2.Research progress in diagnosis and treatment of HPV-associated oropharyngeal squamous cell carcinoma.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(9):734-739
Oropharyngeal carcinoma is one of the most common malignant tumors of head and neck. In recent years, the incidence of Human papilloma virus-associated oropharyngeal squamous cell carcinoma(HPV-OPSCC) has been increasing year by year. With the advancement of minimally invasive surgical techniques, the wide application of intensity modulated radiation therapy, and the demand of patients for organ function protection and higher quality of life, the unique biological behavior and better prognosis of HPV-OPSCC have led to the exploration of a series of attenuated treatment modes. This article reviews the diagnosis and treatment status of oropharyngeal cancer and related research progress based on relevant reports.
Humans
;
Papillomavirus Infections/diagnosis*
;
Quality of Life
;
Squamous Cell Carcinoma of Head and Neck/therapy*
;
Head
;
Human Papillomavirus Viruses
;
Oropharyngeal Neoplasms/therapy*
;
Head and Neck Neoplasms
3.Research progress on the treatment improvement of HPV-associated oropharyngeal cancer.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(9):740-747
The number of new cases of oropharyngeal cancer is increasing year by year among the world, and HPV infection is one of the risk factors for this malignant tumor. Compared with HPV-negative oropharyngeal cancer, HPV-positive patients are more sensitive to radiotherapy and have a better prognosis, but there is no accepted treatment for HPV-positive patients. Reducing treatment intensity moderately and exploring the best option to minimize side effects of treatment are urgent issues to be addressed. This article reviews the research progress on the treatment improvement of HPV-associated oropharyngeal cancer in recent years.
Humans
;
Papillomavirus Infections
;
Oropharyngeal Neoplasms/therapy*
;
Risk Factors
4.Infection of human papillomavirus and head and neck cancer.
Cheng SONG ; Shao Kai ZHANG ; You Lin QIAO
Chinese Journal of Oncology 2023;45(1):39-43
High-risk human papillomavirus (HPV)-related cancers consist of cervical cancer, anal cancer, penile cancer, vulvar cancer, vaginal cancer, and head and neck cancer (HNC). Of these, the disease burden of HNC is second only to cervical cancer. HNC mostly originates from malignant lesions of squamous epithelial cells and mainly includes oral cavity cancer, pharyngeal cancer (including nasopharyngeal cancer, oropharyngeal cancer, and hypopharyngeal cancer), and laryngeal cancer. Tobacco use, alcohol abuse, and HPV infection are three primary risk factors. Recently, there is an upward trend of HNC incidence globally, especially in high-income countries. In China, the disease burden and trends of HPV-related HNC are still not clear. A few small sample size and single-center studies suggest a high HPV prevalence and increasing trend in HNC. Methodological differences in HPV testing and regional variabilities still exist among these studies. Among the anatomic sites, oropharyngeal cancer has been shown to be caused by HPV infection, but the association of HPV with other sites is still under debate. In addition, there is a paucity of relevant studies. Here, this review narrates the association between HPV infection and HNC, compares the differences between global and Chinese studies, and then explores the importance of HPV infection in various anatomical sites. The main objective is to highlight the research on HPV-related HNC and promote relevant prevention and treatment programs.
Female
;
Humans
;
Human Papillomavirus Viruses
;
Papillomavirus Infections/prevention & control*
;
Uterine Cervical Neoplasms/complications*
;
Nasopharyngeal Neoplasms/complications*
;
Head and Neck Neoplasms/epidemiology*
;
Oropharyngeal Neoplasms/epidemiology*
;
Papillomaviridae
5.The characteristics and correlations of vaginal flora in women with cervical lesions.
