Hospital for Maternal & Child Health Care Affiliated, Hunan Normal University, Changsha 410001, Hunan Province, China
| | - Wen-Bo Liao
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care, Hunan Normal University, Changsha 410001, Hunan Province, China
| | - Ding Jia
- Changsha Hospital for Maternal & Child Health Care Affiliated, Hunan Normal University, Changsha 410001, Hunan Province, China
| | - Ji-Yang Liu
- Department of Administrative Office, Hunan Provincial Health Commission, Changsha 410001, Hunan Province, China
| | - Xiang-Wen Peng
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care, Hunan Normal University, Changsha 410001, Hunan Province, China
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Mao Z, Deng A, Jin X, Li M, Lv W, Huang L, Zhong H, Yang H, Wang S, Shi Y, Zhang L, Liao Q, Huang G. A microfluidic-chip-based system with loop-mediated isothermal amplification for rapid and parallel detection of Trichomonas vaginalis and human papillomavirus. Analyst 2023; 148:4820-4828. [PMID: 37606537 DOI: 10.1039/d3an01123b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Cervical cancer is a significant global health issue primarily caused by high-risk types of human papillomavirus (HPV). Recent studies have reported an association between Trichomonas vaginalis (T. vaginalis) infections and HPV infections, highlighting the importance of simultaneously detecting these pathogens for effective cervical cancer risk management. However, current methods for detecting both T. vaginalis and HPV are limited. In this study, we present a novel approach using a microfluidic-chip-based system with loop-mediated isothermal amplification (LAMP) for the rapid and parallel detection of T. vaginalis, HPV16, HPV18, and HPV52 in a reagent-efficient and user-friendly manner. Compared to conventional LAMP assays in tubes, our system exhibits enhanced sensitivity with values of 2.43 × 101, 3.00 × 102, 3.57 × 101, and 3.60 × 102 copies per reaction for T. vaginalis, HPV16, HPV18, and HPV52, respectively. Additionally, we validated the performance of our chip by testing 47 clinical samples, yielding results consistent with the diagnostic methods used by the hospital. Therefore, our system not only offers a promising solution for concurrent diagnosis of T. vaginalis and HPV infections, particularly in resource-limited areas, due to its cost-effectiveness, ease of use, and rapid and accurate detection performance, but can also contribute to future research on the co-infection of these two pathogens. Moreover, the system possesses the capability to simultaneously detect up to 22 different types of pathogens, making it applicable across a wide range of domains such as diagnostics, food safety, and water monitoring.
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Affiliation(s)
- Zeyin Mao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
| | - Anni Deng
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
| | - Xiangyu Jin
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
| | - Meng Li
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
| | - Wenqi Lv
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
| | - Leyang Huang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
| | - Hao Zhong
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
| | - Han Yang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
| | - Shihong Wang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
| | - Yixuan Shi
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
| | - Lei Zhang
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
| | - Qinping Liao
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
| | - Guoliang Huang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
- National Engineering Research Center for Beijing Biochip Technology, Beijing 102206, China
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Zhuang L, Xie X, Wang L, Weng X, Xiu Y, Liu D, Zhong L. Assessment of High-Risk Human Papillomavirus Infection Characteristics in Cervical Squamous Cell Carcinoma and Adenocarcinoma in China. Healthc Policy 2022; 15:2043-2055. [PMID: 36348757 PMCID: PMC9637370 DOI: 10.2147/rmhp.s384342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/23/2022] [Indexed: 11/07/2022] Open
Abstract
Background The characteristics of high-risk human papillomavirus (HR-HPV) infection in different pathological types of cervical cancer in China are unclear. The aim of this study was to evaluate HR-HPV genotypes and age stratification with cervical squamous cell carcinoma (SCC) and adenocarcinoma (ADC) in China. Materials and Methods Patients diagnosed with cervical cancer by histopathology in Fujian Maternity and Child Health Hospital from January 1, 2014, to December 31, 2017, were included in this study. The HR-HPV genotype was analyzed in cervical specimens. Logistic regression was used to calculate odds ratios (ORs). All tests of statistical significance were two-sided, and the P value<0.05. Results A total of 1,590,476 women were screened for cervical cancer, and 688 cervical cancers were detected, including 554 SCC and 93 ADC. The overall HR-HPV infection rate in SCC was higher than that in ADC (91.2% vs 81.7%, P=0.005). HPV-16 was the most prevalent genotype in SCC (70.0%) but was only 31.2% in ADC (P<0.001). However, the prevalence of HPV-18 in ADC was significantly higher than that in SCC (45.2% vs 7.0%; P<0.001). In SCC, the prevalence of HPV-16 was consistently much higher than that of HPV-18 regardless of age group. Among ADC, the prevalence of HPV-18 was higher than that of HPV-16 in women aged ≥45 years. Interestingly, in those aged <35 years, the highest prevalence was observed for HPV-16. HPV-18 infection has the highest risk of ADC (OR= 12.109; P< 0.001), and HPV-45 and HPV-51 were also found to be associated with the occurrence of ADC. However, HPV-16 infection greatly increased the risk of having histological SCC. Conclusion HPV-16 and HPV-18 infections are key risk factors for SCC and ADC. The use of HR-HPV genotyping tests in cervical cancer screening and vaccination against major HPV genotypes could reduce the incidence of cervical cancer.
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Affiliation(s)
- Lijuan Zhuang
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, People’s Republic of China
| | - Xiaoyan Xie
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, People’s Republic of China
| | - Lihua Wang
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, People’s Republic of China
| | - Xiulan Weng
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, People’s Republic of China
| | - Yingling Xiu
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, People’s Republic of China
| | - Dabin Liu
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, People’s Republic of China
| | - Liying Zhong
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, People’s Republic of China
- Correspondence: Liying Zhong; Dabin Liu, Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001, People’s Republic of China, Tel +86-13860610354; +86-13489997701, Fax +86-591-87551247, Email ;
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Chen H, Xiong W, Dong X, Liu Y, Tan X. Infection status and survival impact of high-risk human papillomavirus in cervical adenocarcinomas: A systematic review and meta-analysis. Gynecol Oncol 2022; 167:129-136. [PMID: 35973872 DOI: 10.1016/j.ygyno.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Cervical adenocarcinoma (CAC) comprises a heterogeneous group of tumors that are not universally associated with HPV infection. As has been shown in other organs, it is becoming increasingly apparent that HPV status significantly affects the prognosis of adenocarcinoma. We conducted a systematic review and meta-analysis to investigate the infection status of high-risk Human papillomavirus (hrHPV) in CAC and evaluate its impact on the survival of patients. METHODS PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), and Clinical Trials.gov were searched from inception to May 1st, 2022. Data on HPV infection status and survival outcomes were evaluated using STATA 16.0. RESULTS Seventy-one studies with 11,278 participants were included in HPV infection analysis and eight studies with 1099 participants were included in prognosis analysis. The HPV infection rate (including high-risk and low-risk) and hrHPV infection rate in CAC were 75% (95% CI 0.70-0.80, 6978 participants) and 75% (95% CI 0.70-0.81, 4906 participants), respectively. HPV-16 and -18 were the most common HPVs in CAC, with pooled infection rates of 37% (95% CI 0.33-0.41, 7848 participants) and 34% (95% CI 0.30-0.38, 7730 participants), respectively. hrHPV infection was associated with better overall survival (HR 0.23, 95% CI 0.11-0.47, 1013 participants), better disease-free survival (HR 0.18, 95% CI 0.07-0.43, 292 participants), better progression-free survival (HR 0.20, 95% CI 0.08-0.47, 271 participants) and less recurrence (RR 0.30, 95% CI 0.07-0.43, 181 participants). CONCLUSION HPV infection rates were high in CAC. HPV-16 and -18 had the highest infection rates in CAC. However, hrHPV infection was associated with better survival and less recurrence. Future studies should clarify the relationship between hrHPV infection and other prognostic factors and make reasonable treatment strategies for CAC with different HPV status. PROTOCOL REGISTRATION CRD42022319390.
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Affiliation(s)
- Hengxi Chen
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Wei Xiong
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xue Dong
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yana Liu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xin Tan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
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Zhou F, Zhang W, Cai H, Cao Y. Portrayals of 2v, 4v and 9vHPV vaccines on Chinese social media: a content analysis of hot posts on Sina Weibo. Hum Vaccin Immunother 2021; 17:4433-4441. [PMID: 34543155 DOI: 10.1080/21645515.2021.1971016] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Rather than receive the effective 2vHPV vaccines that are readily available in China, Chinese women usually wait to receive 4v and 9vHPV vaccines, which are difficult to acquire. This means that Chinese women miss the opportunity for optimal protection from cervical cancer. As social media platforms are the main channel by which Chinese women learn about HPV vaccines, this study aimed to explore how HPV vaccines are described on social media, and in particular how they discuss or distinguish 2 v, 4 v and 9vHPV vaccines. The Octopus Web crawler tool was used to capture hot Weibo posts from 2013-2021, and 1,164 valid data were obtained. Results suggested that there are very few posts with great influence on Weibo about HPV vaccines among 9 years and much of them are created by "lay people." HPV-related topics lacked persistent popularity, comprised highly repetitive content and the spread of information was geographically diverse. There were significant differences in the media descriptions of different kinds of HPV vaccines. Price was mentioned more often in the descriptions of 2vHPV vaccines, whereas appointments were referred to most often in the descriptions of 9vHPV vaccines. There was little media attention paid to the safety and effectiveness of HPV vaccines. Chinese media should develop better collaborations with public health professionals, pay more attention to the originality of their news coverage of HPV vaccines and strive to promote HPV vaccination. Such collaboration will help news media to better understand the key points of HPV information that need to be disseminated.
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Affiliation(s)
- Fangzhou Zhou
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, Wuhan, PR China
| | - Wen Zhang
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, Wuhan, PR China
| | - Hongning Cai
- Department of Gynecological Oncology, Hubei Maternal and Child Health Care Hospital, Wuhan, PR China
| | - Yuan Cao
- Analytical and Testing Center, Wuhan University of Science and Technology, Wuhan, PR China
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Xing J, Tan T, Guo YL, Zhu JQ, Zheng AW, Yu AJ, Niu Z. Heat maps present the spatial distribution of human papillomavirus infection in Zhejiang Province, China. Oncol Lett 2021; 21:366. [PMID: 33747223 PMCID: PMC7967952 DOI: 10.3892/ol.2021.12627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 09/14/2020] [Indexed: 01/24/2023] Open
Abstract
Determining the spatial distribution of human papillomavirus (HPV) and performing accurate public health analyses helps to distinguish areas of healthcare that require further research, and enables therapeutic techniques and approaches in healthcare to be focused more accurately. A total of 4,560 women were enrolled in the present study. Flow-through hybridization and gene chip assays were used to detect the genotypes of HPV infection. Heat maps were then generated to present the spatial distribution of HPV infections in Zhejiang Province according to genotype. Of the exfoliated cervical cell samples from the 4,560 women, HPV was detected in 1,886 samples. HPV-16, -58, -52 and -18 were the most prevalently identified genotypes in the population included in the present study. HPV-16 and -58 infections were mainly distributed in the northern and central regions of Zhejiang Province, such as in Hangzhou and Shaoxing, where the prevalence was higher than that in the southern regions (P<0.05). HPV-18 infection was widespread throughout Zhejiang Province, but had a much lower infection rate in Ningbo and Huzhou (P<0.05). High infection rates of HPV-52 were mainly detected in Hangzhou and the eastern coastal areas of Wenzhou, with a relatively low rate of infection in the center of the province (P<0.05). In conclusion, HPV-16, -58, -52 and -18 were the four most prevalent HPV genotypes observed in Zhejiang Province. Heat maps were created to display the spatial distribution of HPV infection according to genotype, which varied by geographical regions. The results indicate that for individuals in Ningbo or Wenzhou, bivalent or quadrivalent vaccines may be suitable, but for those in Hangzhou and Shaoxing, nonavalent vaccines are strongly recommended.
