Human papilloma virus (HPV) is believed to be an essential factor for the development of cervical cancer. Early diagnosis and treatment of cervical intraepithelial neoplasia can effectively inhibit the future progression. HPV late 1 protein possesses epitope that can identify and adhere to host cells, and thus may play an important role in HPV infection and cervical carcinogenesis.
Capsid Proteins ; Cervix Uteri ; metabolism ; virology ; Female ; Humans ; Oncogene Proteins, Viral ; Papillomavirus Infections ; complications ; Uterine Cervical Neoplasms ; virology

OBJECTIVETo investigate the incidence of human papillomavirus (HPV) infection in women and its correlation with redundant prepuce or phimosis in the patients' sexual partners.

METHODSWe conducted a questionnaire investigation among the women outpatients at the cervical disease clinic of Nanjing Maternity and Child Health Hospital from May to December 2011. We obtained information on their sexual life and determined whether their sexual partners had redundant prepuce or phimosis according to the schematic illustrations we offered. We used biology-hybridize HPV-type test kit, PCR and hybrid membrane methods for detection of different HPV genotypes in cervical exfoliated cells, taking any type of HPV detected as positive. We made between-group comparisons by chi-square test and analyzed independent risk factors by non-conditional logistic regression analysis.

RESULTSOf the 2 040 questionnaires, 1 568 were collected and 1 110 (71%) accepted as valid by inclusion criteria. Among the 1 110 subjects, 566 (50.9%) were infected with HPV, and 445 (78.6%) of the infected women admitted that their sexual partners had redundant prepuce or phimosis. The most frequent infection type was HPV16 (34.2%), followed by HPV58 (28.1%), HPV52 (20.2%) and HPV18 (10.8%). Multivariate logistic regression analysis suggested that redundant prepuce or phimosis in the women's sexual partners was an independent risk factor for HPV infection (OR 3.387, 95%CI [2.491-4.607]).

CONCLUSIONIn Nanjing urban area, the majority of the sexual partners of the HPV-infected women have redundant prepuce or phimosis, which is an independent risk factor for female cervical HPV infection. Male circumcision is necessitated in Nanjing to reduce the incidence of cervical HPV infection.

Adult ; Aged ; Cervix Uteri ; virology ; China ; epidemiology ; Female ; Foreskin ; virology ; Humans ; Male ; Middle Aged ; Papillomavirus Infections ; epidemiology ; virology ; Phimosis ; virology ; Retrospective Studies ; Risk Factors ; Sexual Partners ; Young Adult

OBJECTIVEDiscussion of the relationship between cervical cytology and high-risk HPV test and lesions in the cervical tissue.

METHODThe 254 infertile patients were graded into 4 groups based on the results of cervical cytology and high-risk HPV test. The patients in group A were the cervical cytology -positive and HPV-positive. The cervical cytology -positive and HPV-negative patients were in group B. The cervical cytology -negative and HPV-positive patients were in group C and cervical cytology -negative and HPV-negative in group D. Retrospective analysis was used in the relationship between the results and lesions in the cervical tissue.

RESULTSThe incidence of CIN II and higher grade than CIN II was significant higher in group A than in group B (P < 0.01). The incidence of CIN I was no difference among A, B and C group (P > 0.05). The sensitivity was 100.0% and the specificity was 46.74% when cervical cytology was used to test the CIN II grade. But the sensitivity changed to 97.22% and the specificity 87.16% when both of the cervical cytology and HPV test were used.

CONCLUSIONThe cervical cytology is the first choice in cervical examination. And the accuracy will significant higher when the HPV test is used simultaneously.

Adult ; Alphapapillomavirus ; classification ; genetics ; isolation & purification ; Cervix Uteri ; pathology ; virology ; Female ; Humans ; Infertility, Female ; diagnosis ; pathology ; virology ; Papillomavirus Infections ; diagnosis ; pathology ; virology ; Vaginal Smears ; Young Adult

