[Prevalence and frequencies of human papilloma virus types in adenocarcinoma in situ of the uterine cervix]

Zhonghua Bing Li Xue Za Zhi. 2022 Apr 8;51(4):338-343. doi: 10.3760/cma.j.cn112151-20210817-00578.
[Article in Chinese]

Abstract

Objective: To examine the prevalence and frequencies of human papillomavirus (HPV) genotypes in cervical adenocarcinoma in situ (AIS). Methods: The cases of cervical AIS with concurrent tests of cytology and HPV typing from January 2007 to February 2020 in the Obstetrics and Gynecology Hospital of Fudan University were collected and analyzed. Results: A total of 478 cases of cervical AIS were obtained. The average age of the patients was 39.4 years (range, 19-81 years). The largest age group was 30-39 years (44.8%), followed by 40-49 years (34.7%). Among the 478 patients, 355 underwent high-risk HPV (hrHPV) testing and had a hrHPV-positive rate of 93.8%. Of the 355 patients, 277 also underwent HPV typing and were mostly positive for either or both HPV16 and HPV18 (93.1%), with 55.6% positive for HPV18 and 48.7% positive for HPV16. Among the 478 cases, 266 cases (55.6%) were diagnosed with both AIS and squamous intraepithelial lesion (SIL), while 212 cases (44.4%) were diagnosed with only AIS. Patients infected with HPV16 in the AIS and SIL group significantly outnumbered those in the AIS alone group (P<0.05). Moreover, the rate of positive cytology was 55.9% (167/299 cases), while that of negative cytology was 44.1% (132/299). Among the 109 patients with negative cytology results and co-tested hrHPV, there were 101 HPV-positive cases (92.7%), of which 88 cases were subject to HPV typing and showed an HPV16/18 positive rate of 94.3% (83/88 cases). Conclusions: The combination of HPV typing and cytological screening can maximize the detection rate of cervical AIS, and should continue to be utilized, ideally on a larger scale, in the future.

目的: 探讨HPV分型检测和细胞学检查对宫颈原位腺癌的筛查可行性。 方法: 收集2007年1月至2020年2月复旦大学附属妇产科医院组织病理学诊断为宫颈原位腺癌的病例信息,同时收集相应病例此前6个月内的高危型人乳头状瘤病毒(hrHPV)及细胞学检查结果并进行回顾性分析。 结果: 符合条件的组织病理学诊断为宫颈原位腺癌的病例共478例,患者平均年龄39.4岁(19~81岁),44.8%发生于30~39岁,34.7%发生于40~49岁,其中355例行hrHPV检测,阳性率为93.8%(333/355),阳性病例中277例病毒分型,55.6%(154/277)患者感染HPV18,48.7%(135/227)患者感染HPV16,HPV18/16的总感染率达93.1%(258/277)。478例患者中212例为单一原位腺癌,余266例为原位腺癌合并鳞状上皮内病变,后者HPV16的感染患者显著多于前者,差异具有统计学意义(P<0.05)。细胞学检查阳性率55.9%(167/299),余44.1%细胞学阴性患者的hrHPV阳性率为92.7%(101/109),其中HPV16/18占有病毒分型病例的94.3%(83/88)。 结论: HPV分型检测和细胞学联合筛查方案,可以最大限度地提高宫颈原位腺癌的检出率。.

MeSH terms

  • Adenocarcinoma in Situ* / epidemiology
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Human papillomavirus 16 / genetics
  • Human papillomavirus 18 / genetics
  • Humans
  • Middle Aged
  • Papillomaviridae / genetics
  • Papillomavirus Infections* / diagnosis
  • Prevalence
  • Uterine Cervical Neoplasms* / pathology
  • Young Adult