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Affiliation(s)
- Jie Xing
- Department of Gynecological Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310062, P.R. China
| | - Tao Tan
- Department of Gynecological Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310062, P.R. China
| | - Yang-Long Guo
- Department of Gynecological Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310062, P.R. China
| | - Jian-Qing Zhu
- Department of Gynecological Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310062, P.R. China
| | - Ai-Wen Zheng
- Department of Gynecological Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310062, P.R. China
| | - Ai-Jun Yu
- Department of Gynecological Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310062, P.R. China
| | - Zheng Niu
- Department of Gynecology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310002, P.R. China
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Goldstein A, Lei Y, Goldstein L, Goldstein A, Bai QX, Felix J, Lipson R, Demarco M, Schiffman M, Egemen D, Desai KT, Bedell S, Gersten J, Goldstein G, O'Keefe K, O'Keefe C, O'Keefe T, Sebag C, Lobel L, Zhao A, Lu YL. A rapid, high-volume cervical screening project using self-sampling and isothermal PCR HPV testing. Infect Agent Cancer 2020; 15:64. [PMID: 33106753 PMCID: PMC7579849 DOI: 10.1186/s13027-020-00329-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/29/2020] [Indexed: 01/03/2023] Open
Abstract
Objective Rapid, high-volume screening programs are needed as part of cervical cancer prevention in China. Methods In a 5-day screening project in Inner Mongolia, 3345 women volunteered following a community awareness campaign, and self-swabbed to permit rapid HPV testing. Two AmpFire™ HPV detection systems (Atila Biosystems) were sufficient to provide pooled 15-HPV type data within an hour. HPV+ patients had same-day digital colposcopy (DC) performed by 1 of 6 physicians, using the EVA™ system (MobileODT). Digital images were obtained and, after biopsy of suspected lesions for later confirmatory diagnosis, women were treated immediately based on colposcopic impression. Suspected low- grade lesions were offered treatment with thermal ablation (Wisap), and suspected high-grade lesions were treated with LLETZ. Results Of 3345 women screened, 624 (18.7%) were HPV+. Of these, 88.5% HPV+ women underwent same-day colposcopy and 78 were treated. Later consensus histology results obtained on 197 women indicated 20 CIN2+, of whom 15 were detected and treated/referred at screening (10 by thermal ablation, 4 by LLETZ, 1 by referral). Conclusions Global control of cervical cancer will require both vaccination and screening of a huge number of women. This study illustrates a cervical screening strategy that can be used to screen-and-treat large numbers of women. HPV self-sampling facilitates high-volume screening. Specimens can be tested rapidly, promoting minimal loss-to-follow-up. Specifically, the AmpFire™ system used in this study is highly portable, simple, rapid (92 specimens per 65 min per unit), and economical. Visual triage can be performed on HPV+ women with a portable digital colposcope that provides magnification, lighting, and a recorded image. Diagnosis and appropriate treatment remain the most subjective elements. The digital image is under study for deep-learning based automated evaluation that could assist the management decision, either by itself or combined with HPV typing.
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Affiliation(s)
| | - Yang Lei
- Peking University Cancer Hospital, Beijing, China
| | | | | | | | - Juan Felix
- Medical College of Wisconsin, Milwaukee, WI USA
| | | | - Maria Demarco
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD USA
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD USA
| | - Didem Egemen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD USA
| | - Kanan T Desai
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD USA
| | | | | | | | | | - Casey O'Keefe
- Pacific Northwest Urology Specialists, Bellingham, WA USA
| | | | | | | | - Anna Zhao
- United Family Hospitals, Beijing, China
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Goldstein A, Goldstein LS, Lipson R, Bedell S, Wang J, Stamper SA, Brenner G, Goldstein GR, O'Keefe KD, O'Keefe SC, O'Keefe M, O'Keefe T, Goldstein AR, Zhao A. Assessing the feasibility of a rapid, high-volume cervical cancer screening programme using HPV self-sampling and digital colposcopy in rural regions of Yunnan, China. BMJ Open 2020; 10:e035153. [PMID: 32234744 PMCID: PMC7170644 DOI: 10.1136/bmjopen-2019-035153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE Implementation of a novel, rapid, high-volume, see-and-treat cervical cancer screening programme using self-swab human papillomavirus (HPV) testing and digital colposcopy in underserved regions of Yunnan China. DESIGN 480-980 women per day self-swabbed for high-risk HPV (hrHPV+). Four careHPV machines (Qiagen) were run simultaneously to test the specimens. All hrHPV+ patients were contacted the same day and digital colposcopy was performed with the enhanced visual assessment system (MobileODT). Digital images were obtained, and all suspected lesions were biopsied and then treated. SETTING Rural and underserved areas of the Yunnan province, Kunming municipality. PARTICIPANTS 3600 women, mean age 50.2 years, who had never been screened for cervical cancer. The women were of the Yi, Hui, Dai and Han ethnicities. INTERVENTIONS Cryotherapy was performed on all lesions suspicious for cervical intraepithelial neoplasia (CIN) 1 and loop electrosurgical excision procedure was performed on all lesions suspicious for ≥CIN2. Endocervical curettage was performed if the transformation zone was not fully visualised. RESULTS 216 women (6%) were hrHPV+. 168 underwent same-day colposcopy (23 CIN1, 17≥CIN2). Digital colposcopy was able to identify 15 of 16 (93.8%)≥CIN2 lesions. CONCLUSIONS This study illustrates a high-volume, rapid and practical strategy that can be used to screen and treat an ethnically diverse group of Chinese women. First, HPV self-sampling allows large numbers of women to be screened rapidly and relatively inexpensively. Only hrHPV+ women will then require further evaluation. Digital colposcopy is then performed on hrHPV+ women with a portable digital colposcope. The high-resolution images obtained can facilitate appropriate same-day treatment as they are able to accurately distinguish between CIN1 and ≥CIN2 lesions.
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Affiliation(s)
- Andrew Goldstein
- Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- The Center for Vulvovaginal Disorders, Washington, DC, USA
| | | | - Roberta Lipson
- Beijing United Family Hospitals and Clinics, Beijing, China
| | - Sarah Bedell
- The Center for Vulvovaginal Disorders, Washington, DC, USA
| | - Jue Wang
- Beijing United Family Hospitals and Clinics, Beijing, China
| | - Sarah A Stamper
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | | | | | - McKenna O'Keefe
- Engineering, University of California Berkeley, Berkeley, California, USA
| | | | | | - Anna Zhao
- Beijing United Family Hospitals and Clinics, Beijing, China
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11
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Wong LP, Han L, Li H, Zhao J, Zhao Q, Zimet GD. Current issues facing the introduction of human papillomavirus vaccine in China and future prospects. Hum Vaccin Immunother 2019; 15:1533-1540. [PMID: 31017500 DOI: 10.1080/21645515.2019.1611157] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The introduction of human papillomavirus (HPV) vaccination in China aims to prevent HPV infection in all women. The issues that China might face include high cost of vaccines made in other countries, shortage in HPV vaccine supply, negative events attributed to vaccination (whether justified or not) that jeopardizes the general public's confidence in the HPV vaccine, cultural and literacy barriers, and sensitivity to receiving a vaccine for a sexually transmitted disease. Ensuring the effective delivery of the HPV vaccine in China, a country with vast economic, geographical, and cultural complexities, will require a commitment of significant resources. In light of the high price of imported vaccines, the availability of locally manufactured HPV vaccines would greatly facilitate the national HPV vaccination program. New evidence supporting the efficacy of a two-dose regime in younger adolescents would also be advantageous in terms of affordability and logistical simplicity of vaccine administration. Furthermore, it would potentially enhance the compliance and uptake, especially for hard to reach women in remote regions.
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Affiliation(s)
- Li Ping Wong
- a Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia.,b Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo , Zhejiang , PR China
| | - Liyuan Han
- b Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo , Zhejiang , PR China
| | - Hui Li
- c Non-infectious Disease Prevention and Control Institute, Ningbo Municipal Center for Disease Control and Prevention , Ningbo , PR China
| | - Jinshun Zhao
- b Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo , Zhejiang , PR China
| | - Qinjian Zhao
- d State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University , Xiamen , Fujian PR China
| | - Gregory D Zimet
- e Department of Pediatrics, School of Medicine, Indiana University , Indianapolis , IN , USA
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12
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Wang H, Chen L, Ma W, Zeng Y, Qin L, Chen M, Li L. Prediction and identification of human leukocyte antigen-A2-restricted cytotoxic T lymphocyte epitope peptides from the human papillomavirus 58 E7 protein. Oncol Lett 2018; 16:2003-2008. [PMID: 30008894 DOI: 10.3892/ol.2018.8875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 05/03/2018] [Indexed: 01/20/2023] Open
Abstract
Persistent infection with high-risk human papilloma virus (HPV) is the primary cause of cervical intraepithelial neoplasia (CIN) and cervical carcinoma. HPV58 is the third most common HPV genotype in China after HPV16 and HPV18. HPV E6 and E7 are oncoproteins and are constitutively expressed in HPV-associated cancer cells, therefore they are considered to be ideal target antigens for immunotherapy, including HPV therapeutic vaccine. In the present study, human leukocyte antigen (HLA)-A2-restricted cytotoxic T lymphocyte (CTL) epitope peptides were predicted and screened from HPV58 E7 antigen and their immunogenicity was subsequently determined. A total of 6 HLA-A2-binding peptides derived from HPV58 E7 were predicted and selected using 3 different prediction programs. A negative control peptide and PBS were used as two negative controls. Peripheral blood mononuclear cells (PBMCs) with HLA-A2(+) allele were used to detect the specific cellular immune response among the 6 predicted peptides by enzyme-linked immunospot assay (ELISOPT). Following preliminary screening for the predicted peptides, the antigenicity of the peptide HPV58 E772-80 was further assessed by an immunoassay to a vaccine contained HPV58 E7 antigen. Specific humoral and cellular immunity were detected using the peptide HPV58 E772-80 as the specific antigen. A total of 6 peptides from HPV58 E7 protein were predicted and subsequently named P1 (E77-15: TLREYILDL), P2 (E714-22: DLHPEPTDL), P3 (E769-77: CINSTTTDV), and P4 (E772-80: STTTDVRTL), P5 (E779-87: TLQQLLMGT) and P6 (E783-91: LLMGTCTIV). In the ELISPOT assay on HLA-A2 (+) human PBMCs, interferon (IFN)-γ-production was evident in the P2 and P4 groups. The average numbers of IFN-γ associated spots in the P2 and P4 groups was 50.61±5.37 spot-forming cells (SFC)/1×105 and 266±34.42 SFC/1×105, respectively. The numbers of spots in the two peptides were significantly increased compared with the other 4 peptides and the control groups (P<0.05). In the further antigenicity verification of P4 (HPV58 E772-80), the peptide only stimulated the humoral immune response of the AD-HPV16/18/58 mE6E7 vaccine containing HPV58 E7 antigen. Compared with the 2 negative control groups (1:400), the antibody titers of the vaccine group (1:25,600) were significantly increased (P<0.05). In cellular immunoassays the average number of IFN-γ associated spots was 143.3±32.13 SFC/1×105 in the vaccine group, which was significantly enhanced compared with the PBS group (8±5.29 SFC/1×105; P<0.01) and the AD-NC group (28±5.13 SFC/1×105; P<0.01). The peptide HPV58 E772-80 (STTTDVRTL) displayed sufficient antigenicity to a vaccine contained HPV58 E7 antigen. Therefore, HPV58 E772-80 peptide may be considered as a candidate epitope peptide for the construction of HPV58 peptide vaccines.
