What Are the Current HPV Types Contributing to Cervical High-Grade Squamous Intraepithelial Lesions, Adenocarcinoma In Situ, and Early Cervical Cancer?

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada Pub Date : 2025-01-31 DOI:10.1016/j.jogc.2025.102783

Lina Salman MD, MSc , Lilian T. Gien MD, MSc , Danielle Vicus MD, MSc , Michael Shier MD , Rachel Kupets MD , Suzanne Gibbons BSc , Samar Ashfaq BSc , Alberto Severini MD , Allan Covens MD

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Abstract

Objectives

To determine the prevalence of human papillomavirus (HPV) types by genotyping high-grade squamous intraepithelial lesion (HSIL), adenocarcinoma in situ (AIS), and early-stage invasive cervical cancer (ICC) in patients who have been exposed or are naïve to the HPV vaccine.

Methods

This was a cross-sectional study. All patients over the age of 18 years who presented to the colposcopy clinic with HSIL, AIS, or ICC who were expected to undergo a cervical biopsy, loop electrosurgical excisional procedure, or cone biopsy were eligible and approached for informed consent. HPV typing was performed to identify the causative HPV types.

Results

Between November 2016 and May 2023, 113 patients (34 vaccinated with at least 1 dose, and 79 non-vaccinated) consented to this study. The median ages at coitarche and study entry were 18 (range 14–37) and 34 (range 24–66) years, respectively. Only 3 patients were vaccinated prior to coitarche.

Histology was as follows: HSIL = 97, AIS = 9, HSIL and AIS = 2, squamous cell carcinoma = 4, and 1 patient with adenocarcinoma. The causative HPV type was 16 or 18 in 59% of the vaccinated group and in 66% of the non-vaccinated group. Most vaccinated patients (74%) reported receiving 2–3 doses of HPV vaccine.

Conclusions

In our cohort, the distribution of causative HPV 16 and 18 in patients presenting with HSIL/AIS/ICC was similar between vaccine-naïve and vaccinated patients. This data suggests cervical screening guidelines should not differentiate between “vaccinated” and “non-vaccinated” women without further details of their vaccination.

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目前哪些HPV类型导致宫颈高级别鳞状上皮内病变、原位腺癌和早期宫颈癌？

目的：通过基因分型确定HPV类型在高级别鳞状上皮内病变(HSIL)/原位腺癌(AIS)/早期浸润性宫颈癌（ICC）中暴露于HPV疫苗或naïve的患者的患病率。方法：采用横断面研究。所有年龄在18岁以上的患有HSIL、AIS或ICC的患者在阴道镜诊所就诊，并期望接受宫颈活检、环电手术切除手术（LEEP）或锥体活检，均符合条件并获得知情同意。进行HPV分型以确定致病HPV类型。结果：在2016年11月至2023年5月期间，113例患者（34例接种了至少1剂疫苗，79例未接种疫苗）同意参加本研究。研究开始时的中位年龄分别为18岁（范围14-37岁）和34岁（范围24-66岁）。只有3例患者在排卵前接种了疫苗。组织学分析：HSIL=97， AIS=9, HSIL + AIS=2，鳞状细胞癌=4，腺癌1例。在接种疫苗组中，59%的人感染了16或18型HPV，而在未接种疫苗组中，这一比例为66%。大多数接种疫苗的患者（74%）报告接受了2-3剂HPV疫苗。结论：在我们的队列中，在HSIL/AIS/ICC患者中，HPV 16和18在疫苗naïve和接种疫苗患者中的分布相似。这一数据表明，宫颈筛查指南不应在没有进一步疫苗接种细节的情况下区分“接种疫苗”和“未接种疫苗”的妇女。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of obstetrics and gynaecology Canada OBSTETRICS & GYNECOLOGY-

CiteScore

3.30

自引率

5.60%

发文量

302

审稿时长

32 days

期刊介绍： Journal of Obstetrics and Gynaecology Canada (JOGC) is Canada"s peer-reviewed journal of obstetrics, gynaecology, and women"s health. Each monthly issue contains original research articles, reviews, case reports, commentaries, and editorials on all aspects of reproductive health. JOGC is the original publication source of evidence-based clinical guidelines, committee opinions, and policy statements that derive from standing or ad hoc committees of the Society of Obstetricians and Gynaecologists of Canada. JOGC is included in the National Library of Medicine"s MEDLINE database, and abstracts from JOGC are accessible on PubMed.