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Human papillomavirus (HPV) infection contributes to most cases of cervical cancer, and HPV genotypes exhibit different distributions according to geographic region. This study evaluates the prevalence of HPV infection in Hetian Prefecture, Xinjiang, and establishes risk factors associated with high-risk HPV (HR-HPV) genotypes in this region. In this cross-sectional, population-based study, 883 healthy women 15-54 years of age were enrolled. All participants completed a questionnaire regarding sociocultural and sexual activity characteristics. Visual inspections with acetic acid, colposcopies and biopsies were performed using the Preventive Oncology International microbiopsy protocol for pathological diagnosis. Cervical epithelial tissue specimens were collected and tested for HPV using linear array assays. According to the results of HR-HPV infection status, individuals infected with HR-HPV were classified into one group, and the remaining individuals were classified into the control group. The risk factors for HR-HPF infection were analyzed. The participants included 66 women (7.47%) with HR-HPV, 10 women (1.13%) with low-risk HPV, and 14 women (1.59%) with HPV of unknown risk. The five most prevalent types of HR-HPV were HPV-16 (0.31%), HPV-51 (0.08%), HPV-31 (0.07%), HPV-58 (0.07%), and HPV-39 (0.06%). Vulvovaginal ulcers and vulvovaginal inflammation were found in 190 participants (21.52%) and 256 participants (28.99%), respectively. The HR-HPV and control groups significantly differed with respect to age at first marriage, number of marriages, and the presence of vulvovaginal ulcers and vulvovaginal inflammation (p<0.05). Based on this study, an immunization strategy targeting HPV-16 should be prioritized in Hetian Prefecture. These findings contribute to the understanding of HPV infection.

Abstract. The etiology of a high incidence of cervical cancer in populations with a low human papillomavirus (HPV) infection rate is unclear. The current study aimed to investigate the role of HPV16 DNA integration in cervical lesions in women of Han and Uygur ethnicity and to explore the association between viral integration and a high cervical cancer morbidity with a low HPV infection rate. DNA was extracted from the biopsy specimens of cervical lesions of 379 patients of Uygur ethnicity and 464 patients of Han ethnicity, and multiple quantitative polymerase chain reaction (qPCR) assays were performed to determine the copy numbers of the HPV16 E2 and E6 genes. The copy number of the HPV16 DNA was evaluated according to the E2/E6 ratio. Among these cases, 122 Uygur and 121 Han specimens were found to be HPV16 positive. In the two populations, the percentage of cases with HPV16 integration (the sum of integrated-type infection only or a mixture of free-and integrated-type infection) increased with the grade of the cervical lesions (P<0.001). Within groups with the same cervical lesion grade, no significant differences in HPV16 integration were found between women of Uygur and Han ethnicity (rank sum test, P>0.05). No significant differences in the distribution of the HPV16 integration rate according to lesion grade were found in either population (P>0.05). When the two subpopulations were considered as one sample population, the integration rate significantly increased with lesion grade (P=0.02). These results indicate that the integration rate of HPV16 E2 may serve as a molecular biological marker for the development of cervical lesions. IntroductionCervical cancer is the second most common malignant tumor in women throughout the world, ranking just behind breast cancer (1). The essential pathogenic factor in cervical cancer is the persistence of high-risk human papillomavirus (HPV), which is a double-stranded DNA virus with a capsid (2).To date, numerous studies have reported on the integration of HPV DNA into the host genome in precancerous uterine cervical lesions and cervical cancers (3). High-risk HPV DNA integration into the host genome is a key factor eliciting malignant transformation in cervical lesions; both the HPV16 integration rate and the persistence of HPV16 infection demonstrate a positive correlation with the cervical lesion grade (4). Although the integration rates of HPV16 and HPV18 DNA increase with an increase in the malignancy level, the mixed type, that is, cases in which both free-type and integrated-type infection is present, is much more frequently observed in HPV16 integration. The integration of HPV16 and HPV18 into the host genome is an early step in cervical tumor development, and the incidence rate of HPV DNA integration increases with the aggravation of cervical lesions (5). HPV DNA integration has been detected in 7.4% of lesion tissues in HPV16-positive precancerous lesions of the uterine cervix, but integration occurs only in severe cervical lesions (6). These findings indicat...

BackgroundCervical cancer is the most common genital malignant tumor in women worldwide. However, the reliability of different detection methods may vary according to populations and epidemics. This study analyzed factors relevant to high-risk human papillomavirus (hrHPV) infection among rural Uyghur women aged > 30 years and evaluated the value of different screening methods for cervical precancerous lesions.MethodsFrom July 2015 to May 2016, 225 rural Uyghur women aged > 30 years were recruited from local health clinics throughout Pishan, Xinjiang, China. HrHPV DNA testing, colposcopy, biopsy of cervical precancerous lesions, and surveys were conducted. The results of different screening methods were compared, and factors associated with hrHPV infection were analyzed.ResultsThe rates of hrHPV infection and cervical epithelial lesions were 9.3 and 1.8%, respectively. The area under the ROC curve was 0.538 (95% CI: 0.292, 0.784; P = 0.753) for the HPV test and 0.995 (95% CI: 0.988, 1.003; P < 0.001) for colposcopy. Factors associated with HPV infection included widowhood (OR = 13.601 (2.170, 85.263), P = 0.005) and ≥ 3 sexual partners in the past 5 years (OR = 16.808 (4.148, 68.101), P < 0.001). .ConclusionsAmong rural Uyghur women aged > 30 years, the main factors for HPV infection include marriage and frequent sexual intercourse. Colposcopy has a higher screening value for cervical epithelial lesions than hrHPV testing.