Ming Xuan ZHANG ; Jia Hao WANG ; Le ZHANG ; Jia Xin YAN ; Cai Hong WU ; Rui Xin PEI ; Yuan Jing LYU ; Li SONG ; Meng CUI ; Ling DING ; Zhi Lian WANG ; Jin Tao WANG
Chinese Journal of Oncology 2023;45(3):253-258
Objective: To explore the characteristics and correlations of vaginal flora in women with cervical lesions. Methods: A total of 132 women, including 41 women diagnosed with normal cervical (NC), 39 patients with low-grade cervical intraepithelial neoplasia (CIN 1), 37 patients with high-grade cervical intraepithelial neoplasia (CIN 2/3) and 15 patients with cervical squamous cell carcinoma (SCC), who came from the gynecological clinic of Second Hospital of Shanxi Medical University during January 2018 to June 2018, were enrolled in this study according to the inclusive and exclusive criteria strictly. The vaginal flora was detected by 16S rDNA sequencing technology. Co-occurrence network analysis was used to investigate the Spearman correlations between different genera of bacteria. Results: The dominant bacteria in NC, CIN 1 and CIN 2/3 groups were Lactobacillus [constituent ratios 79.4% (1 869 598/2 354 098), 63.6% (1 536 466/2 415 100) and 58.3% (1 342 896/2 301 536), respectively], while Peptophilus [20.4% (246 072/1 205 154) ] was the dominant bacteria in SCC group. With the aggravation of cervical lesions, the diversity of vaginal flora gradually increased (Shannon index: F=6.39, P=0.001; Simpson index: F=3.95, P=0.012). During the cervical lesion progress, the ratio of Lactobacillus gradually decreased, the ratio of other anaerobes such as Peptophilus, Sneathia, Prevotella and etc. gradually increased, and the differential bacteria (LDA score >3.5) gradually evolved from Lactobacillus to other anaerobes. The top 10 relative abundance bacteria, spearman correlation coefficient>0.4 and P<0.05 were selected. Co-occurrence network analysis showed that Prevotella, Peptophilus, Porphyrinomonas, Anaerococcus, Sneathia, Atopobium, Gardnerella and Streptococcus were positively correlated in different stages of cervical lesions, while Lactobacillus was negatively correlated with the above anaerobes. It was found that the relationship between vaginal floras in CIN 1 group was the most complex and only Peptophilus was significantly negatively correlated with Lactobacillus in SCC group. Conclusions: The increased diversity and changed correlations between vaginal floras are closely related to cervical lesions. Peptophilus is of great significance in the diagnosis, prediction and early warning of cervical carcinogenesis.
Female
;
Humans
;
Vagina/microbiology*
;
Uterine Cervical Neoplasms/genetics*
;
Uterine Cervical Dysplasia
;
Cervix Uteri
;
Lactobacillus/genetics*
;
Papillomavirus Infections
6.Expert consensus on the immunization strategy and practice of human papillomavirus vaccine for female adolescents in the Yangtze River Delta region.
Chinese Journal of Preventive Medicine 2023;57(2):135-153
Persistent infection of high-risk human papillomavirus (HPV) is the leading cause of cervical cancer. In order to achieve the goal of cervical cancer elimination, the World Health Organization (WHO) proposed the "90-70-90" goal, one of which is "90% of girls fully vaccinated with HPV vaccine by age 15 years". Based on the epidemiological characteristics of HPV infection and the characteristics of HPV vaccine, it is important to give priority to female adolescents to be vaccinated with HPV vaccine. CAV Affiliated Association for Standardized Management and Practice of Immunization Program organized an expert group to develop an expert consensus on the immunization strategy and practice of human papillomavirus vaccine for female adolescents in the Yangtze River Delta region. This consensus introduces HPV infection and related disease burden, safety, efficacy and effectiveness of HPV vaccination for female adolescents, factors affecting the health benefits of HPV vaccination for female adolescents, current HPV vaccination strategies for female adolescents, the expert advice, common problems and precautions in the Yangtze River Delta region. This consensus is developed to guide HPV vaccination for female adolescents in the Yangtze River Delta region and provide reference for other regions.
Female
;
Adolescent
;
Humans
;
Papillomavirus Vaccines
;
Papillomavirus Infections/prevention & control*
;
Human Papillomavirus Viruses
;
Uterine Cervical Neoplasms/prevention & control*
;
Consensus
;
Vaccination
;
Immunization Programs
7.Application of multiplex PCR capillary electrophoresis and analysis of distribution characteristics of HPV infection subtypes.