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Affiliation(s)
- He Wang
- Gynecologist Tumor Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Lilai Chen
- Gynecologist Tumor Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Weihong Ma
- Gynecologist Tumor Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Yue Zeng
- Gynecologist Tumor Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Lu Qin
- Gynecologist Tumor Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Mengjie Chen
- Gynecologist Tumor Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Li Li
- Gynecologist Tumor Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
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13
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Lou H, Gharzouzi E, Guerra SP, Domgue JF, Sawitzke J, Villagran G, Garland L, Boland JF, Wagner S, Rosas H, Troxler J, McMillen H, Kessing B, Alvirez E, Castillo M, Morales H, Argueta V, Rosingh A, van Aerde-van Nunen FJHB, Lopez G, Pinedo HM, Schiffman M, Dean M, Orozco R. Low-cost HPV testing and the prevalence of cervical infection in asymptomatic populations in Guatemala. BMC Cancer 2018; 18:562. [PMID: 29764400 PMCID: PMC5952444 DOI: 10.1186/s12885-018-4438-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 04/26/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND A low cost and accurate method for detecting high-risk (HR) human papillomavirus (HPV) is important to permit HPV testing for cervical cancer prevention. We used a commercially available HPV method (H13, Hybribio) which was documented to function accurately in a reduced volume of cervical specimen to determine the most prevalent HPV types and the distribution of HPV infections in over 1795 cancer-free women in Guatemala undergoing primary screening for cervical cancer by cytology. METHODS HR-HPV detection was attempted in cervical samples from 1795 cancer-free women receiving Pap smears using the Hybribio™ real-time PCR assay of 13 HR types. The test includes a globin gene internal control. HPV positive samples were sequenced to determine viral type. Age-specific prevalence of HPV was also assessed in the study population. RESULTS A total of 13% (226/1717) of women tested HPV+, with 78 samples (4.3%) failing to amplify the internal control. The highest prevalence was found in younger women (< 30 years, 22%) and older ones (≥60 years, 15%). The six most common HR-HPV types among the 148 HPV+ typed were HPV16 (22%), HPV18 (11%), HPV39 (11%), HPV58 (10%), HPV52 (8%), and HPV45 (8%). CONCLUSIONS In this sample of cancer free women in Guatemala, HPV16 was the most prevalent HR type in Guatemala and the age-specific prevalence curve peaked in younger ages. Women in the 30-59-year age groups had a prevalence of HR-HPV of 8%, however, larger studies to better describe the epidemiology of HPV in Guatemala are needed.
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Affiliation(s)
- Hong Lou
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, Leidos Biomedical Research, Inc., National Laboratory for Cancer Research, Gaithersburg, MD USA
| | - Eduardo Gharzouzi
- Instituto de Cancerologia, 6ª Avenida 6-58, Zona11, Guatemala City, Guatemala
| | - Sarita Polo Guerra
- Instituto de Cancerologia, 6ª Avenida 6-58, Zona11, Guatemala City, Guatemala
| | | | - Julie Sawitzke
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, Leidos Biomedical Research, Inc., National Laboratory for Cancer Research, Gaithersburg, MD USA
| | - Guillermo Villagran
- Instituto de Cancerologia, 6ª Avenida 6-58, Zona11, Guatemala City, Guatemala
| | - Lisa Garland
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, Leidos Biomedical Research, Inc., National Laboratory for Cancer Research, Gaithersburg, MD USA
| | - Joseph F. Boland
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, Leidos Biomedical Research, Inc., National Laboratory for Cancer Research, Gaithersburg, MD USA
| | - Sarah Wagner
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, Leidos Biomedical Research, Inc., National Laboratory for Cancer Research, Gaithersburg, MD USA
| | - Héctor Rosas
- Department of Gynecology and Obstetrics, Hospital General San Juan de Dios, Guatemala City, Guatemala
| | - Jami Troxler
- Cancer Research Technology Program, Leidos Biomedical Research, Inc., National Cancer Institute, 8560 Progress Drive, Frederick, MD 21701 USA
| | - Heidi McMillen
- Cancer Research Technology Program, Leidos Biomedical Research, Inc., National Cancer Institute, 8560 Progress Drive, Frederick, MD 21701 USA
| | - Bailey Kessing
- Cancer Research Technology Program, Leidos Biomedical Research, Inc., National Cancer Institute, 8560 Progress Drive, Frederick, MD 21701 USA
| | - Enrique Alvirez
- Hospital Central Universitario “Dr. Antonio M Pineda”, Lara State, Barquisimeto, Venezuela
| | - Miriam Castillo
- Instituto de Cancerologia, 6ª Avenida 6-58, Zona11, Guatemala City, Guatemala
| | - Hesler Morales
- Instituto de Cancerologia, 6ª Avenida 6-58, Zona11, Guatemala City, Guatemala
| | - Victor Argueta
- Department of Pathology, Hospital General San Juan de Dios, Guatemala City, Guatemala
| | | | | | - Griselda Lopez
- Department of Pathology, Hospital General San Juan de Dios, Guatemala City, Guatemala
| | | | | | - Michael Dean
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Gaithersburg, MD USA
| | - Roberto Orozco
- Department of Pathology, Hospital General San Juan de Dios, Guatemala City, Guatemala
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14
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Li L, Liu J, Liu C, Lu X. The correlation between TNF-α-308 gene polymorphism and susceptibility to cervical cancer. Oncol Lett 2018; 15:7163-7167. [PMID: 29725439 PMCID: PMC5920275 DOI: 10.3892/ol.2018.8246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 02/14/2018] [Indexed: 01/30/2023] Open
Abstract
Tumor necrosis factor-α (TNF-α) is closely related to the occurrence of human cancers. Cervical cancer seriously affects female health. Therefore, our study aimed to investigate the correlation between the polymorphism of TNF-α-308 gene and susceptibility to cervical cancer. Whole blood was collected from 142 patients with cervical cancer and 150 healthy controls. PCR-RFLP was used to detect the polymorphism of TNF-α-308 and the correlation between polymorphism of TNF-α-308 and the susceptibility to cervical cancer was analyzed. The three genotypes of TNF-α-308 were GG, GA and AA, and the distributions of genotypes of TNF-α-308 were consistent with Hardy-Weinberg equilibrium in both cervical cancer group and control group. There were no significant differences in genotype and allele frequency between cervical cancer group and healthy control group (P>0.05). A/A genotype increased the risk of cervical cancer by 1.46 times with 95% confidence interval of 0.32-6.67. Different genotypes were not associated with tumor type (P>0.05). Different genotypes are correlated with cervical cancer TNM stages, tumor differentiation and lymph node metastasis. Proportion of GA+AA genotype in TNM stage III+IV group, low differentiation group and lymph node metastasis group were 28.1, 29.0 and 29.8%, respectively, which were significantly higher than those in stage I+II group, moderate/high differentiation group and non-lymph node metastasis group (P<0.05). The results suggested that TNF-α-308 gene polymorphism is associated with the degree of malignancy of cervical cancer. Female patients with A allele have higher malignant degree of cervical cancer.
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Affiliation(s)
- Liping Li
- Department of Gynaecology and Obstetrics, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Jie Liu
- Department of Gynaecology and Obstetrics, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Chunjing Liu
- Department of Gynaecology and Obstetrics, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Xianghui Lu
- Department of Gynaecology and Obstetrics, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
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15
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Wu D, Zhang J, Fan P, Li H, Li D, Pan H, He H, Ren X, Pan Z, Shao R, Pan Z. Methylation in the promoter regions of WT1, NKX6-1 and DBC1 genes in cervical cancer tissues of Uygur women in Xinjiang. Genet Mol Biol 2018; 41:9-17. [PMID: 29658966 PMCID: PMC5901490 DOI: 10.1590/1678-4685-gmb-2016-0146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 06/07/2017] [Indexed: 11/22/2022] Open
Abstract
This study aimed to explore: 1) DNA methylation in the promoter regions of Wilms tumor gene 1 (WT1), NK6 transcription factor related locus 1 gene (NKX6-1) and Deleted in bladder cancer 1 (DBC1) gene in cervical cancer tissues of Uygur women in Xinjiang, and 2) the correlation of gene methylation with the infection of HPV16/18 viruses. We detected HPV16/18 infection in 43 normal cervical tissues, 30 cervical intraepithelial neoplasia lesions (CIN) and 48 cervical cancer tissues with polymerase chain reaction (PCR) method. Methylation in the promoter regions of the WT1, NKX6-1 and DBC1 genes in the above-mentioned tissues was measured by methylation-specific PCR (MSP) and cloning sequencing. The expression level of these three genes was measured by real-time PCR (qPCR) in 10 methylation-positive cervical cancer tissues and 10 methylation-negative normal cervical tissues. We found that the infection of HPV16 in normal cervical tissues, CIN and cervical cancer tissues was 14.0, 36.7 and 66.7%, respectively. The infection of HPV18 was 0, 6.7 and 10.4%, respectively. The methylation rates of WT1, NKX6-1 and DBC1 genes were 7.0, 11.6 and 23.3% in normal cervical tissues, 36.7, 46.7 and 30.0% in CIN tissues, and 89.6, 77.1 and 85.4% in cervical cancer tissues. Furthermore, WT1, NKX6-1 and DBC1 genes were hypermethylated in the high-grade squamous intraepithelial lesion (CIN2, CIN3) and in the cervical cancer tissues with infection of HPV16/18 (both P< 0.05). The expression of WT1, NKX6-1 and DBC1 was significantly lower in the methylation-positive cervical cancer tissues than in methylation-negative normal cervical tissues. Our findings indicated that methylation in the promoter regions of WT1, NKX6-1 and DBC1 is correlated with cervical cancer tumorigenesis in Uygur women. The infection of HPV16/18 might be correlated with methylation in these genes. Gene inactivation caused by methylation might be related to the incidence and development of cervical cancer.
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Affiliation(s)
- Dan Wu
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China.,Clinical Laboratory, Branch of the First Affiliated Hospital of Xinjiang Medical University, Changji, Xinjiang, China
| | - Jinli Zhang
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China
| | - Peiwen Fan
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China
| | - Hongtao Li
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China
| | - Dongmei Li
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China
| | - Huan Pan
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China
| | - Hongchang He
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China
| | - Xianxian Ren
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China
| | - Zhenzhen Pan
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China
| | - Renfu Shao
- Genecology Research Centre, School of Science and Engineering, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
| | - Zemin Pan
- Department of Biochemistry and Molecular Biology, School of Medicine, Shihezi University, Xinjiang Endemic and Ethnic Disease and Education Ministry Key Laboratory, Shihezi, Xinjiang, China
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16
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Terra APS, Murta EFC, Maluf PJ, Caballero OLSD, Brait M, Adad SJ. Aberrant Promoter Methylation Can be Useful as a Marker of Recurrent Disease in Patients with Cervical Intraepithelial Neoplasia Grade III. TUMORI JOURNAL 2018; 93:572-9. [DOI: 10.1177/030089160709300610] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Introduction Although studies of risk factor profiles have been conducted to identify biological markers to predict the natural history of cervical intraepithelial neoplasia (CIN) grade III, there is not sufficient information to support the routine clinical use of any biomarker. Objectives The purpose of this study was to examine aberrant promoter methylation, which is implicated in cancer development and progression, in CIN III lesions in order to identify markers associated with more aggressive biological behavior that could be used to recognize women who are at higher risk of recurrence. Patients and methods We used methylation-specific polymerase chain reaction to analyze promoter hypermethylation of 8 genes ( p16, RARβ, GSTP1, MGMT, p14, TIMP3, E-cad and DAPk) in 33 uterine cervix cones with CIN III that were also submitted to human papillomavirus (HPV) genotyping. All 33 patients in this study had been clinically followed after conization with Papanicolaou smears, colposcopy, and biopsy when indicated, every 6 months during 5 years. Results Of the 33 patients, 12 (36%) underwent immediate hysterectomy after conization for having compromised cone margins, 14 (43%) have not relapsed, and 7 (21%) presented CIN relapse. The frequency of HPV infection in this group was 97% and no significant difference between the groups was observed. HPV of high oncogenic risk was present in 29 (87.9%) cases; HPV 16 was the most frequent (69.7%), while HPV 18 was found in 33.3%; however, it was associated with HPV 16 in 15.1%. Concomitant infection by HPV 6/11 was detected in 21.2% (15.1% with HPV 16 and 6.1 with HPV 18). 85.7% (6/7) of patients with recurrence had HPV 18 vs 0% (0/14) of patients without recurrence ( P = 0.0001). At least 1 of the 8 genes was found hypermethylated in all samples. Concomitant hypermethylation of several genes was frequently found. However, CIN relapse was only seen in the cases with hypermethylation of 3 or more of the 8 genes studied ( P = 0.0039). Conclusion We suggest that aberrant promoter methylation may play a role and may serve as a useful biomarker in the recurrence of CIN.
