Risk stratification of type-specific human papillomavirus for cervical precancers: evidence from a cross-sectional study in Shenzhen
10.3760/cma.j.issn.0253-3766.2018.10.007
- VernacularTitle: 高危型人乳头状瘤病毒风险分层在深圳地区人乳头状瘤病毒初筛阳性人群分流中的应用
- Author:
Zhihua LIU
1
;
Wei LIN
2
;
Yueyun WANG
2
;
Bo WU
2
;
Shixin YUAN
2
;
Jilong YAO
1
;
Xiaoshan ZHAO
2
;
Bin CHEN
2
;
Youlin QIAO
3
;
Fanghui ZHAO
3
;
Wen CHEN
3
;
Shangying HU
3
Author Information
1. Department of Gynecology, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen 518028, China
2. Department of Healthcare, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen 518028, China
3. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Publication Type:Clinical Trail
- Keywords:
Human papillomavirus;
Genotype;
Risk stratification;
Cervical screening
- From:
Chinese Journal of Oncology
2018;40(10):757-763
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the epidemiological genotype features of human papillomavirus (HPV) in cervical infection and their risks for cervical precancers among women in Shenzhen area.
Methods:A total of 2 717 individuals ranging in age from 30~59 years were recruited in 18 community health centers of Shenzhen city from March 1 to June 15, 2015 by a cluster sampling method. The results of genotype of HPV, liquid-based cytology (LBC), colposcopy and pathology were analyzed. The clinical sensitivity and specificity as well as positive (PPV) and negative (NPV) predictive values of the combination of different HPV genotype in screening the cervical intraepithelial neoplasia (CIN) 2 and above were estimated.
Results:The HPV infection rate in Shenzhen area was 15.9% (432/2 717). The most common HPV genotype was HPV52 (22.9%), followed by HPV16 (12.7%), HPV53 (10.0%), HPV51 (8.6%) and HPV58 (8.1%). Compared with HPV16/18 genotyping, HPV33/16 genotyping had a higher sensitivity (57.1% vs. 42.9%, P<0.05) and an analogous specificity (87.3% vs. 86.9%, P>0.05) in predicting CIN2+ . The sensitivity of combination of HPV33/16 genotyping and low grade squamous intraepithelial lesion (LSIL) positive tested by LBC in predicting CIN2+ was 75.0%, significantly higher than 64.3% of atypical squamous cells of undetermined significance (ASC-US) positive tested by LBC alone (P<0.05). The specificities of these two methods mentioned above in predicting CIN2+ were 83.5% and 89.2%, respectively, without statistical difference (P>0.05).
Conclusions:Women infected by HPV have distinct risks for CIN2+ according to different high-risk HPV genotypes. The top five risks were HPV 33, 16, 58, 56, and 68. HPV-positive women triaged by LBC LSIL+ combined with HPV33/16 genotyping may be a potential strategy for cervical cancer screening in developed urban area.