Yuan GAO ; Yue JIANG ; Yan Qing TIE ; Ding YU ; Meng Chuan ZHAO ; He TAN ; Zhi Peng TANG ; Wen Chao ZHANG ; Zhi Shan FENG
Chinese Journal of Preventive Medicine 2023;57(3):393-399
Objective: To analyze the characteristics of human papillomavirus (HPV) infection and the distribution of HPV subtypes in Shijiazhuang, Hebei Province, and to explore the application evaluation of multiple PCR capillary electrophoresis fragment analysis for HPV typing test. Methods: A population-based cross-sectional study was conducted among 434 women (age range 17 to 74 years old, 260 patients and 174 physical examinations) included from May to August 2022 in Hebei General Hospital. HPV typing was detected by multiple PCR-capillary electrophoresis fragment analysis. Using the multiple fluorescence quantitative PCR kit as a reference, Chi-square test was used to analyze the diagnostic effect of multiple PCR-capillary electrophoresis fragment analysis, and the consistency was analyzed by Kappa value. Results: The total HPV infection rate was 45.85%(199/434), including 35.48% (154/434) of high-risk HPV (HR-HPV), 3.92% (17/434) of low-risk HPV (LR-HPV), 6.45% (28/434) of HR-HPV and LR-HPV mixed infection, 27.88% (121/434) of single type HPV and 17.97% (78/434) of multi type HPV. HPV52 (9.68%, 42/434), HPV16 (6.91%, 30/434), and HPV58 (6.91%, 30/434) are common HPV subtypes. The positive rate of physical examination was 45.40% (79/174), which was slightly lower than that of patients 46.15% (120/260), there was no significant difference (χ2=0.024,P>0.05). The highest infection rate in the 17-30 age group was 54.76% (46/84), and there was no statistical difference among the age groups(χ2=4.123,P>0.05). The sensitivity and specificity of multiplex PCR capillary electrophoresis fragment analysis were 92.96% and 94.04%, respectively, and Kappa value was 0.870, with the multiplex fluorescent quantitative PCR as the reference. Conclusion: HPV infection may appear younger, and the positive rate of HR-HPV infection is the highest, with HPV52, 16, 58 as the main infection subtypes. The detection results of multiplex PCR capillary electrophoresis fragment analysis method are highly consistent with those of multiplex fluorescent quantitative PCR method, which is suitable for HPV DNA typing.
Humans
;
Female
;
Adolescent
;
Young Adult
;
Adult
;
Middle Aged
;
Aged
;
Uterine Cervical Neoplasms
;
Multiplex Polymerase Chain Reaction
;
Papillomavirus Infections/diagnosis*
;
Cross-Sectional Studies
;
Genotype
;
Papillomaviridae/genetics*
8.Improved population coverage of the human papillomavirus vaccine after implementation of a school-based vaccination programme: the Singapore experience.
Karuppiah VIJAYALAKSHMI ; Anne Hui Yi GOEI
Singapore medical journal 2023;64(5):294-301
INTRODUCTION:
Cervical cancer has a high disease burden in Singapore, and it is strongly associated with human papillomavirus (HPV) infections. Despite constant efforts to encourage vaccination, local HPV vaccine uptake remains low. Universal mass vaccination is a proven cost-effective method to reduce the cervical cancer disease burden. This paper reviews the newly implemented school-based HPV vaccination programme in Singapore and the factors that led to its success.
METHODS:
Fully subsidised HPV vaccinations were offered to all Secondary 1 female students on an opt-in basis, starting as a rollout dose in 2019. One-time catchup vaccination was also offered to female students in Secondary 2-5. Eligible recipients were identified using enrolment data provided by Ministry of Education schools. A total of 19,144 students across 139 schools were offered the rollout dose, and 20,854 students across 140 schools were offered the catchup doses.
RESULTS:
High vaccine uptake rates of 80.6%-87.3% were noted with the introduction of the school-based programme, translating to high vaccine coverage of 90.3%-93.4%. Only a small proportion of students (1.5%-1.9% per cohort) opted out. The rate of reported side effects, which were commonly known effects, was low at one in 1000. Among the students who reported side effects, those who received the second vaccine dose did so uneventfully.
CONCLUSION
High HPV vaccine coverage was achieved after implementation of the school-based immunisation programme. Timely assessment of knowledge lapses and targeted intervention, strong partnerships with stakeholders, constant on-site adaptation and positive social influence contributed to its success. This model can be applied to future school health programmes.
Humans
;
Female
;
Papillomavirus Vaccines/therapeutic use*
;
Human Papillomavirus Viruses
;
Papillomavirus Infections/prevention & control*
;
Singapore
;
Uterine Cervical Neoplasms/epidemiology*
;
Vaccination
;
Immunization Programs
9.Assessment of the diagnostic value and prognosis of different detection markers in endocervical adenocarcinoma.