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Affiliation(s)
| | | | - Paulo José Maluf
- Discipline of Gynecology and Obstetrics, Research Institute of Oncology (IPON), Uberaba, Brazil
| | | | - Mariana Brait
- Ludwig Institute of Cancer Research, Federal University of Triângulo Mineiro (UFTM), Uberaba, Brazil
| | - Sheila Jorge Adad
- Discipline of Special Pathology, Research Institute of Oncology (IPON), Uberaba, Brazil
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Wang JF, Wang CX, Wang LS, Zhang J, Yang XJ, Liu M, Zheng GX. Association of Human Papillomavirus Type 16 E7 and HLA Class I Antigen Expression in Cervical Premalignant and Malignant Lesions. Int J Biol Markers 2018; 22:124-31. [PMID: 17549668 DOI: 10.1177/172460080702200206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In the present experiment we studied the correlation between HPV16 infection and expression of HLA-I antigen in cervical premalignant and malignant lesions (cervicitis, CIN, cervical squamous carcinomas and adenocarcinoma samples). The HPV16 E7 DNA load and the expression of HLA-I antigen in the samples were measured by real-time fluorescence quantitative polymerase chain reaction (RFQ-PCR) and immunohistochemical S-P staining, respectively. Our data indicate that HPV16 E7 load was highly and positively associated with the development of cervical lesions (Spearman's correlation coefficient r=0.848, p<0.001), the negative rate of HLA-I antigen was significantly distinguished among groups (p<0.001), and HPV16 E7 infection and downregulation of HLA-I antigen were highly correlated in cervical lesions (Pearson's correlation coefficient r=-0.487, p<0.001). HPV16 E7 may play an important role in the downregulation of HLA-I antigen in cervical lesions, which results in the immune escape of the virus and the occurrence, development, invasion and metastasis of cancer. Furthermore, quantitative PCR for HPV16 E7 may play an important role in the early detection of cervical diseases and in guiding future therapy toward prevention.
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Affiliation(s)
- J-F Wang
- Department of Laboratory Medicine, Qilu Hospital, Shandong University, Jinan, China
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18
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Prevalence of human papillomavirus genotypes and relative risk of cervical cancer in China: a systematic review and meta-analysis. Oncotarget 2018; 9:15386-15397. [PMID: 29632652 PMCID: PMC5880612 DOI: 10.18632/oncotarget.24169] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/06/2017] [Indexed: 11/25/2022] Open
Abstract
High-risk HPV (hrHPV) is related to cervical carcinogenesis, although clinical data comparing the natural history and carcinogenic potential of type-specific HPV remain limited. Furthermore, the nationwide prevalence rates of overall and type-specific HPV among women with cervical precancerous lesions and cancer have not been reported. Here, a meta-analysis was performed for type-specific HPV distribution among 30,165 HPV-positive women, including 12,094 invasive cervical cancers (ICCs), 10,026 cervical intraepithelial neoplasia grade 2/3 (CIN2/3), 3246 CIN1, and 4799 normal cervices from 45 PCR-based studies. We found that HPV16 was the most common hrHPV type involved in cervical disease. The HPV16 positivity rate varied little across normal (22.7%) and CIN1 individuals (23.6%) but increased through the CIN2 (37.6%) and CIN3 patients (51.9%) to 65.6% in ICC cases. HPV16, 18, 35, 39, 45, and 59 were more frequent in ICC than CIN3, with ICC:CIN3 ratios ranging from 2.3 for HPV18 to 1.1 for HPV35/45. HPV31, 33, 52, and 58 were more frequent in CIN3 compared with normal cervices but less common in ICC compared with CIN3 (ICC:CIN3 ratios ranging from 0.6 for HPV58 and 0.4 for HPV52). The ICC:normal ratios were particularly high for HPV18, 52 and 58 in West China (4.1, 3.9 and 2.9, respectively) and for HPV45 and 59 in North China (1.6 and 1.1, respectively). In summary, this study is the most comprehensive analysis of type-specific HPV distribution in cervical carcinogenesis and could be valuable for HPV-based cervical cancer screening strategies and vaccination policies in China.
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Zhang L, Yang B, Zhang A, Zhou A, Yuan J, Wang Y, Sun L, Cao H, Wang J, Zheng W. Association between human papillomavirus type 16 E6 and E7 variants with subsequent persistent infection and recurrence of cervical high-grade squamous intraepithelial lesion after conization. J Med Virol 2016; 88:1982-8. [PMID: 27038009 DOI: 10.1002/jmv.24541] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2016] [Indexed: 11/10/2022]
Abstract
The study aimed to detect the variants of human papillomavirus (HPV) type 16 E6 and E7 in patients with cervical high-grade squamous intraepithelial lesion (HSIL), and to determine the existence and recurrence of persistent infection after treatment with loop electrosurgical excision procedure (LEEP). Preoperatively collected cervical exfoliated cells from 100 HPV 16 positive HSIL patients enrolled in the study were used to test for E6 and E7 variants. Follow-ups which included TCT, HPV test, and colposcopy were performed every 3 months after the operation, and colposcopic biopsy and endocervical curettage were performed for patients with abnormalities. Patients were followed for 2 years, and recurrence was defined as detecting low-grade squamous intraepithelial lesion (LSIL) or relapse of HSIL in 1 year. In 81% of patients, the E6 variant was the Asian prototype (As.P), 14% of patients had the European variant, 2% had the European prototype (EP), and 3% had the African 1 variant (Af1). The HPV16 could be easily cleared by LEEP in patients with As.P. Persistent infection or recurrence was very rare in this group. The patients with European variants T350G or A442C had a significantly higher incidence of persistent and recurring HPV16 infection. In conclusion, (i) in most cases, As.P caused HSIL. (ii) The European variant E6 T350G/A442C may be associated with higher rates of recurring and persistent HPV16 infection after the LEEP. (iii) The E7 gene mutation may not be a risk factor for recurring HSIL caused by HPV16 or persistent infection. J. Med. Virol. 88:1982-1988, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Lei Zhang
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Binlie Yang
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Ai Zhang
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Aizhi Zhou
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Jieyan Yuan
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Yuhua Wang
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Liyan Sun
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Huimin Cao
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Jieru Wang
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Wenxin Zheng
- Department of Pathology, University of Arizona College of Medicine, Tucson, Arizona.,Department of Obstetrics and Gynecology, University of Arizona, Tucson, Arizona
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Baloch Z, Li Y, Yuan T, Feng Y, Liu Y, Tai W, Liu L, Wang B, Zhang AM, Wu X, Xia X. Epidemiologic characterization of human papillomavirus (HPV) infection in various regions of Yunnan Province of China. BMC Infect Dis 2016; 16:228. [PMID: 27230472 PMCID: PMC4881205 DOI: 10.1186/s12879-016-1562-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 05/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was designed to determine the Human papillomavirus (HPV) prevalence and its distribution of genotypes in various regions of Yunnan Province, China. METHOD In this study, participants were recruited during routine gynecologic examination between Oct 2013 and Feb 2015. A total of 17,898 women were recruited. Polymerase chain reaction was used for detecting the HPV positive samples and HPV geno-array test was used for genotyping. RESULTS The overall HPV infection rate (19.9 %) among the south-western women was significantly higher (P = 0.001) than that among the north-western (18.0 %), south-eastern (13.3 %), north-eastern (11.1 %) and central women (12.9 %). The high-risk (HR) (18.1 %, P = 0.001) and single genotype (16.7 %, P = 0.001) infection rates among the South-western women were also significantly higher than those of among the north-western (13.9 %, 11.3 %), south-eastern (11.6 %, 10.5 %), north-eastern (9.6 %, 9.1 %) and central women (10.5 %, 10.0 %), respectively. While, the infections with multiple HPV (4.2 %) genotypes were significantly more common (P = 0.001) among women in north-western Yunnan than women in the south-western (1.3 %, 3.1 %), south-eastern (1.7 %, 2.7 %), north-eastern (1.5 %, 2.0 %) and central Yunnan (2.4 %, 2.9 %). A total of 30 HPV genotypes were detected; among them 13 were HR-HPV, 3 were PHR-HPV (Potential High risk), 8 were LR-HPV (Low risk) and six were unclassified. The most common HPV genotypes were HPV-52, 16, 58, 53 in control group, HPV-16, 52, 58, 39 and 53 in CINI (Cervical intraepithelial Neoplasia), HPV-52, 16, 58, 33, 53 and 81 in CINII, HPV16, 58, 18, 52, 81 in CINIII and HPV-16 18, 58, 52 in cervical cancer (CC), respectively. Such variation has also been observed about distribution of HPV genotypes distribution among single and multiple infections. CONCLUSION This study gives an epidemiological estimate of HPV prevalence and different genotype distribution in various region of Yunnan province and further explains its prevalence in different neoplastic lesions. Overall HPV-16, 52, 58, and 18 are the leading HR-HPV genotypes.
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Affiliation(s)
- Zulqarnain Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- The Research Center for Molecular Medicine, Kunming, 650500, China
| | - Yuanyue Li
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- The Research Center for Molecular Medicine, Kunming, 650500, China
| | - Tao Yuan
- The First Hospital in Yunnan province, Kunming, 650034, China
| | - Yue Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- The Research Center for Molecular Medicine, Kunming, 650500, China
| | - Yanqing Liu
- The First Hospital in Yunnan province, Kunming, 650034, China
| | - Wenlin Tai
- The First Hospital in Yunnan province, Kunming, 650034, China
| | - Li Liu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- The Research Center for Molecular Medicine, Kunming, 650500, China
| | - Binghui Wang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- The Research Center for Molecular Medicine, Kunming, 650500, China
| | - A-Mei Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- The Research Center for Molecular Medicine, Kunming, 650500, China
| | - Xiaomei Wu
- The First Hospital in Yunnan province, Kunming, 650034, China.
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China.
- The Research Center for Molecular Medicine, Kunming, 650500, China.
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Baloch Z, Yuan T, Wang B, Tai W, Feng Y, Liu Y, Li X, Feng Y, Liu L, Zhang AM, Wu X, Xia X. Ethnic and geographic variations in HPV prevalence and genotype distribution in north-western Yunnan, China. J Med Virol 2016; 88:532-540. [PMID: 26266484 DOI: 10.1002/jmv.24352] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 11/09/2022]
Abstract
The prevalence and genotype distribution of human papillomavirus (HPV) vary throughout the world. To assess the prevalence and genotype distribution of HPV among three ethnic groups in two geographic locations in north-western Yunnan, we recruited 522 women in Shangri-le (n = 255) and Lijiang (n = 267). PCR amplification of HPV DNA was performed on cervical cells from these women using two consensus primer systems (MY09/11 and GP5/6). Amplified-HPV DNA was genotyped using the HPV GenoArray test. Geographically, the HPV prevalence was significantly higher (P = 0.002) among Shangri-le women than among Lijiang women. Infections with high-risk (HR)-HPV and with multiple HPV genotypes were also significantly more common (P = 0.001) among women in Shangri-le than women in Lijiang. Additionally, the prevalence of overall, HR-HPV, and single genotype HPV infections was significantly higher (P = 0.001) among Tibetan women than among Naxi and Han women. HPV-16 and HPV-33 were significantly more frequent in Shangri-le women compared with Lijiang (P = 0.006) women. In addition, HPV-16 (9.81%) and HPV-33 (5.88%) were significantly more prevalent in Tibetan women than in Naxi and Han women. Here, for the first time, we highlight the significant variation in the prevalence and genotype distribution of HPV in various populations in the north-western region of Yunnan Province.