TNFAIP8L1 and FLT1 play critical roles in the occurrence and development of tumors, but no in-depth studies have been carried out in cervical cancer. The present study aims to research the correlation between polymorphisms of these two genes and the risk of cervical cancer in the Uygur women. The study involved 342 cervical cancer patients and 498 healthy women. Five single nucleotide polymorphisms (SNPs) from the TNFAIP8L1 gene and the FLT1 gene were selected and genotyped. Odds ratio and 95% CIs were calculated by logistic regression analysis to evaluate the correlation between SNPs and cervical cancer risk. The alleles rs9917028-A (P=0.032), rs10426502-A (P=0.007), and rs1060555-G (P=0.026) of TNFAIP8L1 were associated with a decreased risk of cervical cancer. In the multiple genetic models, these three SNPs were also associated with the risk of cervical cancer. The stratified analysis showed that TNFAIP8L1-rs10426502, -rs1060555, and FLT1-rs9513111 were associated with a decreased risk of cervical cancer amongst people older than 43 years. Moreover, the haplotypes AG (P=0.007) and GC (P=0.026) of linkage disequilibrium block rs10426502|rs1060555 in TNFAIP8L1 were significantly associated with an increased risk of cervical cancer. Our results suggested that the relationships between TNFAIP8L1 and FLT1 polymorphisms and the risk of cervical cancer amongst Uyghur females.

Background PGF and TNFAIP2 are important angiogenic factors, which were abnormal expression in cervical cancer (CC). However, there is currently no report investigating the relationship of PGF and TNFAIP2 gene polymorphisms to CC risk. Methods We conducted a case-control study of 342 CC patients and 498 cancer-free controls in a Chinese Uygur female population. Three SNPs (PGF rs8019391, PGF rs2268615, and TNFAIP2 rs710100) were selected and genotyped to assess the possible association of PGF and TNFAIP2 polymorphisms with CC susceptibility. Logistic regression analysis adjusted by age was used. Results PGF rs2268615 (OR = 1.39, 95% CI = 1.04–1.86, p = 0.024) and TNFAIP2 rs710100 (OR = 1.44, 95% CI =1.07–1.95, p = 0.018) polymorphisms were associated with the increased risk of CC. Moreover, T allele of PGF rs8019391 was highly represented in patients with stage III–IV compared with stage I-II (OR = 2.17, p = 4.58 × 10− 4). MDR analysis revealed a positive interaction between the SNPs. Conclusion Our data indicated that PGF rs2268615, and TNFAIP2 rs710100 polymorphisms might be risk factors for CC susceptibility, which contributed to the increased risk of CC. Trial registration Not applicable.

Background: The detection of human papillomavirus (HPV) E6/E7 mRNA indicates a risk of further deterioration in cervical lesions. We explored the clinical value of HPV E6/E7 mRNA detection in cervical cancer screening in women positive for HPV or with abnormal thin-prep cytology test (TCT) results in the Xinjiang region of China. Methods: A total of 6,800 women were screened in our hospital for cervical cancer by both TCT and HPV DNA testing from August 2013 to June 2015. Of these, 197 had abnormal cytological or HPV test results and subsequently underwent HPV E6/E7 mRNA detection and histopathological examination, while 101 underwent an HPV DNA typing test. Using pathological results as the gold standard, we compared the accuracies of HPV E6/E7 mRNA detection or HPV DNA type testing alone, in parallel, and in series for diagnosing high-grade cervical lesions. Results: Pathological examination revealed 80 cases of chronic cervicitis, 16 cases of cervical intraepithelial neoplasia (CIN)-I, 50 cases of CIN-II-III, and 51 cases of cervical cancer. The area under the receiver operating characteristic (ROC) curve (AUC) for diagnosing high-grade cervical lesions by HPV E6/E7 mRNA detection was 74.95% (sensitivity, 85.15%; specificity, 66.67%; Youden index, 0.139; positive predictive value, 72.9%; negative predictive value, 81.0%; positive likelihood ratio, 2.555; negative likelihood ratio, 0.222; and post-test probability, 72.9%). Conclusions: HPV E6/E7 mRNA detection is superior to HPV DNA type testing for diagnosing high-grade cervical lesions. (Clin. Lab. 2018;64:xx-xx.

The timely detection of precancerous lesions and early intervention can greatly reduce cervical cancer occurrence. The current study aimed to assess the diagnostic value and accuracy of different methods of cervical lesion screening. A total of 1622 females who visited the Outpatient Department of Xinjiang Uyghur Autonomous Region People’s Hospital between January and December 2018 were consecutively enrolled. All participants underwent separate high-risk human papilloma virus (HR-HPV) DNA detection, ThinPrep cytology testing (TCT) and colposcopic biopsy. Their medical records were retrospectively analyzed. While considering biopsy outcomes as the gold standard, the diagnostic values of TCT, HR-HPV testing, and TCT+HR-HPV testing for cervical cancer screening were compared. The sensitivity, specificity and Youden index of each method were calculated. Among the different methods, TCT+HR-HPV testing had the highest sensitivity (89.8%), followed by TCT (79.9%) and HR-HPV testing (49.2%). The combined method also had the highest Youden value, and its screening outcomes exhibited the highest consistency with those of biopsy. In addition, the combined method had the largest area under the receiver operating characteristic (ROC) curve, which was 0.673 (0.647, 0.699), compared with any other screening method. Compared with TCT or HR-HPV testing alone, TCT+HR-HPV testing serves as a better screening method for cervical cancer and precancerous lesions.