Chang Ning ZHANG ; Xiao Yang LIU ; Qing LI ; Yi Zhe SONG ; Bin LIU ; Jian YIN ; Jing Hong YANG ; Li ZHONG ; Li SUN ; Xun ZHANG ; Wen CHEN
Chinese Journal of Oncology 2023;45(5):402-409
Objective: To study the diagnostic value of different detection markers in histological categories of endocervical adenocarcinoma (ECA), and their assessment of patient prognosis. Methods: A retrospective study of 54 patients with ECA in the Cancer Hospital, Chinese Academy of Medical Sciences from 2005-2010 were performed. The cases of ECA were classified into two categories, namely human papillomavirus-associated adenocarcinoma (HPVA) and non-human papillomavirus-associated adenocarcinoma (NHPVA), based on the 2018 international endocervical adenocarcinoma criteria and classification (IECC). To detect HR-HPV DNA and HR-HPV E6/E7 mRNA in all patients, we used whole tissue section PCR (WTS-PCR) and HPV E6/E7 mRNA in situ hybridization (ISH) techniques, respectively. Additionally, we performed Laser microdissection PCR (LCM-PCR) on 15 randomly selected HR-HPV DNA-positive cases to confirm the accuracy of the above two assays in identifying ECA lesions. Receiver operating characteristic (ROC) curves were used to analyze the efficacy of markers to identify HPVA and NHPVA. Univariate and multifactorial Cox proportional risk model regression analyses were performed for factors influencing ECA patients' prognoses. Results: Of the 54 patients with ECA, 30 were HPVA and 24 were NHPVA. A total of 96.7% (29/30) of HPVA patients were positive for HR-HPV DNA and 63.3% (19/30) for HR-HPV E6/E7 mRNA, and 33.3% (8/24) of NHPVA patients were positive for HR-HPV DNA and HR-HPV E6/E7 mRNA was not detected (0/24), and the differences were statistically significant (P<0.001). LCM-PCR showed that five patients were positive for HR-HPV DNA in the area of glandular epithelial lesions and others were negative, which was in good agreement with the E6/E7 mRNA ISH assay (Kappa=0.842, P=0.001). Analysis of the ROC results showed that the AUC of HR-HPV DNA, HR-HPV E6/E7 mRNA, and p16 to identify HPVA and NHPVA were 0.817, 0.817, and 0.692, respectively, with sensitivities of 96.7%, 63.3%, and 80.0% and specificities of 66.7%, 100.0%, and 58.3%, respectively. HR-HPV DNA identified HPVA and NHPVA with higher AUC than p16 (P=0.044). The difference in survival rates between HR-HPV DNA (WTS-PCR assay) positive and negative patients was not statistically significant (P=0.156), while the difference in survival rates between HR-HPV E6/E7 mRNA positive and negative patients, and p16 positive and negative patients were statistically significant (both P<0.05). Multifactorial Cox regression analysis showed that International Federation of Obstetrics and Gynecology (FIGO) staging (HR=19.875, 95% CI: 1.526-258.833) and parametrial involvement (HR=14.032, 95% CI: 1.281-153.761) were independent factors influencing the prognosis of patients with ECA. Conclusions: HR-HPV E6/E7 mRNA is more reflective of HPV infection in ECA tissue. The efficacy of HR-HPV E6/E7 mRNA and HR-HPV DNA (WTS-PCR assay) in identifying HPVA and NHPVA is similar, with higher sensitivity of HR-HPV DNA and higher specificity of HR-HPV E6/E7 mRNA. HR-HPV DNA is more effective than p16 in identifying HPVA and NHPVA. HPV E6/E7 mRNA and p16 positive ECA patients have better survival rates than negative.
Female
;
Humans
;
Papillomavirus Infections/diagnosis*
;
Retrospective Studies
;
Uterine Cervical Neoplasms/pathology*
;
Prognosis
;
Oncogene Proteins, Viral/genetics*
;
Human Papillomavirus Viruses
;
Adenocarcinoma/pathology*
;
RNA, Messenger/genetics*
;
Papillomaviridae/genetics*
;
RNA, Viral/genetics*
10.Control study of HPV E6/E7 mRNA and p16 immunohistochemistry detection in oropharyngeal squamous cell carcinoma.
Ye LI ; Lei WANG ; Si xia HUANG ; Jiang Wei LI ; Guo Dong LI ; Yi Fan SHANG ; Di ZHAO ; Yu Jiao WANG ; Wen Jie ZHAO ; Ling Li CHEN ; Wen Cai LI ; Xin Quan LYU
Chinese Journal of Pathology 2023;52(7):727-729
Humans
;
Squamous Cell Carcinoma of Head and Neck
;
RNA, Messenger
;
Immunohistochemistry
;
Papillomavirus Infections/diagnosis*
;
Oncogene Proteins, Viral/genetics*
;
Head and Neck Neoplasms
;
Cyclin-Dependent Kinase Inhibitor p16
;
Papillomaviridae
;
Papillomavirus E7 Proteins/genetics*
;
DNA, Viral

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