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Affiliation(s)
- Zulqarnain Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Research Center for Molecular Medicine, Kunming, 650500, China
| | - Tao Yuan
- First Hospital, Yunnan Province, Kunming, 650034, China
| | - Binghui Wang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Research Center for Molecular Medicine, Kunming, 650500, China
| | - Wenlin Tai
- Second Affiliated Hospital, Kunming Medical University, Kunming, 650101, China
| | - Yue Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Research Center for Molecular Medicine, Kunming, 650500, China
| | - Yanqing Liu
- First Hospital, Yunnan Province, Kunming, 650034, China
| | - Xiao Li
- First Hospital, Yunnan Province, Kunming, 650034, China
| | - Yue Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Research Center for Molecular Medicine, Kunming, 650500, China
| | - Li Liu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Research Center for Molecular Medicine, Kunming, 650500, China
| | - A-mei Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Research Center for Molecular Medicine, Kunming, 650500, China
| | - Xiaomei Wu
- First Hospital, Yunnan Province, Kunming, 650034, China
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- Research Center for Molecular Medicine, Kunming, 650500, China
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Xiao M, Xu Q, Li H, Gao H, Bie Y, Zhang Z. Prevalence of Human Papillomavirus Genotypes Among Women With High-Grade Cervical Lesions in Beijing, China. Medicine (Baltimore) 2016; 95:e2555. [PMID: 26817906 PMCID: PMC4998280 DOI: 10.1097/md.0000000000002555] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The aim of the study is to investigate the prevalence of high-risk human papillomavirus (hr-HPV) genotypes among Han women with high-grade cervical lesions in Beijing, China.Cervical cell specimens from patients with histopathologically confirmed cervical lesions at 7 hospitals in Beijing were examined with a validated HPV kit for 13 hr-HPV genotypes during the study period. The patients were divided into a low-grade cervical lesions group (cervical intraepithelial neoplasia grade 1, CIN1) and a high-grade cervical lesions group (CIN2+, including cervical intraepithelial neoplasia grade 2, CIN2; cervical intraepithelial neoplasia grade 3, CIN3; squamous cervical cancer, SCC; and adenocarcinoma of the cervix, ACC) based on the histopathology results.A total of 2817 eligible patients were enrolled, including 610 cases identified as CIN1 and 2207 as CIN2+. The hr-HPV positive rates in the CIN1 and CIN2+ groups were 78.2% (477/610) and 93.3% (2060/2207), respectively. The most frequently detected genotypes were HPV16, 58, 52 and18 in the CIN1 group and HPV16, 58, 33, and 52 in the CIN2+ group, in descending order of prevalence. In addition, the prevalence of HPV18 among the patients with ACC was 28.6% (14/49), significantly >7.2% (54/752) prevalence among the SCC patients (P < 0.001). Additionally, significantly more women in the CIN2+ group had multiple infections compared with those in the CIN1 group (38.1% and 24.9%, respectively; P < 0.001). However, as the cervical lesion grade increased, the prevalence of multiple hr-HPV infections gradually deceased to 44.2% in the CIN2 patients, 36.7% in the CIN3 patients, and 35.3% in the cervical cancer (CC) patients, which included SCC and ACC patients. In cases of multiple hr-HPV infections in the CIN2+ group, double infections accounted for ∼76.6%, and HPV16+58, HPV16+52, and HPV16+18 were the most common combinations, in descending order. The most frequent combination for triple infections was HPV16+58+31, with a rate of 4.2%. The highest positive rate occurred in the ≤24 year-old group for all types of cervical lesions.The prevalence of HPV genotypes in the targeted population with high-grade cervical lesions differs from that of other countries. This information could be helpful for the prevention of CC in Beijing, China.
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Affiliation(s)
- Meizhu Xiao
- From the Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University (MX, QX, HG, YB, ZZ); and Department of Obstetrics and Gynecology, the General Hospital of the People's Liberation Army, Beijing, China (HL)
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Baloch Z, Yue L, Yuan T, Feng Y, Tai W, Liu Y, Wang B, Li X, Liu L, Zhang AM, Wu X, Xia X. Status of Human Papillomavirus Infection in the Ethnic Population in Yunnan Province, China. BIOMED RESEARCH INTERNATIONAL 2015; 2015:314815. [PMID: 26819950 PMCID: PMC4706867 DOI: 10.1155/2015/314815] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 11/24/2015] [Indexed: 12/27/2022]
Abstract
HPV genotypes have distinct distributions among various ethnic populations worldwide. In December 2013, 237 and 159 cervical samples were collected from Hani and Han ethnic women, respectively, in Mojiang, a rural county in southern Yunnan. The overall HPV infection rate (21.1%) among the Hani women was significantly higher than that among the Han women (12.6%). The high-risk (HR) and low-risk (LR) HPV and single- and multiple-genotype infection rates among the Hani women were 11.0%, 4.6%, 15.6%, and 5.5%, respectively. HPV-16 (3.8%) was the most prevalent genotype among the Hani women, followed by HPV-52 (1.7%), HPV-31 (0.8%), and HPV-33 (0.8%). Comparatively, the Han women had lower infection rates of high-risk (8.2%), low-risk (1.2%), single-genotype (9.4%), and multiple-genotype HPV infections (3.1%). HPV-16 (3.1%) was also the predominant genotype among the Han women, followed by HPV-52 (1.3%), HPV-33 (0.6%), HPV-44 (0.6%), and HPV-54 (0.6%). The area background, number of children, and past history of STIs were recognized as potential risk factors for HPV infection. Rural background, age, education level, number of children, and illness history were significantly associated with HPV infection among the Hani women. These findings highlight the urgent need for HPV prevention and control strategies in Yunnan, particularly for the Hani ethnic women.
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Affiliation(s)
- Zulqarnain Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
- The Research Centre for Molecular Medicine in Yunnan Province, Kunming 650500, China
| | - Lei Yue
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
- The Research Centre for Molecular Medicine in Yunnan Province, Kunming 650500, China
| | - Tao Yuan
- The First Hospital of Yunnan Province, Kunming 650034, China
| | - Yue Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
- The Research Centre for Molecular Medicine in Yunnan Province, Kunming 650500, China
| | - Wenlin Tai
- The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China
| | - Yanqing Liu
- The First Hospital of Yunnan Province, Kunming 650034, China
| | - Binghui Wang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
- The Research Centre for Molecular Medicine in Yunnan Province, Kunming 650500, China
| | - Xiao Li
- The First Hospital of Yunnan Province, Kunming 650034, China
| | - Li Liu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
- The Research Centre for Molecular Medicine in Yunnan Province, Kunming 650500, China
| | - A-Mei Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
- The Research Centre for Molecular Medicine in Yunnan Province, Kunming 650500, China
| | - Xiaomei Wu
- The First Hospital of Yunnan Province, Kunming 650034, China
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
- The Research Centre for Molecular Medicine in Yunnan Province, Kunming 650500, China
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Mijit F, Ablimit T, Abduxkur G, Abliz G. Distribution of human papillomavirus (HPV) genotypes detected by routine pap smear in Uyghur-Muslim women from Karasay Township Hotan (Xinjiang, China). J Med Virol 2015; 87:1960-5. [PMID: 26081269 PMCID: PMC5033003 DOI: 10.1002/jmv.24240] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 11/12/2022]
Abstract
HPV infection is an important public health problem in developing countries. We investigated HPV genotypes in the Uyghur female population of Karasay Township, Hotan region. A population-based cervical cancer screening was conducted for 4,500 women in Karasay Township, Xinjiang Hotan, China. A total of 900 women were selected by systematic sampling with a 5:1 proportion (ages 20-69). The subjects completed a questionnaire and consented to HPV typing and Pap smear examination. Colposcopic biopsies were performed for patients with cytological abnormalities (≥ ASCUS). A total of 117 of the 900 women (13%) assessed were infected with HPV. The most common subtype was HPV-16, and other common high-risk types included HPV-58 and HPV-39. A total of 40 women (4.44%) were identified with abnormal cytology (≥ ASCUS) by Pap smear. A significant link was found between HPV prevalence and cytological diagnosis. The HPV infection rates for the patients with cervical inflammation, CIN, and cancer were 18.18%, 64.71%, and 100%, respectively. Significant differences in HPV infection rates were found among the patients with the three groups of pathological results. In Karasay, the HPV infection rate in Uyghur women is lower than previously reported; however, the proportion infected with HR-HPV is higher. HPV-16, HPV-58, and HPV-39 are the most prevalent genotypes.
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Affiliation(s)
- Fatima Mijit
- 5th Department of the Gynecological SurgeryXinjiang Medical University Affiliated Tumor HospitalPeople's Republic of China
| | - Tangnur Ablimit
- 5th Department of the Gynecological SurgeryXinjiang Medical University Affiliated Tumor HospitalPeople's Republic of China
| | - Guzalnur Abduxkur
- 5th Department of the Gynecological SurgeryXinjiang Medical University Affiliated Tumor HospitalPeople's Republic of China
| | - Guzalnur Abliz
- 5th Department of the Gynecological SurgeryXinjiang Medical University Affiliated Tumor HospitalPeople's Republic of China
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Zhao J, Du H, Belinson JL, Qu X, Zhang W, Mei J, Yang B, Wang C, Zhang L, Wu R. Evaluation of The Cervista HPV A9 group In Screening Patients for Cervical Cancer. J Med Screen 2015; 23:38-43. [PMID: 26466824 DOI: 10.1177/0969141315604863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 08/18/2015] [Indexed: 11/15/2022]
Abstract
Objective To exploit the prevalence of HPV genotypes 52/58 in a Chinese population, we evaluated algorithms that the use the Cervista Assay A9 group for primary cervical cancer screening. Methods The SHENCCAST II trial database was re-analyzed, focussing on the A9 pool of the Cervista HR-HPV Assay. Results for the detection CIN2+ and CIN3+ were correlated with a genotyping assay (MALDI-TOF) and cervical cytology to explore various screening algorithms. Results This analysis included 8,556 women with a mean age of 38.9. CIN 2+ rates were 2.7% (233/8556); CIN 3+ rates were 1.7% (141/8556). Overall HPV infection rates were 11.1% (950/8556) for Cervista, in which A5/A6, A7 and A9 groups were 26.5% (227/950), 22.9% (218/950) and 67.8% (644/950), respectively. The HPV A9 group is highly predictive of high-grade cervical lesions (CIN2+ OR = 103.61, CIN3+ OR = 128.059). Sensitivity and specificity for Cervista A9 group for CIN 2+ was 85.4% and 94.7%, and for CIN 3+ 89.4% and 93.8% respectively. Cervista A9 Assay followed by triage cytology for non-A9 positives has sensitivity and specificity for CIN2+ of 91.5% of 93.5%, and for CIN 3+ 94.3% and 92.6%. Conclusion Using the Cervista A9 as the primary screen instead of the full Cervista assay, the percentage referred to colposcopy would decrease from 11.1% to 8.8% and percentage requiring cytology would decrease from 11.1% to 3.6%. Sensitivity of detecting CIN 2+(91.5%), CIN3+(94.3%) would remain similar to the complete Cervista HR-HPV assay for CIN 2+(93.1%), CIN3+(95.0%).
