The clinical utility of extended high‐risk HPV genotyping in risk‐stratifying women with L‐SIL cytology: A retrospective study of 8726 cases

Tao, Xiang; Zhang, Huina; Zhang, Hao; Xiao, Yaoxing; Zhong, Fangfang; Zhou, Xianrong; Cong, Qing; Sui, Long; Zhao, Chengquan

doi:10.1002/cncy.22573

Cited by 15 publications

(17 citation statements)

References 47 publications

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“…HPV26, a potential hrHPV, had a low prevalence but showed a higher OR for CIN2+ than the majority of traditional hrHPV. One study from our hospital showed that HPV26 was one of the top 5 CIN2+-associated HPV infection types in patients with LSIL cytology [29]. Thus, HPV26 should probably be considered a "high-risk" type.…”

Section: Discussionmentioning

confidence: 96%

Extensive HPV Genotyping Reveals High Association between Multiple Infections and Cervical Lesions in Chinese Women

Zhong

et al. 2022

Disease Markers

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Objective. The relationship between human papillomavirus (HPV) and cervical lesions has been extensively elucidated, but infection with multiple genotypes is less investigated due to methodology limitations. In the current study, with a method of genotyping 21 HPVs in a routine cervical screening population, we aimed to investigate the prevalence and diversity of HPV infections in Chinese women and further evaluate the impact of multiple infections of HPV on cervical lesion progression. Methods. Totally, 73,596 patients who underwent 21-genotype HPV testing from January 2018 to April 2019 were retrieved from the database of the Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University. HPV testing was performed by real-time PCR assay, including 13 high-risk HPVs (hrHPV), 5 potential hrHPVs, and 3 low-risk HPVs. Results. Of the 17,079 (infection rate, 23.2%) hrHPV- or potential hrHPV- (hr/phrHPV-) positive cases, 26.3% had multiple infections. Women younger than 25 and older than 65 were more prone to multiple infections. Of the hr/phrHPV-positive cases involving cervical intraepithelial neoplasia (CIN) 2 or worse (CIN2+), HPV73, 53, and 66 (=59) were the top three genotypes most likely to be included in multiple infections, while HPV16, 18, and 58 were the 3 least. Patients with single infection of HPV16 had higher incidences of CIN2+ than those with multiple-infection pattern ( P < 0.001 ), indicating that mixing with other genotypes alleviated pathogenicity. The infection of HPV52, 53, 56, 51, 39, 66, 59, 68, and 35 showed an opposite pattern, indicating that they were less likely to be pathogens individually. All other types showed no significant differences, indicating the capability of pathogenesis independently. HPV26 showed a higher OR for CIN2+ than most traditional hrHPV genotypes. The vial load and the percentage of HPV16 showed positive correlation with the severity of cervical lesions. Conclusion. Extensive genotyping identified 3 most frequent genotypes, HPV16, 52, and 58, in CIN2+ of Chinese population. HPV16 mixing with other genotypes alleviated its pathogenicity. The vial load and the percentage of HPV16 were positively correlated with the severity of cervical lesions. HPV26 may be considered as a hrHPV, which needs to be evaluated and confirmed by more cases.

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Section: Discussionmentioning

confidence: 96%

Extensive HPV Genotyping Reveals High Association between Multiple Infections and Cervical Lesions in Chinese Women

Zhong

et al. 2022

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“…It has also been identified in Korean and Danish women at prevalences of 9.3% and 1.6%, respectively 32,47 . The prevalence of HPV82 in multiple studies from China has been low (0.6%–1.2%), but accounts for 10%–30.8% of CIN2 + lesions 24,45,46 …”

Section: Discussionmentioning

confidence: 99%

“…32,47 The prevalence of HPV82 in multiple studies from China has been low (0.6%-1.2%), but accounts for 10%-30.8% of CIN2 + lesions. 24,45,46 Our patient cohort was mostly comprised of unvaccinated women who predominantly underwent cervical biopsy due to abnormal cervical screening test results. Although several HPV vaccines are available in China, they have not yet been officially included in the national vaccination program.…”