PURPOSE: Human papillomavirus (HPV) infection is a well-known cause of cervical cancer, which, along with its precursors, can be diagnosed and treated with cervical conization (CC). This study aimed to assess HPV- and procedure-related knowledge among women who had undergone CC. MATERIALS AND METHODS: Between February and May 2014, consecutive women who had undergone CC at five different educational hospitals were recruited. All patients had undergone a loop electrosurgical excision procedure as the method of CC. A survey was conducted with a self-developed, 29-item questionnaire, measuring knowledge related to HPV and CC. We analyzed the responses of 160 patients who completed the questionnaire. RESULTS: Mean total knowledge scores (±standard deviation) for HPV and CC were 5.2±3.0 of a possible 13.0 and 8.3±4.2 of a possible 16.0, respectively. While 73% of the patients knew that HPV is the main cause of cervical cancer, only 44% knew that HPV is sexually transmitted. The purpose of CC was correctly identified by 71% of the patients. However, 35% failed to indicate the anatomical area resected at the time of CC in the schematic diagram. Women who were younger (p<0.001), had higher education level (p<0.001), and higher family income (p=0.008) had higher knowledge scores. In contrast, neither interval from CC to survey nor disease severity were associated with total knowledge score. CONCLUSION: The level of knowledge related to HPV and CC was unexpectedly low in women who had undergone CC. Intuitive educational resources may improve this knowledge, and further cohort studies are warranted.
Adult ; Cervix Uteri/*pathology/*virology ; *Conization ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Middle Aged ; Papillomaviridae/*physiology ; Republic of Korea ; Sexual Behavior ; *Surveys and Questionnaires ; Uterine Cervical Neoplasms/virology ; Young Adult

OBJECTIVETo detect the human papillomavirus (HPV) infectious condition in women with abnormal cytology and evaluate its values in the screening of high grade cervical intraepithelial lesion.

METHOD101 patients who underwent thinprep cell test(TCT) with abnormal cervical cytology were selected to undergo HPV test, all subjects also received tissue biopsy at the same time.

RESULTS(1) Among the 101 patients,the incidence rates of high risk HPV infection of those with ASCUS, LSIL, HSIL and squamous cell carcinoma were 84.2%, 88.6%, 100.0% and 2/2 respectively. (2) Among the patients with abnormal cytology,the number of patients with pathologically confirmed results of CIN I and CIN II or worse were 20 and 81, the incidence rates of high risk HPV infection of those with CIN I and CIN II or worse were 60.0% and 97.5% respectively. (3) In the ASCUS group, the incidence rates of CIN II or worse with high risk HPV infection were 87.5% and the incidence rates of CIN II or worse without high risk HPV infection were 16.7%. (4) The prevalence of high risk HPV types from highest to lowest order were follow: HPV16 (39.6%), 58 (17.8%), 52 (16.8%), 18 (9.9%), 33 (9.9%).

CONCLUSIONSThe infection rate of high risk HPV was positively correlated with the levels of cervical lesions. HPV test is a good triage approach for the patients with ASCUS. HPV16, 58, 52, 18, 33 are the most common in the patients of cervical lesions.

Adult ; Alphapapillomavirus ; genetics ; isolation & purification ; Cervix Uteri ; cytology ; pathology ; virology ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; diagnosis ; pathology ; virology ; Young Adult

OBJECTIVETo study the clinical efficacy and mechanisms of Youdujing (YDJ) preparation in treating the cervical high-risk human papilloma virus (HR-HPV) infection.

METHODSTotally HR-HPV infection 70 patients were assigned to the treatment group and the control group using random single blind method, 35 cases in each group. YDJ external lotion and YDJ cream were applied to patients in the treatment group, while normal saline was applied for those in the control group. HR-HPV DNA detection was performed by the end of the 1st menstruation after 3 menstrual cycles. The cervical biopsy and cervical smear were performed using vaginoscope before and after treatment. The mRNA expression of human telomerase reverse transcriptase (hTERT) was detected from fresh tissues of the cervical lesion.

RESULTSThe total effective rate was 96.6% in the treatment group, higher than that of the control group (70.00%, P<0.01). Before treatment there was no statistical difference in the pathological results of the cervix and the mRNA expression of hTERT between the two groups (P>0.05). The mRNA expression of hTERT decreased in the two groups after treatment, showing statistical difference (P<0.01). Better effects on the pathological results of the cervix and the mRNA expression of hTERT were obtained in the treatment group after treatment (P<0.05).

CONCLUSIONYDJ played a role in clearing HR-HPV infection and reversing the cervical precancerous changes possibly through down-regulating the mRNA expression of hTERT and lowering the telomerase activation.

Adult ; Cervix Uteri ; virology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Papillomaviridae ; Papillomavirus Infections ; drug therapy ; virology ; Phytotherapy ; RNA, Messenger ; genetics ; Single-Blind Method ; Telomerase ; metabolism ; Treatment Outcome

AIMTo investigate whether urine is a good medium for screening and whether there is a correlation between the amount of extracted DNA and human papillomavirus (HPV)-positivity.

METHODSIn the present study, 30 first-voided urine (FVU) specimens and 20 urethroglandular swabs using cervex-brushes from male partners of HPV-positive patients, and 31 FVU specimens and 100 liquid-based cervix cytology leftovers sampled with cervix-brushes from HPV-positive women were examined for the presence of beta-globin. Oncogenic HPV were detected using type-specific PCR.