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Affiliation(s)
- Jinghui Zhao
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Hui Du
- Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Jerome L Belinson
- Preventive Oncology International, Inc. Cleveland Heights, USA and Cleveland Clinic, Women’s Health Institute, Cleveland, USA
| | - Xinfeng Qu
- Preventive Oncology International, Inc. Cleveland Heights, USA and Cleveland Clinic, Women’s Health Institute, Cleveland, USA
| | - Wei Zhang
- Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Jing Mei
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Bin Yang
- Cleveland Clinic, Department of Anatomic Pathology, Cleveland, USA
| | - Chun Wang
- Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Lijie Zhang
- Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Ruifang Wu
- Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
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Xu QX, Zhang ZY. High-risk Human Papillomavirus Genotypes in Cervical Lesions and Vaccination Challenges in China. Asian Pac J Cancer Prev 2015; 16:2193-7. [DOI: 10.7314/apjcp.2015.16.6.2193] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ding X, Liu Z, Su J, Yan D, Sun W, Zeng Z. Human papillomavirus type-specific prevalence in women referred for colposcopic examination in Beijing. J Med Virol 2014; 86:1937-43. [PMID: 25132373 DOI: 10.1002/jmv.24044] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2014] [Indexed: 11/11/2022]
Abstract
Human papillomavirus (HPV) is associated with several disorders of the genital tract, skin, and oropharynx. This study investigated the prevalence of infection by 37 HPV genotypes among women of the Beijing area in China. Cervical specimens from 1,082 patients and 165 healthy controls were tested for HPV genotypes using a chip hybridization assay. Based on the local pathology, patients were divided into cervicitis and cervical lesion groups. Overall HPV infection rates were 30.5% for the cervicitis group and 78.4% for the cervical lesion group; whereas infection rates for high-risk HPV types (i.e., those associated with cervical cancers) were 24.0% and 73.4%, respectively. The most common HPV genotypes were HPV 52, 16, 81, 58, and 18 in healthy controls, HPV 52, 61, 55, 16, and 53 in those with cervicitis, HPV 52, 16, 33, 39, and 58 in cervical intraepithelial neoplasia grade 1, HPV 16, 58, 31, 52, and 33 in cervical intraepithelial neoplasia grade 2 or grade 3, and HPV 16, 33, 18, 52, and 58 in cervical cancer. Established high-risk HPV showed two peaks, in patients aged 30-34 and 55-79 years. In Beijing, HPV 16, 52, 58, and 33 are the most prevalent HPV types in women with cervical lesions, which should affect development of a cervical cancer vaccination for local use.
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Affiliation(s)
- Xiurong Ding
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Shen XH, Liu SH. Human papillomavirus genotypes associated with mucopurulent cervicitis and cervical cancer in Hangzhou, China. Asian Pac J Cancer Prev 2014; 14:3603-6. [PMID: 23886152 DOI: 10.7314/apjcp.2013.14.6.3603] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate the infection status and predominant genotype distribution of human papillomavirus (HPV) infection among Chinese patients with mucopurulent cervicitis (MPC) or cervical cancer (CC) in Hangzhou. METHODS Initially, 217 cases of healthy cervix controls (n=50), acute MPC (n=89), and CC (n=78) were included; samples were collected between January 1, 2010, and January 30, 2013. Cervical specimens were screened for HPV using a nested polymerase chain reaction assay and DNA sequencing. RESULTS Overall prevalence of HPV infection was 16.7% in the control group, 51.9% in the MPC group, and 84.4% in the CC group. The predominant genotype detected in all 3 groups was the oncogenic variant HPV 16 (55.8%, 17.3%, and 6.3% in the CC, MPC and control specimens, respectively), HPV58 was the second most predominant HPV type in CC (9.1%), MPC (8.6%), and control group (4.2%). Most or all of the genotypes were oncogenic in the three groups. CONCLUSIONS Infection with HPV was found to be prevalent among Chinese women with MPC or CC and oncogenic variants were in the majority. Therefore, peoples who suffered MPC with HPV DNA positive should be regularly followed-up, for prevention and early treatment of cervical cancer.
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Affiliation(s)
- Xing-Hang Shen
- Department of Obstetrics and Gynecology, Chinese Medicine Hospital of Hangzhou, Hangzhou, China.
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Chan PK. Epidemiology of human papillomavirus in Asia: do HPV-52 and HPV-58 play a special role? ACTA ACUST UNITED AC 2013. [DOI: 10.1179/095741905x49098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hu YM, Huang SJ, Chu K, Wu T, Wang ZZ, Yang CL, Cai JP, Jiang HM, Wang YJ, Guo M, Liu XH, Huang HJ, Zhu FC, Zhang J, Xia NS. Safety of an Escherichia coli-expressed bivalent human papillomavirus (types 16 and 18) L1 virus-like particle vaccine: an open-label phase I clinical trial. Hum Vaccin Immunother 2013; 10:469-75. [PMID: 24161937 DOI: 10.4161/hv.26846] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
An Escherichia coli-expressed recombinant bivalent human papillomavirus (types 16 and 18) vaccine candidate has been shown to be safe and immunogenic in preclinical trials. The safety of this vaccine was analyzed in an open-label phase I clinical trial in Jiangsu province, China. Thirty-eight healthy women from 18 to 55 y of age were enrolled and vaccinated at 0, 1, and 6 mo. Adverse events that occurred within 30 d after each injection and serious adverse events that occurred throughout the study were recorded. In addition, blood parameters were tested before and after each injection. All but one woman received all 3 doses. Thirty-two (84.2%) of the participants reported adverse events, all adverse events of which were mild, of short duration and resolved spontaneously. No serious adverse events occurred during the study. Changes in blood parameters after each injection were random, mild, and not clinically significant. These preliminary results show that a new Escherichia coli-expressed recombinant HPV 16/18 bivalent vaccine is well tolerated in healthy women and support further immunogenicity and efficacy studies for this HPV vaccine candidate.
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Affiliation(s)
- Yue-Mei Hu
- Jiangsu Provincial Center for Disease Control and Prevention; Nanjing, Jiangsu Province, PR China
| | - Shou-Jie Huang
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases; School of Public Health; Xiamen University; Xiamen, PR China
| | - Kai Chu
- Jiangsu Provincial Center for Disease Control and Prevention; Nanjing, Jiangsu Province, PR China
| | - Ting Wu
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases; School of Public Health; Xiamen University; Xiamen, PR China
| | - Zhong-Ze Wang
- Dongtai Center for Disease Control and Prevention; Dongtai, Jiangsu Province, PR China
| | - Chang-Lin Yang
- Dongtai Center for Disease Control and Prevention; Dongtai, Jiangsu Province, PR China
| | - Jia-Ping Cai
- Dongtai Center for Disease Control and Prevention; Dongtai, Jiangsu Province, PR China
| | - Han-Min Jiang
- Dongtai Center for Disease Control and Prevention; Dongtai, Jiangsu Province, PR China
| | - Yi-Jun Wang
- Dongtai Center for Disease Control and Prevention; Dongtai, Jiangsu Province, PR China
| | - Meng Guo
- Xiamen Innovax Biotech Company, Ltd.; Xiamen, PR China
| | - Xiao-Hui Liu
- Xiamen Innovax Biotech Company, Ltd.; Xiamen, PR China
| | | | - Feng-Cai Zhu
- Jiangsu Provincial Center for Disease Control and Prevention; Nanjing, Jiangsu Province, PR China
| | - Jun Zhang
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases; School of Public Health; Xiamen University; Xiamen, PR China
| | - Ning-Shao Xia
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases; School of Public Health; Xiamen University; Xiamen, PR China
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Li J, Huang R, Schmidt JE, Qiao YL. Epidemiological Features of Human Papillomavirus (HPV) Infection among Women Living in Mainland China. Asian Pac J Cancer Prev 2013; 14:4015-23. [DOI: 10.7314/apjcp.2013.14.7.4015] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
Persistent infection of high-risk human papillomavirus (HPV) has been recognized as the direct cause of cervical carcinoma. Therefore, detection and genotyping of HPV are important to cervical-cancer screening. In this study, we have evaluated the efficacy of flow-through hybridization and gene chip (HybriMax) on HPV genotyping through comparison of the results with Hybrid Capture II (HC-II) and in situ hybridization (ISH). 591 women were classified into 6 groups according to their histological diagnoses. The overall accordance rate on 13 types of HPV genotypes between HybriMax and HC-II were 92.5% and 100% in the cancer group. The overall accordance was excellent with the Kappa index (KI) of 0.814. The value of KI in each group was 0.750 (normal cytological diagnosis), 0.781 (chronic cervicitis), 0.80 (condyloma acuminatum), 0.755 (cervical intraepithelial neoplasia (CIN) I), 0.723 (CIN II), and 0.547 (CIN III) (0.75 > KI > 0.4, good; KI ≥ 0.75, excellent). The 10 most common HPV subtype detected by HybriMax were 16, 52/58, 18, 33, 31, 81, 53, 68, and 66 in patients, and 16, 68, 18, 52, 58, 11, 53, 31/39, and 33 in normal controls. In conclusion, HybriMax is an efficient method for HPV genotyping and more suitable for clinical use.
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Yang MJ, Luo L, Nie K, Wang M, Zhang C, Li J, Ma XJ. Genotyping of 11 human papillomaviruses by multiplex PCR with a GeXP analyzer. J Med Virol 2012; 84:957-63. [PMID: 22499019 DOI: 10.1002/jmv.23275] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A new, rapid, and high-throughput method was developed for simultaneous detection of 11 human papillomavirus (HPV) genotypes including nine high-risk types (HPV16, 18, 31, 33, 35, 39, 52, 58, and 66) and two low-risk types (HPV6 and 11) in a single tube by multiplex PCR based on a GenomeLab Gene Expression Profiler (GeXP) analyzer (GeXP-PCR). Eleven sets of chimeric primers were used to initiate the PCR, and one pair of universal primers was used for the subsequent cycles of the PCR. The specificity of GeXP-PCR for each HPV type was examined with clinical samples of single type HPV infection tested previously. The sensitivity of GeXP-PCR was evaluated by performing the assay on serial 10-fold dilutions of cloned PCR products. The GeXP-PCR achieved a sensitivity of 100 copies when all of the 11 pre-mixed plasmids containing HPV targets were present. Analyses of 124 clinical specimens using the GeXP-PCR demonstrated that the GeXP-PCR assay had comparable sensitivity and specificity to those of reported multiple PCR assay and an increased detection of HPV 11 in samples with mixed infections. In conclusion, the GeXP-PCR is a fast, sensitive, and high throughput method for the detection of multiple HPV infections.
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Affiliation(s)
- Meng-Jie Yang
- State Key Laboratory for Molecular Virology and Genetic Engineering, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Ge S, Gong B, Cai X, Yang X, Gan X, Tong X, Li H, Zhu M, Yang F, Zhou H, Hong G. Prevent cervical cancer by screening with reliable human papillomavirus detection and genotyping. Cancer Med 2012; 1:59-67. [PMID: 23342254 PMCID: PMC3544437 DOI: 10.1002/cam4.9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 05/11/2012] [Accepted: 05/16/2012] [Indexed: 02/06/2023] Open
Abstract
The incidence of cervical cancer is expected to rise sharply in China. A reliable routine human papillomavirus (HPV) detection and genotyping test to be supplemented by the limited Papanicolaou cytology facilities is urgently needed to help identify the patients with cervical precancer for preventive interventions. To this end, we evaluated a nested polymerase chain reaction (PCR) protocol for detection of HPV L1 gene DNA in cervicovaginal cells. The PCR amplicons were genotyped by direct DNA sequencing. In parallel, split samples were subjected to a Digene HC2 HPV test which has been widely used for "cervical cancer risk" screen. Of the 1826 specimens, 1655 contained sufficient materials for analysis and 657 were truly negative. PCR/DNA sequencing showed 674 infected by a single high-risk HPV, 188 by a single low-risk HPV, and 136 by multiple HPV genotypes with up to five HPV genotypes in one specimen. In comparison, the HC2 test classified 713 specimens as infected by high-risk HPV, and 942 as negative for HPV infections. The high-risk HC2 test correctly detected 388 (57.6%) of the 674 high-risk HPV isolates in clinical specimens, mislabeled 88 (46.8%) of the 188 low-risk HPV isolates as high-risk genotypes, and classified 180 (27.4%) of the 657 "true-negative" samples as being infected by high-risk HPV. It was found to cross-react with 20 low-risk HPV genotypes. We conclude that nested PCR detection of HPV followed by short target DNA sequencing can be used for screening and genotyping to formulate a paradigm in clinical management of HPV-related disorders in a rapidly developing economy.
