Carcinogenic risk of human papillomavirus (HPV) genotypes and potential effects of HPV vaccines in Korea

Eunhyang Park,Dae Shick Kim,Ji-Ye Kim,Young Lyun Oh,Sangjoon Choi

doi:10.1038/s41598-019-49060-w

Abstract

This study investigated the distribution of HPV types in Korean women and evaluated the carcinogenic risk of individual HPV types and the potential effects of HPV vaccines. A total of 4,081 HPV-positive samples between 2014 and 2017 were included. The most prevalent genotypes were HPV 16, 58, 68, and 56. Among them, HPV 16 was significantly higher in high-grade squamous intraepithelial neoplasia or worse (HSIL+ ) group. In cytologically evaluating the risk for HSIL+ by individual HPV types, HPV 16 was associated with the highest risk of HSIL+ (OR = 10.82; 95% CI: 7.93–14.77), followed by HPV 33, 31, 52, 18, 58, 51, and 35, in descending order (OR = 3.50 [type 33] to 2.62 [type 35]). Among those types, HPV 16, 18, 31, 33, and 58 were also significantly associated with HSIL+ on histologic evaluation. The analysis of the HPV subgroups covered by the different vaccines revealed that the HPV types covered by the 9-valent vaccine had a high association with HSIL+ (OR = 4.09; 95% CI: 3.02–5.54). Our findings highlight the different carcinogenic risks posed by the high risk HPV genotypes and the positive potential effects of the 9-valent HPV vaccine in reducing HPV-associated cervical cancer in Korea.

Highlights

Human papillomaviruses (HPVs) are a well-known cause of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer[1]
Pathologists diagnosed the cytology slides according to the 2001 Bethesda system for cervicovaginal cytology: negative for intraepithelial lesions or malignancy (NILM); atypical squamous cells of undetermined significance (ASCUS); low-grade squamous intraepithelial neoplasia (LSIL); atypical squamous cells-cannot exclude high-grade squamous intraepithelial neoplasia (ASC-H); high-grade squamous intraepithelial neoplasia (HSIL); squamous cell carcinoma (SCC); and adenocarcinoma (ADC)[15]
We used three subgroups based on the cytologic diagnoses: NILM, LSIL, and HSIL+

Summary

Introduction

Human papillomaviruses (HPVs) are a well-known cause of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer[1]. The 2- and 4-valent vaccines protect against HPV 16 and 18, which are the two major carcinogenic types, and the 9-valent vaccine further protects against HPV 31, 33, 45, 52, and 58 These vaccines are expected to address approximately 70% and 90% of cervical cancers, respectively[5,6], their preventive effects need to be evaluated on a regional basis. A number of studies have reported the distribution of HPV types in cervical cancer patients or healthy women, few studies have evaluated the carcinogenic potential of individual HPV genotypes by analyzing case-controlled differences, as in the IARC definition[12,13,14]. We evaluated the distribution of HPV types in Korean women and estimated the carcinogenic potential of individual HPV types by considering the association between specific HPV types and cervical cancer or precancerous lesions. We evaluated the potential effects of HPV vaccines in Korea

Methods

Results

Conclusion