Distribution of HPV Genotype in Invasive Cervical Carcinoma and Cervical Intraepithelial Neoplasia in Zhejiang Province, Southeast China: Establishing the Baseline for Surveillance

Abstract

Human papillomavirus (HPV) are firmly established as the principal causative agent for cervical carcinoma. Current vaccines may provide some protection for women from cervical carcinoma linked to HPV genotype 16 and 18. This may be the best vaccine for Western women, but the geographical variation in HPV distributions may not make it the most appropriate vaccine for China or Asia. This study provided an observational, retrospective, hospital-based cross-sectional study on the distribution of HPV genotypes among 5410 women with invasive cervical cancer (ICC) or cervical intraepithelial neoplasia (CIN). Overall, the positive rates of the four HPV types included in current prophylactic vaccines were counted, the two high-risk types (HPV-16 and -18) covered by current vaccines represented 66.9% of women with squamous cancer, 55.0% with adenocarcinoma, 64.9% with adenosquamous carcinoma and 77.4% of other type ICC, as well as 59.5% of CIN III, 45.0% of CIN II and 38.1% of CIN I cases. As expected, two low-risk types (HPV-6 and -11) included in the quadrivalent vaccine did not show good coverage data. Particularly worth mentioning is the fact that the addition of HPV-52 and -58 to the vaccine cocktail would increase cancer protection in our population, potentially preventing up to beyond 16% of squamous/adenosquamous carcinoma and other type of cervical cancers, and 7.75% of adenocarcinomas. It might also potentially reduce the rate of CIN III by a further 28.6% and CIN II and I by a third. This study established the baseline for surveillance in Zhejiang Province, and provides data for further vaccine designs: a quadrivalent HPV vaccine covering HPV-16/-58/-18/-52, would be more welcome in our region in the forthcoming year compared to the currently available vaccine.

Distribution characteristics of different human papillomavirus genotypes in women in Wuhan, China

“…Given that China covers a vast territory, the prevalence patterns differ regionally, even among different regions of mainland China. For example, different prevalence rankings of HPVs are seen in Beijing with HPVs 16, 58, 33, and 36 and Tianjin with HPVs 16, 58, 18, and 66 (both are part of Northern China); Shanghai with HPVs 52, 16, 58, 53, and 33 (Eastern China); Zhejiang Province with HPVs 16, 58, 18, and 52 (Southern China); Wuhan with HPV 52, followed by HPVs 16, 58, 39, 51, and 53 (Central China), as seen in this study; Yunnan province with geographically and ethnically diverse distribution characteristics (Western China). In sum, these regional differences may be due to variation in the ranking of the prevalence estimates of these HPV genotypes by region.…”

“…This method, called HybriMax, can be used to simultaneously identify 21 different HPV genotypes, including 14, 5, and 2 genotypes of HR‐HPVs, LR‐HPVs and unknown‐risk HPVs, respectively. This identification is particularly useful for detecting multiple or coinfections of different HPV genotypes, and HybriMax is a reasonable or even ideal technique for performing HPV genotyping in a clinical setting …”

“…All the DNA samples were amplified using the Real‐Time PCR system ABI 7500 (Applied Biosystems, USA) using a PCR reagent kit (Chaozhou Hybribio Biochemical Co., Ltd.). HPV genotyping was performed with a HybriMax HPV GenoArray Test Kit (HybriBio Ltd., Chaozhou, China) according to the manufacturer’s instructions . Positive and negative controls were run in each PCR analysis process to control for possible contamination and accuracy.…”

“…Wuhan is a city in central China with a 2014 population of 10.34 million, and it is one of the largest cities in China. As China’s population is unvaccinated and represents 19% of the total world population, a large sample size epidemiological study on HPV infection and subtype distribution in this region should be performed to guide the prevention and treatment of cervical cancer. In this study, a total of 13 775 patients from our outpatient department were identified for a molecular epidemiological survey, which may provide evidence for further etiological diagnosis, treatment and prevention in this region.…”

Distribution and role of high‐risk human papillomavirus genotypes in women with cervical intraepithelial neoplasia: A retrospective analysis from Wenzhou, southeast China

“…As etiologic cause of cervical cancer, HPV has been studied in many ways including its prevalence and genotype distribution. The results of relative studies were varied because of different regions, races, age groups, and different methodologies or assays used . This study mainly adds to the growing literature on the prevalence and distribution of HR‐HPV genotypes in CIN.…”