Abstract
A complete understanding of the natural history of infection with high-risk human papillomaviruses (HPVs) in cervical cancer requires data from regional and ethnic studies. The prevalence of high-risk HPVs was evaluated retrospectively in 2040 patients with cervicitis, 239 with cervical intraepithelial neoplasia grade 1 (CIN1), 242 with CIN2/3, and 42 patients with invasive squamous cell carcinoma (SCC) based on data from patients who visited our hospital between May 2013 and May 2015. The rates of high-risk HPV infection in patients with cervicitis, CIN1, CIN2/3, and invasive SCC were 40.8%, 74.9%, 70.2%, and 83.3%, respectively. The three most dominant HPV genotypes were HPV16, 58, and 52. HPV16 and HPV58 positivity in cervicitis, CIN1, CIN2/3, and SCC patients were 20.9% and 16.4%, 19.0% and 20.1%, 44.1% and 23.5%, and 60.0% and 31.4%, respectively. Compared to cervicitis, the odds ratios (ORs) for CIN2/3 in HPV16- and HPV58-positive patients were 2.99 (95% confidence interval [CI]: 1.32–4.33) and 1.56 (1.11–3.21), respectively; for SCC, the corresponding values were 5.68 (2.31–7.893) and 2.33 (1.41–3.87). Further identifying of carcinogenic HPVs and a fully aware of regional differences in HPV genotype distribution are tasks of top priority for cervical cancer control and prevention.
Highlights
In 2012, the American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology jointly published screening guidelines for the prevention and early detection of cervical precancerous lesions and cervical cancer [1]
Because the data from the Centers for Disease Control and Prevention showed that the incidence of squamous cell cervical cancer (SCC) increased sharply in women older than 30 years [16], all patients were divided into two groups (≤30 years and >30 years of age) to determine whether the distribution of human papillomaviruses (HPVs) infection significantly differed between the two groups (Table 1), but this was not the case in our population
Our data showed that 40.8% of patients with cervicitis, 74.9% with cervical intraepithelial neoplasia grade 1 (CIN1), 70.2% with CIN2/3, and 83.3% with invasive SCC were positive for high-risk HPV DNA
Summary
In 2012, the American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology jointly published screening guidelines for the prevention and early detection of cervical precancerous lesions and cervical cancer [1]. A supportive study performed in the USA, in which 42,209 nonpregnant women 21 years of age and older underwent routine cervical cancer screening, showed that primary screening for HPV in women ≥25 years of age is as effective as a hybrid screening strategy that uses www.impactjournals.com/oncotarget cytology in women 25–29 years of age and as effective as co-testing in women ≥30 years of age [5]. Another followup of four European randomized controlled trials showed that HPV-based screening provided 60–70% greater protection against invasive cervical carcinomas compared with cytology [6]. A further objection is that studies supporting HPV DNA testing alone adopted cervical intraepithelial neoplasia (CIN) grade 3 (CIN3) instead of cervical cancer to evaluate the performance of HPV DNA testing in cervical cancer screening [7]
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