塞尔维亚北部伏伊伏丁那地区队列研究人群中HPV感染的地向性和致癌潜力

Q4 Medicine
A. Mandić, N. Nikolic, S. Maričić, B. Gutic, N. Stevanovic, Branka Basica
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引用次数: 0

摘要

背景/目的:人乳头瘤病毒(HPV)的地向性代表了不同基因型在世界范围内的异质分布。本研究的目的是评估塞尔维亚伏伊伏丁那省妇女HPV感染的患病率,根据宫颈发育不良和癌症的细胞学状况和病理变化。方法:在伏伊伏丁那肿瘤研究所和伏伊伏丁那公共卫生研究所(IPHV)进行回顾性研究。研究使用了2016年至2021年期间在斯雷姆斯卡卡梅尼卡伏伊伏丁那肿瘤研究所妇科、外科肿瘤诊所治疗的宫颈上皮内瘤变或宫颈癌女性患者的医疗记录数据,以及一组Papanikolau (PAPA)涂片细胞学结果正常的患者的ipv实验室结果。结果:共纳入731名女性,年龄从20岁到82岁,细胞学结果不同。567例归为NILM, 164例归为组织病理异常组(LSIL/HSIL/子宫颈癌)。采用EUROArray HPV检测进行HPV基因分型分析,检测30种HPV基因型。在细胞学检查结果正常的总人数中,242例(42.7%)患者被证实感染HPV,其中135例(55.8%)被证实感染高危HPV,而76例(31.4%)被证实感染HPV混合组(低风险/高风险HPV)。在NILM细胞学状态下,最常见的基因型是HPV 16、31、53、51和18。在组织病理学异常的样本中,最常见的基因型是HPV 16、33、31和56,而18和39同样被证实。基因型16在检测样本中最为普遍,在更高级别的组织病理学结果中患病率更高:低级别鳞状上皮性白血病18.8%,高级别鳞状上皮性白血病31.9%,宫颈癌75.0%。多相关基因型HPV感染与组织病理学无相关性。通过比较组织病理学诊断和年龄,老年患者的病变级别更高。结论:根据HPV基因型的致癌潜力及其在样本中的患病率,可以得出结论,针对基因型6、11、16、18、31、33、45、52和58的九价HPV疫苗有可能在85%的女性中预防HPV感染和癌前病变和宫颈癌的发生。观察HPV流行趋势,特别是HR型HPV基因型,对于进一步实施二级和一级预防策略,以及将HPV检测作为联合检测的一部分或考虑在初始筛查计划中引入HPV检测具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Geotropism and oncogenic potential of HPV infections in cohort study populations in Vojvodina, North region of Serbia
Background/Aim: Geotropism of the human papillomavirus (HPV) represents the heterogeneous distribution of different genotypes worldwide. Aim of this study was to evaluate the prevalence of the HPV infection in women from Vojvodina, Serbia, according to cytological status and pathological changes of cervix - dysplasia and cancer. Methods: The research was conducted as a retrospective study at the Oncology Institute of Vojvodina and the Institute of Public Health of Vojvodina (IPHV). Data from the medical records of female patients treated for cervical intraepithelial neoplasia or cervical cancer at the Department of Gynaecology, Clinic for Surgical Oncology, Oncology Institute of Vojvodina in Sremska Kamenica in the period from 2016 to 2021 were used, as well as the laboratory findings of the IPHV for a group of patients with normal cytological results of the Papanikolau (PAPA) smear. Results: A total of 731 women, from 20 to 82 years of age, with different cytological results were enrolled. 567 samples were classified as NILM, while 164 samples belong to a group of abnormal histopathology (LSIL/HSIL/cervical cancer). The HPV genotyping assay was performed using the EUROArray HPV test to detect 30 HPV genotypes. In the overall number with normal cytological findings, HPV infection was verified in 242 (42.7 %) patients, of which 135 (55.8 %) were verified with high risk HPV, while 76 (31.4 %) were verified with a mixed group of HPV (Low risk/High risk HPV). Most prevalent genotypes were HPV 16, 31, 53, 51 and 18 in NILM cytological status. In the samples with the abnormal histopathology, the most prevalent genotypes were HPV 16, 33, 31 and 56, while 18 and 39 were equally verified. Genotype 16 was the most prevalent in the examined sample, with a higher prevalence in higher-grade histopathological findings: 18.8 % in LSIL, 31.9 % in HSIL and 75.0 % in cervical cancer samples. Infection with multiple associated genotypes of HPV was not correlated with histopathology. By comparing histopathological diagnosis and age, older patients had higher-grade lesions. Conclusion: Based on the estimated oncogenic potential of HPV genotypes as well as their prevalence in presented sample, it can be concluded that the nine-valent HPV vaccine for genotypes 6, 11, 16, 18, 31, 33, 45, 52 and 58 would have the potential to prevent HPV infection and the incidence of precancerous lesions and cervical cancer in about 85 % of women. Observing trends in the prevalence of HPV, especially HR HPV genotypes, can be important in the further strategy of applying secondary and primary prevention, as well as the application of HPV detection as part of co-testing or considering the introduction of HPV testing in the initial screening program.
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