HPV genotyping of cervical histologic specimens of 61, 422 patients from the largest women hospital in China

Abstract

ObjectivesWe investigated HPV genotypes in a large cohort of patients with definitive cervical histologic diagnosis.MethodsHPV testing was performed by real-time PCR assay, including 18 high-risk HPV (hrHPV) and 3 low-risk HPV (lrHPV). Totally 61,422 patients with documented HPV genotyping results within 6 months before cervical histologic diagnoses were included.ResultsHrHPV positive rate was 55.1% among all tested cases with the highest in adenosquamous carcinoma (94.1%), followed by squamous cell carcinoma (SCC) (93.7%), cervical intraepithelial neoplasia 2/3 (CIN2/3) (92.8%). HrHPV positive rates were significantly higher in high-grade squamous lesions than in those in glandular lesions. HPV16 was the most common genotype followed by HPV52 and HPV58 in CIN2/3. The most frequent hrHPV genotype in adenocarcinoma in situ (AIS) was HPV18, followed by HPV16, HPV45 and HPV52. In SCC cases, HPV16 was the most common type followed by HPV58, HPV52, HPV18 and HPV33. However, HPV18 showed significantly higher prevalence in adenocarcinoma and adenosquamous carcinoma than in that in SCC. Theoretically, the protective rates of 2/4-valent and 9-valent vaccine were 69.1% and 85.8% for cervical cancers.ConclusionsThe prevalence of HPV genotypes in Chinese population was different from that in Western population. Some hrHPV types were identified in cervical precancerous lesions and cancers, which are not included in current HPV vaccines. These data provide baseline knowledge for future HPV vaccine development.

Comprehensive overview of genotype distribution and prevalence of human papillomavirus in cervical lesions

“… 13 – 15 Similar to the negative group, the CIN1 group also showed decreased trends with increasing age for HR-HPV prevalence: 90.7% (<30 years), 87.9% (30–49 years), 87.4% (≥50 years) in Shanghai city, and 79.0% (<30 years), 74.1% (30–49 years), 76.8% (≥50 years) in Chengdu city. 13 14 The top three genotypes of HR-HPV in the CIN1 groups are HPV52 (25.2% and 23.5%), HPV58 (16.5% and 13.5%) and HPV16 (16.9% and 13.1%) among Chinese cities. 13 14 The similar findings in HPV genotype and age distribution between CIN1 and histologically negative cases support follow-up-only as an optimal clinical management for most CIN1 cases.…”

“…HR-HPV prevalence was highest in the <30 years group in all categories except SCC and ADC. 13 14 As shown in figure 1 , HPV52, 58 and 53 are involved primarily in the benign or low-grade cervical squamous lesions, while HPV16 is mainly associated with more severe lesions (CIN2/3 and SCC). HPV18 is significantly more common in glandular lesions than in squamous lesions ( figures 1 and 2 ).…”

“…HPV18 is significantly more common in glandular lesions than in squamous lesions ( figures 1 and 2 ). 13 14 …”

“…The prevalence of HR-HPV infection in negative cases was 36.2% (Beijing city), 43.9% (Shanghai city) and 44.9% (Chengdu city), respectively, by three independent large-scale retrospective studies. 7 13 14 The relatively higher HR-HPV positivity rate in histologically biopsied negative specimens may be due to selective bias. These women underwent biopsy due to abnormal screening results; the study populations are not representative of the general Chinese population.…”

“…These women underwent biopsy due to abnormal screening results; the study populations are not representative of the general Chinese population. 13 14 By age stratification, the HR-HPV infection rates were 14.8% (<30 years), 11.9% (30–49 years), 11.3% (≥50 years) in Beijing city; 58.2% (<30 years), 40.9% (30–49 years), 43.8%, (≥50 years) in Shanghai city; and 55.7% (<30 years), 41.6% (30–49 years), 47.7% (≥50 years) in Chengdu city. HR-HPV prevalence was highest in the <30 years group in all three studies.…”