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Affiliation(s)
- Shichao Ge
- State Key Laboratory of Molecular Biology, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences Shanghai, China
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35
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Zhang L, Wang Y, Peng M, She Q, Xiang Q, Chen Q, Liu Z, Zhang W, Tao N, Qiu L, Wu X. Prevalence and type distribution of high-risk human papillomavirus infections among women in Wufeng County, China. Arch Gynecol Obstet 2012; 286:695-9. [PMID: 22546949 DOI: 10.1007/s00404-012-2344-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 04/17/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of this survey was to assess the prevalence and type distribution of oncogenic human papillomavirus (HPV) infections among women in Wufeng County of Hubei province, where the cervical cancer mortality rate is the highest in China Cervical. METHODS DNA samples were collected from 1,100 women, then screened and quantified by a multi-fluorescent, quantitative real-time PCR assay. The cervical DNA samples were then re-typed by real-time PCR using seven-pair primers of high-risk (HR) HPVs designed to detect types 16, 31, 18/45, 33, 52, 58, and 67. RESULTS The overall prevalence of HR HPVs was 11.14 % (95 % CI, 9.74-13.72 %) in Wufeng County, which was not statistically different between Tu (12.17 %; 95 % CI, 10.03-12.34 %) and Han nationality (8.95 %; 95 % CI, 3.55-14.35 %). Among different types of HPV, HPV 16 was the most frequently detected genotype, followed by HPV 52, 58, 18/45, and 31. The most prevalent types of HR HPV in Tu nationality were HPV 16, 52, and 58, and the most prevalent types of HR HPV in Han nationality were HPV 16, 33, and 18/45. The overall prevalence of HPV was highest in the 20-24 year age group (21.43 %; 95 % CI, 17.56-25.30 %) and the prevalence of HR HPV was associated with education. CONCLUSIONS HPV 16, 52, and 58 are common genotypes in Wufeng County, and support the hypothesis that second-generation HPV prophylactic vaccines, including HPV 52 and 58, may offer higher protection for women in China and other areas of Asia. The findings of this study contribute to preventive and screening measures in clinical practice.
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Affiliation(s)
- Li Zhang
- Institution of Virology, School of Medicine, State Key Laboratory of Virology, Wuhan University, 430071, Wuhan, Hubei, China
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36
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HPV prevalence and genotyping in the cervix of Chinese women. ACTA ACUST UNITED AC 2010; 4:259-63. [DOI: 10.1007/s11684-010-0095-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 05/18/2010] [Indexed: 10/19/2022]
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37
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Detection of HPV types and neutralizing antibodies in women with genital warts in Tianjin City, China. Virol Sin 2010; 25:8-17. [PMID: 20960279 DOI: 10.1007/s12250-010-3078-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Accepted: 08/26/2009] [Indexed: 01/25/2023] Open
Abstract
The serum samples and corresponding cervical swabs were collected from 50 women with genital warts from Tianjin city, China. The neutralizing antibodies against HPV-16, -18, -58, -45, -6 and -11 in serum samples were tested by using pseudovirus-based neutralization assays and HPV DNAs in cervical swabs were also tested by using a typing kit that can detect 21 types of HPV. The results revealed that 36% (18/50) of sera were positive for type-specific neutralizing antibodies with a titer range of 160-2560, of which 22%(11/50), 12%(6/50), 10%(5/50), 4%(2/50), 4%(2/50) and 2%(1/50) were against HPVs -6, -16, -18, -58, -45 and -11, respectively. Additionally, 60% (30/50) of samples were HPV DNA-positive, in which the most common types detected were HPV-68(18%), HPV-16(14%), HPV-58(12%), HPV-33(8%) and HPV-6, HPV-11, HPV-18 and HPV-52 (6% each). The concordance between HPV DNA and corresponding neutralizing antibodies was 56% (28/50) with a significant difference (P<0.05). The full-length sequences of five HPV types (HPV -42, -52, -53, -58 and -68) were determined and exhibited 98%-100% identities with their reported genomes. The present data may have utility for investigating the natural history of HPV infection and promote the development of HPV vaccines.
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38
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Characteristics of HPV prevalence among women in Liaoning province, China. Int J Gynaecol Obstet 2010; 109:105-9. [DOI: 10.1016/j.ijgo.2009.11.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 11/21/2009] [Accepted: 01/12/2010] [Indexed: 11/21/2022]
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39
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Cai H, Chen C, Ding X. Human papillomavirus type 16 E6 gene variations in Chinese population. Eur J Surg Oncol 2010; 36:160-3. [DOI: 10.1016/j.ejso.2009.07.186] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2008] [Revised: 07/31/2009] [Accepted: 07/31/2009] [Indexed: 10/20/2022] Open
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40
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Liu X, Zhang S, Ruan Q, Ji Y, Ma L, Zhang Y. Prevalence and type distribution of human papillomavirus in women with cervical lesions in Liaoning Province, China. Int J Gynecol Cancer 2010; 20:147-53. [PMID: 20130516 DOI: 10.1111/igc.0b013e3181c20860] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INSTRUCTION Type-specific persistence of human papillomavirus (HPV) infection can cause invasive cervical cancer. The distribution and prevalence of HPV genotypes depend on the geographic region and on demographic factors. METHODS This study aimed to investigate the prevalence and distribution of HPV genotypes in uterine cervical lesions in Liaoning Province, China. A total of 1444 cervical swabs from patients with cervical cancer (CC, n = 134), cervical intraepithelial neoplasia (CIN) II/III (n = 517), and CIN I (n = 180) were detected for HPV genotypes using the PGMY09/11 primer system and HPV GenoArray test (HybriBio Ltd., Hong Kong). Age-matched samples of 613 women without cervical neoplasia were analyzed as control. RESULTS The prevalence of HPV was 82.84% in CC, 89.56% in CIN II/III, 70.56% in CIN I, and 44.70% in control. The 5 leading genotypes in CIN II/III were, in descending order of prevalence, HPV types 16 (61.12%), 58 (14.12%), 33 (13.93%), 31 (8.32%), and 52(6.27%); whereas HPV types 16 (73.13%), 18 (7.46%), 58 (3.73%), and 31/33/39 (all were 2.24%) were in CC. Multiple HPV infections comprising 2 to 5 types were found in 17.59% of the patients. Human papillomavirus 16 was the predominant genotype in all categories. The prevalence of both HPV type 16 and single HPV infection increased with the severity of cervical lesions (P = 0.000). CONCLUSIONS The efficacy of the prophylactic vaccine against types 16 and 18 for preventing cervical cancer would be close to 80% in Liaoning Province, China. Human papillomavirus types 16, 18, 58, 33, and 31 may be predominant high-risk factors for CC and its precursors in this region.
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Affiliation(s)
- Xia Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
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41
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Chen W, Zhang X, Molijn A, Jenkins D, Shi JF, Quint W, Schmidt JE, Wang P, Liu YL, Li LK, Shi H, Liu JH, Xie X, Niyazi M, Yang P, Wei LH, Li LY, Li J, Liu JF, Zhou Q, Hong Y, Li L, Li Q, Zhou HL, Bian ML, Chen J, Qiao YL, Smith JS. Human papillomavirus type-distribution in cervical cancer in China: the importance of HPV 16 and 18. Cancer Causes Control 2009; 20:1705-13. [PMID: 19705288 DOI: 10.1007/s10552-009-9422-z] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Accepted: 08/04/2009] [Indexed: 10/20/2022]
Abstract
Prophylactic vaccination against HPV 16 and 18 has the potential for effective prevention of high-grade precancer (cervical intraepithelial neoplasia [CIN)] 2/3) and ICC caused by these viruses (globally 50 and 70%, respectively) when employed in women prior to starting sexual activity. To provide data for decisions on HPV vaccination in China, we determined HPV type-distribution in ICC and CIN 2/3 from women of different regions within China. A multicenter study was conducted by randomized sampling of paraffin blocks of 664 ICC (630 squamous cell carcinoma [SCC]; 34 adenocarcinoma [ADC]), 569 CIN 2/3 cases from seven regions of China. Histological diagnosis was confirmed in 1,233 cases by consensus review. HPV DNA was detected using the SPF10 LiPA25 version 1 assay. HPV prevalence was 97.6% in SCC, 85.3% in adenocarcinoma, and 98.9% in CIN 2/3. HPV 16 (76.7%) and HPV 18 (7.8%) were the most common, together accounting for 84.5% of SCC, followed by HPV 31 (3.2%), HPV 52 (2.2%), and HPV 58 (2.2%). HPV positivity in SCC did not differ notably by region. However, SCC cases from women <or=34 years had higher HPV 16 positivity than women over 50 years, among whom HPV 52, 58, and 39 were more common. HPV 16 and 18 were under-represented, whereas HPV 31, 52, and 58 were over-represented in CIN2/3 compared to SCC. The potential impact of vaccines against oncogenic HPV types 16 and 18 is estimated to be high (84.5%) against total SCC. These data are critical for China's future evaluation of the cost-effectiveness of current cervical cancer vaccines and of HPV-based screening guidelines.
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Affiliation(s)
- Wen Chen
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
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Ginsberg GM, Edejer TTT, Lauer JA, Sepulveda C. Screening, prevention and treatment of cervical cancer -- a global and regional generalized cost-effectiveness analysis. Vaccine 2009; 27:6060-79. [PMID: 19647813 DOI: 10.1016/j.vaccine.2009.07.026] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 07/06/2009] [Accepted: 07/10/2009] [Indexed: 10/20/2022]
Abstract
The paper calculates regional generalized cost-effectiveness estimates of screening, prevention, treatment and combined interventions for cervical cancer. Using standardised WHO-CHOICE methodology, a cervical cancer model was employed to provide estimates of screening, vaccination and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. In regions characterized by high income, low mortality and high existing treatment coverage, the addition of any screening programme to the current high treatment levels is very cost-effective. However, based on projections of the future price per dose (representing the economic costs of the vaccination excluding monopolistic rents and vaccine development cost) vaccination is the most cost-effective intervention. In regions characterized by low income, low mortality and existing treatment coverage around 50%, expanding treatment with or without combining it with screening appears to be cost-effective or very cost-effective. Abandoning treatment in favour of screening in a no-treatment scenario would not be cost-effective. Vaccination is usually the most cost-effective intervention. Penta or tri-annual PAP smears appear to be cost-effective, though when combined with HPV-DNA testing they are not cost-effective. In regions characterized by low income, high mortality and low treatment levels, expanding treatment with or without adding screening would be very cost-effective. A one off vaccination plus expanding treatment was usually very cost-effective. One-off PAP or VIA screening at age 40 are more cost-effective than other interventions though less effective overall. From a cost-effectiveness perspective, consideration should be given to implementing vaccination (depending on cost per dose and longevity of efficacy) and screening programmes on a worldwide basis to reduce the burden of disease from cervical cancer. Treatment should also be increased where coverage is low.
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Affiliation(s)
- Gary Michael Ginsberg
- World Health Organization, Health Systems Financing Department, Costs, Effectiveness, Expenditure and Priority Setting Unit, Geneva, Switzerland.
