Predicting the risk of high-grade precancerous cervical lesions based on high-risk HPV typing in Changsha China.

IF 2.4 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Yaling Xiao, Rangjiao Liu, Shaobo Wang, Yuxiang Wang, Weimin Miao, Meiwei Chen, Xiaowen Liu, Yan Chen, Yongchun Wen, Zhongping Deng, Lizhong Dai, Zenghui Mao, Jun He
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Abstract

Background: Persistent infection with high-risk human papillomavirus (HPV) is a significant risk factor for cervical cancer. HPV typing and cytology are conducted in women of appropriate age to assess the risk of cervical lesions and to guide the need for further diagnostic procedures such as colposcopy, cervical biopsy, or treatment. This article explores methods to predict the risks of high-grade precancerous cervical lesions based on high-risk HPV typing.

Methods: We conducted a retrospective analysis of HPV typing data from 158,565 women, including 19,707 who underwent ThinPrep cytologic testing (TCT), 7,539 who had colposcopy examinations, and 4,762 who had biopsies. We evaluated the sensitivity, specificity, and risk parameters of high-grade lesions associated with high-risk HPV types.

Results: (1) The overall prevalence of HPV infection was 17.89%, with the most prevalent types being HPV52 (4.44%), HPV58 (2.10%), HPV53 (1.96%), HPV81 (1.85%), HPV42 (1.75%), and HPV16 (1.44%). (2) The sensitivity and specificity of detecting high-grade lesions in TCT, colposcopy, and biopsy, based on high-risk HPV typing, demonstrated a strong linear correlation with the infection rate of each type. (3) HPV16 was confirmed to have a higher risk of CIN2 + in biopsies using a self-defined risk parameter. (4) The top five HPV types with the highest PPVs and pathogenicity risks in biopsies were HPV45, HPV16, HPV58, HPV33, and HPV18.

Conclusion: In Changsha, China, HPV52, HPV58, and HPV53 were the most prevalent and contributed significantly to high-grade lesions. After adjusting for infection rates, a self-defined risk parameter was proposed as a measure of the intrinsic risks of high-grade lesions associated with high-risk HPV types. Focused monitoring of prevalent high-risk HPV types such as HPV45, HPV16, HPV58, HPV33, and HPV18, which show the highest pathogenicity risks, is recommended in our region.

基于中国长沙高危HPV分型预测高级别宫颈癌前病变的风险
背景:持续感染高危人乳头瘤病毒(HPV)是宫颈癌的重要危险因素。在适当年龄的妇女中进行HPV分型和细胞学检查,以评估宫颈病变的风险,并指导进一步诊断程序的需要,如阴道镜检查、宫颈活检或治疗。本文探讨了基于高危HPV分型预测高级别宫颈癌前病变风险的方法。方法:我们对158,565名女性的HPV分型数据进行了回顾性分析,其中19,707名接受了ThinPrep细胞学检查(TCT), 7,539名接受了阴道镜检查,4,762名接受了活检。我们评估了与高危型HPV相关的高级别病变的敏感性、特异性和风险参数。结果:(1)HPV总感染率为17.89%,其中HPV52型(4.44%)、HPV58型(2.10%)、HPV53型(1.96%)、HPV81型(1.85%)、HPV42型(1.75%)、HPV16型(1.44%)感染率最高。(2)基于高危HPV分型,TCT、阴道镜和活检检测高级别病变的敏感性和特异性与各类型感染率呈较强的线性相关。(3)使用自定义的风险参数,HPV16在活检中证实具有较高的CIN2 +风险。(4) HPV45、HPV16、HPV58、HPV33、HPV18是活检中ppv和致病性风险最高的5种HPV类型。结论:长沙市HPV52、HPV58、HPV53患病率最高,对高级别病变有重要影响。在对感染率进行调整后,提出了一个自定义的风险参数,作为与高危HPV类型相关的高级别病变的内在风险的度量。建议重点监测本地区流行的高危型HPV,如HPV45、HPV16、HPV58、HPV33和HPV18,这些类型的致病性风险最高。
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来源期刊
BMC Women's Health
BMC Women's Health OBSTETRICS & GYNECOLOGY-
CiteScore
3.40
自引率
4.00%
发文量
444
审稿时长
>12 weeks
期刊介绍: BMC Women''s Health is an open access, peer-reviewed journal that considers articles on all aspects of the health and wellbeing of adolescent girls and women, with a particular focus on the physical, mental, and emotional health of women in developed and developing nations. The journal welcomes submissions on women''s public health issues, health behaviours, breast cancer, gynecological diseases, mental health and health promotion.
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