RESULTSbeta-globin was found in all the brushed samples, whereas it was found in only 68.9% of the FVU specimens. HPV-PCR was positive in 60.0% of the male brushes, in 29% of the female brushes and in 0% of the male FVU specimens. DNA concentration was, respectively, 0.9998 ng/microL, 37.0598 ng/microL and 0.0207 ng/microL.

CONCLUSIONUrine is not a good tool for HPV detection, probably because the low DNA concentration reflects a low amount of collected cells. beta-globin is measurable in FVU by real time quantitative PCR, but the DNA concentration is lower compared to brush sampling for both genders. beta-globin-positivity of urethral and cervical swabs is 100%, showing a higher mean concentration of DNA, leading to a higher detection rate of HPV. This is the first article linking DNA-concentration to the presence of HPV.

Alphapapillomavirus ; genetics ; isolation & purification ; Cervix Uteri ; virology ; DNA, Viral ; genetics ; isolation & purification ; Female ; Globins ; urine ; Humans ; Male ; Papillomavirus Infections ; diagnosis ; epidemiology ; urine ; Polymerase Chain Reaction ; Urine ; virology

OBJECTIVETo evaluate the diagnostic performance of different specimens for detecting CIN2(+), and to find the solution of the problem that why the performance of self-collected specimen is worse than cervical specimen collected by physician.

METHODSThe cervix, lower 1/3 vagina, upper 1/3 vagina and self-collected specimens from each of the 806 women who took part in this multi-center screening program from May 2006 to April 2007 were tested by hybrid capture 2 (HC2) technique. The diagnostic performance of HC2 on the four specimens for detecting CIN2(+) lesions was calculated. Linear array was performed on the four specimens from 489 out of the 806 women and the diagnostic performance of linear array on the four specimens for detecting CIN2(+) lesions was also calculated. Z test was used to compare the area under ROC and McNemar or χ(2) test was used to compare the sensitivity and specificity of different specimens.

RESULTSThe area under ROC of the cervix, 1/3 upper vagina, 1/3 lower vagina and self-collected samples testing by HC2 for detecting CIN2(+) lesions were 0.902, 0.793, 0.769 and 0.773, respectively (P < 0.001). Using 1 RUL/CO as the cut-point of HC2, the sensitivity of the cervix, upper vagina, lower vagina and self-collected samples were 98.0%, 91.8%, 83.7% and 81.6%. Compared with the cervical specimen, the sensitivity of self-collected specimen for detecting CIN2(+) lesions was significantly lower (P = 0.008). Lowering the cutoff value for HC2 test could improve the sensitivity of self-collected specimen, but it significantly compromised the specificity. The sensitivity of self-collected specimen tested by linear array for detecting CIN2(+) lesions was 95.7% and it was not significantly different compared with the sensitivity of cervical specimen (97.9%) tested by HC2.

CONCLUSIONSThe performance of self-collected specimen tested by HC2 for detecting CIN2(+) lesions is lower than that of physician-collected cervical specimen, and lowering the cutoff value can't improve its diagnostic performance. Using linear array as the HPV DNA test can significantly improve the screening diagnostic performance of self-collected specimens.

Adolescent ; Cervical Intraepithelial Neoplasia ; diagnosis ; virology ; Cervix Uteri ; virology ; DNA, Viral ; analysis ; Female ; Human Papillomavirus DNA Tests ; Humans ; Mass Screening ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; diagnosis ; virology ; Self-Examination ; Specimen Handling ; methods ; Uterine Cervical Neoplasms ; diagnosis ; virology ; Vagina ; virology

OBJECTIVETo evaluate the value of high-risk HPV (hrHPV) detection by Hybrid Capture II (HC2) in screening cervical intraepithelial neoplasm (CIN).

METHODSTotally 723 patients who had received a dual screening with thinprep cytologic test (TCT) and HC2 in our department were analyzed retrospectively. Among them, 350 patients received a triple examination with TCT, HC2, and colposcopic biopsy.

RESULTSAmong the 723 patients, the incidences of hrHPV infection with atypical squamous cell (ASC), low squamous intraepithelial lesion, and high squamous intraepithelial lesion were 70.7% (94/133), 88.9% (249/280), and 90.9% (90/99), respectively, significantly higher than 55.5% (117/211), the incidence of hrHPV infection with normal cytological results (P = 0.005, P < 0.001, P < 0.001, respectively). Among 350 cases who were received triple examination, the incidence of hrHPV infection with cervical intraepithelial neoplasia (CIN) 1 and CIN 2 were 88.9% (72/81) and 96.3% (52/54), significantly higher than 77.7% (153/197), the incidence of hrHPV infection with normal pathological results (P = 0.03, P = 0.002); The incidence of hrHPV infection with CIN 3 and squamous cancer were 91.7% (11/12) and 100.0% (6/6), also higher than normal cases. Among these 350 cases, the incidence of hrHPV infection with ASC was 79.3% (69/87). The incidence of CIN 2-3 with ASC and hrHPV infection was 38.0%, significantly higher than the incidence of CIN 2-3 with ASC and without hrHPV infection (5.9%) (P = 0.04).