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Wu X, Zhang C, Feng S, Liu C, Li Y, Yang Y, Gao J, Li H, Meng S, Li L, Zhang Y, Hu X, Wu X, Lin L, Li X, Wang Y. Detection of HPV types and neutralizing antibodies in Gansu province, China. J Med Virol 2009; 81:693-702. [PMID: 19235880 DOI: 10.1002/jmv.21435] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A total of 82 samples from patients with cervical cancer (Group 1) and 50 samples from patients with other genital diseases (Group 2) were collected in Gansu, China. All 132 samples were tested for HPV DNA with a typing kit that can detect 21 types of HPV, and also tested for neutralizing antibodies against HPV-16, -18, -58, -45, -6, and -11 using pseudovirus-based neutralization assays. The results revealed that 28% (23/82) of sera in Group 1 were positive for type-specific neutralizing antibodies with a titer range of 160-640, of which 23.2% (19/82), 2.4% (2/82), 2.4% (2/82), 1.2% (1/82), and 1.2% (1/82) were against HPV-16, -58, -6, -18, and -45, respectively. Only one serum (2%) in Group 2 was positive for neutralizing antibodies, which were against HPV-6 with a titer of 2,560. Overall, 85.4% (70/82) of samples in Group 1 were HPV DNA-positive, compared with 28% (14/50) of samples in Group 2. The seven most common types detected in Group 1 were HPV-16 (80%), HPV-52 (7.1%), HPV-66 and HPV-11 (5.7% each), and HPV-58, HPV-18, and HPV-33 (4.3% each), while the four most common types in Group 2 were HPV-16 (12%), HPV-52 and HPV-11 (6% each), and HPV-68 (4%). The concordance between HPV DNA and corresponding neutralizing antibodies was 32.9% (27/82) with a significant difference (P < 0.005). More specifically, the concordance was 42.7% (35/82) for HPV-16 in Group 1. The full-length sequences of six HPV types (HPV-16, -58, -33, -59, -11, and -68) were determined and showed 99% identities with their reported genomes.
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Affiliation(s)
- Xueling Wu
- Department of Cell Biology, National Institute for the Control of Pharmaceutical and Biological Products (NICPBP), Beijing, China
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Evaluation of high-risk human papillomaviruses type distribution in cervical cancer in Sichuan province of China. BMC Cancer 2008; 8:202. [PMID: 18644159 PMCID: PMC2490702 DOI: 10.1186/1471-2407-8-202] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Accepted: 07/22/2008] [Indexed: 11/22/2022] Open
Abstract
Background Infection with high-risk human papillomavirus is an important factor associated with cervical cancer, and the distribution of HPV types varies greatly worldwide. Determination of type-specific HPV prevalence constitutes an important step towards the development of vaccines for the prevention of cervical cancer. Methods The human papillomavirus (HPV) genotypes in 190 cervical cancer specimens taken from the Sichuan province, the most populous province of Southwest China, were detected by a combination of MY09/11 consensus primers PCR (MY09/11 PCR), type-specific primers one-step PCR (One-step TS PCR) and E6/E7 gene type-specific primers nested PCR (Nested TS PCR). The prevalence and distribution of HPV in patients with cervical cancer, especially for HPV types 16, 18, 52, 58 and 59, suspected to be most common in certain parts of China, was investigated. Results The HPV infection rates detected by MY09/11 PCR, One-step TS PCR and Nested TS PCR were 159 (83.7%), 145 (76.3%) and 172 (90.5%), respectively. The overall HPV prevalence was 93.2% (177/190). The positive specimens for HPV16, 18, 52, 58 and 59 detected by One-step TS-PCR were 111 (58.4%), 14 (7.4%), 6 (3.2%), 13 (6.8%) and 4 (2.1%), respectively. By Nested TS-PCR analysis, the detection rates of HPV16, 52, 58 and 59 were increased to 140 (73.7%), 30 (15.8%), 37 (19.5%) and 25 (13.2%), while only 4 (2.1%) additional specimens were found to be infected with HPV18. Conclusion Our data demonstrate that, besides HPV 16, which was found to be the most prevalent type, HPV types 58, 52 and 59 are more prevalent than HPV18 in women with cervical cancer in the Sichuan area of China.
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Tay EH, Garland S, Tang G, Nolan T, Huang LM, Orloski L, Lu S, Barr E. Clinical trial experience with prophylactic HPV 6/11/16/18 VLP vaccine in young women from the Asia-Pacific region. Int J Gynaecol Obstet 2008; 102:275-83. [PMID: 18555997 DOI: 10.1016/j.ijgo.2008.03.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Revised: 03/14/2008] [Accepted: 03/17/2008] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate results of three phase 3 clinical trials of quadrivalent HPV 6/11/16/18 vaccination of young Asia-Pacific women. METHODS A total of 814 women from the Asia-Pacific region (aged 16 to 26 years) received vaccine or placebo in 1 of 3 protocols. Descriptive analyses focused on the efficacy, safety, and immunogenicity of the vaccine and the natural history of HPV disease. RESULTS Vaccine efficacy against disease caused by HPV types 6, 11, 16, or 18 was 100% for cervical intraepithelial neoplasia (0 vs 12 cases; 95% confidence interval [CI], 63.1%-100%) and 100% for vulvar and vaginal intraepithelial neoplasia or condylomata accuminata (0 vs 5 cases; 95% CI, -11.8% to 100%). The vaccination was highly immunogenic. Vaccine recipients experienced a significantly higher injection site adverse event rate (P=0.002). Compared with other world regions, lower rates of smoking and baseline positivity to 14 HPV types (including the vaccine types) were observed among Asia-Pacific participants. CONCLUSION Prophylactic quadrivalent HPV 6/11/16/18 vaccination of young Asia-Pacific women demonstrated high efficacy, safety, and tolerability. Together with an observed low baseline HPV positivity rate, the Asia-pacific population is potentially an important cohort to benefit from vaccination.
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Affiliation(s)
- E H Tay
- KK Women's and Children's Hospital, Singapore.
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Chu TY. Risk Factors and Genetic Markers of Human Papillomavirus-induced Cervical Carcinogenesis: A Focus on Chinese Populations in Southeast Asia and Southern China. Tzu Chi Med J 2008. [DOI: 10.1016/s1016-3190(08)60017-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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47
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Increase of integration events and infection loads of human papillomavirus type 52 with lesion severity from low-grade cervical lesion to invasive cancer. J Clin Microbiol 2008; 46:1356-62. [PMID: 18272718 DOI: 10.1128/jcm.01785-07] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Infection load and the integration of human papillomaviruses (HPV) have been implicated as determinants for oncogenesis, but whether variation among different HPV types exists remains unclear. We investigated 91 women infected with HPV type 52 (HPV-52), a type that is rare worldwide but common in East Asia. The median viral load increased with the severity of the lesion (248 copies/cell equivalent for normal/cervical intraepithelial neoplasia [CIN] grade 1, 402 copies/cell equivalent for CIN 2, 523 copies/cell equivalent for CIN 3, and 1,435 copies/cell equivalent for invasive cancer). The proportion of specimens with integration increased significantly with the severity of the lesion (P < 0.001). The viral load was associated with the physical status of the viral genome, with higher levels for the pure episomal form (P = 0.001). Infection status should be considered when interpreting viral load data for HPV-52, as single infections with this HPV type were found to have marginally higher viral loads than coinfections (P = 0.051). All except one sample had E2 disruption restricted to only a part of the gene. Integration is a critical step in HPV-52-induced carcinogenesis. The profile of E2 disruption was different from that described for HPV-16, with the amino-terminal region being most frequently involved. Selecting the appropriate E2 region for amplification is critical in studying the integration of HPV-52. In summary, the HPV-52 viral load and the integrated proportion increased with the severity of the cervical lesions but had a different pattern than that of HPV-16.
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48
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Development and validation of a real-time PCR assay specifically detecting human papillomavirus 52 using the Roche LightCycler® 480 system. J Virol Methods 2008; 147:290-6. [DOI: 10.1016/j.jviromet.2007.09.018] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2007] [Revised: 09/18/2007] [Accepted: 09/20/2007] [Indexed: 11/22/2022]
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49
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Bao YP, Li N, Smith JS, Qiao YL. Human papillomavirus type-distribution in the cervix of Chinese women: a meta-analysis. Int J STD AIDS 2008; 19:106-11. [DOI: 10.1258/ijsa.2007.007113] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Summary The aim of the study was to determine human papillomavirus (HPV) type-distribution in the cervix of Chinese women, and to estimate the potential future impact of HPV prophylactic vaccines for cervical cancer prevention in China. A total of 32 studies using polymerase chain reaction for HPV detection were included in the meta-analysis, including 2844 invasive cervical cancer (ICC), 820 high-grade squamous intraepithelial lesions (HSIL), 432 low-grade squamous intraepithelial lesions (LSIL) and 2902 women with normal cytology/histology. The overall and type-specific HPV prevalence of 18 HPV types (HPV 6, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 70, 73 and 82 of different cervical stages) were estimated. Overall HPV prevalence was 83.7%, 66.2%, 61.3% and 11.2% in ICC, HSIL, LSIL and normal, respectively. HPV 16 was the predominant type in all cervical stages. Estimated HPV 16/18-positive fractions in ICC, HSIL, LSIL and normal were 69.7%, 45.5%, 32.23% and 4.6%, respectively. HPV-16/18 vaccine has the 69.7% potential prevention in ICC. HPV 58 and 52 were the priority HPV types in Chinese women.
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Affiliation(s)
- Y P Bao
- Department of Cancer Epidemiology, Cancer Institute/Chinese Academy of Medical Sciences, Beijing
| | - N Li
- Department of Epidemiology, China Medical University, Shenyang, People's Republic of China
| | - J S Smith
- University of North Carolina, Chapel Hill, NC, USA
| | - Y L Qiao
- Department of Cancer Epidemiology, Cancer Institute/Chinese Academy of Medical Sciences, Beijing
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Bao YP, Li N, Smith JS, Qiao YL. Human papillomavirus type distribution in women from Asia: a meta-analysis. Int J Gynecol Cancer 2008; 18:71-9. [PMID: 17466054 DOI: 10.1111/j.1525-1438.2007.00959.x] [Citation(s) in RCA: 139] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to determine human papillomavirus (HPV) type distribution in women with and without cervical neoplasia from Asia and to estimate the potential future impact of an HPV 16/18 prophylactic vaccine in this region. A meta-analysis was conducted including 79 studies using polymerase chain reaction to detect HPV types. A total of 5954, 1653, 958, and 16,803 women with invasive cervical cancer (ICC), high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL), and normal cytology or histology were included, respectively. Type-specific prevalence of HPV types 6, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 70, 73, and 82 were estimated and stratified by cervical lesion grade. Overall HPV prevalence was 85.9%, 81.0%, 72.9%, and 14.4%, respectively, in women with ICC, HSIL, LSIL, and normal cytology/histology. In ICC, HPV 16 was the predominant type (52.4%), followed by HPV 18, 58, 33, 52, 45, 31, and 35. The estimated HPV 16/18-positive fraction was 66.9%, 40.4%, 26.7%, and 3.3% in women with ICC, HSIL, LSIL, and normal cytology or histology, respectively. In ICC, the estimated HPV 16/18-positive fraction was about 70% in all Asian geographic regions, with the exception of Japan (51.3%). HPV 16/18 vaccines are estimated to provide about 67% protection against ICC in Asia. HPV 58 and 52 were among the five most common types in ICC in eastern and southeastern Asia but not in south central Asia. After HPV 16 and 18, the next most six common HPV types were 58, 33, 52, 45, 31, and 35 that accounted for additional 20% of cervical cancer cases in Asia. For optimal population coverage, these HPV carcinogenic types should be considered for second-generation HPV prophylactic vaccines.
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Affiliation(s)
- Y-P Bao
- Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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