九价HPV疫苗所针对的高危型HPV亚型在宫颈癌及其癌前病变中应用有效性的初步预测

发布时间：2018-03-20 18:19

本文选题：基因型别　切入点：九价人乳头状瘤病毒疫苗　出处：《中国癌症杂志》2017年07期 　论文类型：期刊论文

【摘要】：背景与目的:宫颈癌是世界范围内女性第4常见的恶性肿瘤,在我国其发病率和死亡率都呈上升趋势,高危型人乳头状瘤病毒(high-risk human papillomavirus,hr HPV)持续感染与浸润宫颈癌(invasive cervical carcinoma,ICC)及其癌前病变的发生、发展关系密切,HPV预防性疫苗的研制应用成为宫颈癌一级预防的有效措施。该研究拟通过分析九价HPV疫苗所针对的7种HPV高危亚型(HPV16、18、31、33、45、52和58)在经组织学证实的宫颈癌及癌前病变中的分布,为九价疫苗在本地区人群的应用前景评估提供更多依据。方法:回顾性收集复旦大学附属肿瘤医院病理科行聚合酶链反应-反向点杂交法(polymerase chain reaction-reverse dot blot,PCR-RDB)进行HPV基因分型检测的患者,经计算HPV阳性患者中特定HPV亚型的阳性比例来评价HPV亚型对宫颈癌及其癌前病变的相对贡献。采用比例权重归因(proportional weighting attribution,PWA)方法将多重感染中亚型占比折算至相应的单型别感染。结果:符合入组条件者共计624例,分别为117例未见上皮内病变及恶性病变(negative for intraepithelial lesion or malignancy,NILM),45例低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL),268例高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)和194例ICC。HPV总感染率为84.29%(526/624),在LSIL、HSIL及ICC组中的感染率分别为71.11%,95.90%及91.75%。HPV16/18 PWA合计占比在LSIL、HSIL和ICC组中依次上升,分别为50.00%、70.44%和91.71%。九价疫苗针对的7种hr HPV的PWA合计占比均较HPV16/18提高,在LSIL、HSIL和ICC中分别为86.34%,98.61%和94.89%。额外增加的5种hr HPV(HPV31、33、45、52和58)的相对贡献在LSIL、HSIL和ICC组中依次下降,分别为36.34%、28.17%和3.18%。结论:九价疫苗额外增加的5种hr HPV型别在本地区有望令更高比例的ICC及癌前病变得到预防,尤其对于LSIL和HSIL的预防有较大改善。
[Abstract]:Background & objective: cervical cancer is the fourth most common malignant tumor in women in the world. The morbidity and mortality of cervical cancer are on the rise in China. High risk human papillomavirus (HPV) infection and invasive cervical carcinomatosis of cervical cancer and its precancerous lesions, The development and application of HPV-prophylaxis vaccine has become an effective measure for primary prevention of cervical cancer. This study is intended to be based on histologically proven cervical cancer by analyzing seven HPV high-risk subtypes of HPV16, HPV16, HPV16, HPV16, HPV16, and HPV3, 3HPV3, 4552, and 58, which are highly effective in the prevention of cervical cancer. And the distribution of precancerous lesions, Methods: polymerase chain reaction-reverse dot blotblotPCR-RDBs were collected from the Department of Pathology, affiliated Cancer Hospital of Fudan University. The patients tested for typing, The relative contribution of HPV subtype to cervical cancer and its precancerous lesions was evaluated by calculating the positive ratio of specific HPV subtypes in HPV positive patients. Results: a total of 624 patients met the requirements of the group. The total infection rates of 48 cases of low-grade squamous intraepithelial lesioning and 268 cases of high-grade squamous intraepithelial lesions with high grade squamous intraepithelial lesions and 194 cases with ICC.HPV were 84.2929 52662424% and 84.2929% 526624%, respectively, in 45 cases of low-grade squamous intraepithelial lesionism and 268 cases of high-grade squamous intraepithelial lesions. The total infection rates of 44 cases of ICC.HPV were 84.2929% 526% 62424%, respectively. The total infection rate was 84.29% in the LSILHIL group and in the ICC group. The total infection rate was 84.29% in the LSILHIL group and in the ICC group. The infection rate was 71.115.90% and 91.75.HPV16 / 18 PWA, respectively. The percentage of HPV16 / 18 PWA increased in turn in the group of Lsil HSIL and ICC. 70.44% and 91.71%, respectively, of the seven kinds of hr HPV targeted by the nine-valent vaccine were higher than that of HPV16/18, respectively, and the relative contributions of the additional five kinds of HPV-HPV333455C52 and 58 in Lsil HSIL and ICC decreased respectively in Lsil HSIL and ICC groups. Conclusion: the five additional hr HPV types of nine-valent vaccine are expected to prevent a higher proportion of ICC and precancerous lesions in the region, especially for the prevention of LSIL and HSIL.
【作者单位】：复旦大学附属肿瘤医院病理科复旦大学上海医学院肿瘤学系;复旦大学附属肿瘤医院妇瘤科复旦大学上海医学院肿瘤学系;
【基金】：国家自然科学基金青年科学基金项目(81101956/H1621)
【分类号】：R737.33

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