CONCLUSIONhrHPV infection has a close relation with CIN, and the incidence of hrHPV infection increases along with the severity of CIN.

Adolescent ; Adult ; Cervical Intraepithelial Neoplasia ; virology ; Cervix Uteri ; pathology ; virology ; Female ; Human papillomavirus 16 ; isolation & purification ; Human papillomavirus 18 ; isolation & purification ; Humans ; Middle Aged ; Nucleic Acid Hybridization ; methods ; Papillomavirus Infections ; epidemiology ; virology ; Uterine Cervical Neoplasms ; virology

OBJECTIVETo determine the association between viral load of high risk human papillomavirus (HR-HPV) and cervical intraepithelial neoplasia (CIN).

METHODSCervical exfoliated cells were collected from 18 186 women aged 17 -59 from six urban areas and eight rural areas when they were screened in the cross-sectional population-based studies from 1999 to 2008. HR-HPV was detected by the Hybrid Capture 2 (hc2) system, and viral load was measured by the ratio of relative light units to standard positive control (RLU/PC). RLU/PC was categorized for analysis into four groups: negative [0, 1.00), low viral load [1.0, 10.00), moderate viral load [10.00, 100.00), and high viral load > or = 100.00. Cervical lesions were diagnosed by biopsies as normal, CIN 1, CIN 2, CIN 3 and squamous cervical cancer (SCC). Association between HR-HPV viral load and CIN was evaluated by unconditional multinomial logistic regression.

RESULTSThe HR-HPV infection rate of the population was 14.51% (2515/17334). 100.00% (29/29) of SCC, 97.63% (206/211) of CIN 3, 93.43% (199/213) of CIN 2, 75.04% (421/561) of CIN 1 and 10.17% (1660/16320) of normal women were positive for HR-HPV DNA. The median RLUs for the HR-HPV positive women with SCC, CIN 3, CIN 2, CIN 1 and normal were 320.85, 158.05, 143.70, 125.34 and 9.64, respectively. There were significant differences among the distributions of viral loads in each lesion (chi2 = 6190.40, P < 0.01). The severity of CIN increased with the viral load (chi2 = 5493.35, P <0.01). Compared with the risks of CINs in HR-HPV negative population, the risks of CINs in low, moderate and high viral loads were increased gradually [OR(95% CI) : CIN 1 : 9.01(6.31 - 12.87), 24.96(18.23 - 34.17) and 68.42(51.40 - 91.08); CIN 2 : 26.44(12.07 - 57.95), 98.53(49.54 - 195.98) and 322.88(168.62 - 618.27); CIN 3+ : 72.89(24.02-221.18); 343.58(121.81-969.09) and >999.99(473.38 - >999.99)], and there were obvious dose-response relationships (chi2trend was 3115.05, 2413.95 and 3098.57, respectively. P< 0.01). In each age group of the HR-HPV positive population,the risks of CIN 2 + in the women with moderate or high viral load were higher than the one with low viral load [OR(95% CI): <35 : 4.71(1.23 - 18.09) and 15.06(4.40 - 51.49); 35 -: 4.01 (1.62 -9.90) and 14.09(6.15 -32.28); 40 - : 3.06(1.52 -6.16) and 7.78(4.05 -14.95); > or =45: 3.50(1.36 -9. 01) and 7.57(3.13 - 18. 30)], and there was a positive correlation between the risk of CIN 2+ and the viral load (chi2trend was 51.33, 66.28, 53.64 and 51.00, respectively. P <0.01). The risk of CIN 2 + was highest among the women aged 40 - with high viral load [OR (95% CI) : 2.02 (1.15 - 3.52)].

CONCLUSIONThere is strong correlation between the HR-HPV viral load and the severity of CIN, and so is the correlation between the HR-HPV viral load and the risk of CIN 2 +. A moderate to high viral load of HR-HPV should be the major risk factor for the cervical cancer and CIN 2 and CIN 3, and there is a higher risk in the women aged 35 or older than the younger ones. Considering both the age and viral load could help the doctors to manage the screening women more effectively.

Adult ; Cervical Intraepithelial Neoplasia ; epidemiology ; pathology ; virology ; Cervix Uteri ; pathology ; virology ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; epidemiology ; pathology ; virology ; Risk Factors ; Uterine Cervical Neoplasms ; epidemiology ; pathology ; virology ; Viral Load