Section: Distribution Of Hrhpv Genotypes In Endocervical Glandular Le...mentioning

confidence: 99%

“…There are four HPV types which are possibly high-risk that were included in the genotyping panels in this study and which have not been included in US FDA-approved testing kits: HPV26, 53, 73, and 82. HPV53 has been frequently identified in Chinese women, with positivity rates varying from 1.50% to 15.7% in various Chinese populations, 9,[43][44][45][46] and has been identified in cases of CIN2/3. 32 It has also been identified in Korean and Danish women at prevalences of 9.3% and 1.6%, respectively.…”

Section: Distribution Of Hrhpv Genotypes In Endocervical Glandular Le...mentioning

confidence: 99%

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Extended human papillomavirus genotype distribution in cervical intraepithelial neoplasia and cancer: Analysis of 40 352 cases from a large academic gynecologic center in China

Tang

Jones

Jiang

et al. 2022

Journal of Medical Virology

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Our aim was to conduct a large epidemiologic analysis of the distribution of human papilloma virus (HPV) genotypes associated with cervical neoplasias and cancers at a major Chinese gynecologic center. The pathologic database was searched for cervical histopathologic diagnoses with prior HPV genotyping from liquid cervical cytology specimens obtained ≤6 months before biopsy. HPV testing was performed by using the Tellgenplex HPV27 or YanengBio HPV23 genotyping assays. A total of 40 352 cases meeting study criteria were identified. High risk human papillomavirus (hrHPV) was detected in 94.1% of squamous cancers compared to in only 83.3% of cervical adenocarcinomas. The prevalence of multiple HPV infections was highest in cervical intraepithelial neoplasia 1 (CIN1) (33.8%) and decreased with increasing severity of squamous lesions. The distribution of HPV genotypes was similar between CIN1 and histopathologic‐negative cases. HPV16 was one of the three most common hrHPV genotypes before all histopathologic abnormalities, ranging from 72.0% for cervical cancers, 38.7% for CIN2/3/AIS, 13.1% for CIN1, and 9.1% for biopsy‐negative cases. HPV16 and HPV18 accounted for over 87.2% of detected hrHPV genotypes for all glandular intraepithelial neoplastic lesions and cancers, whereas squamous lesions did not show this pattern. 80.3% of cervical cancers were associated with genotypes covered by HPV16/18 vaccines and 89.6% with genotypes covered by 9‐valent vaccination.

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“…HPV is a DNA virus comprising more than 100 genotypes. Thirteen high-risk HPV (hrHPV) types including type 16,18,31,33,35,39,45,51,52,56,58,59, and 68, account for more than 90% of cervical cancers, with HPV16 and HPV18 being the most common oncogenic genotypes. Clinically, hrHPV status is usually determined by HPV pooled assays with limited genotyping (HPV16 and HPV18) (2).…”

Section: Introductionmentioning

confidence: 99%

HPV genotyping of cervical histologic specimens of 61, 422 patients from the largest women hospital in China

et al. 2023

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ObjectivesWe investigated HPV genotypes in a large cohort of patients with definitive cervical histologic diagnosis.MethodsHPV testing was performed by real-time PCR assay, including 18 high-risk HPV (hrHPV) and 3 low-risk HPV (lrHPV). Totally 61,422 patients with documented HPV genotyping results within 6 months before cervical histologic diagnoses were included.ResultsHrHPV positive rate was 55.1% among all tested cases with the highest in adenosquamous carcinoma (94.1%), followed by squamous cell carcinoma (SCC) (93.7%), cervical intraepithelial neoplasia 2/3 (CIN2/3) (92.8%). HrHPV positive rates were significantly higher in high-grade squamous lesions than in those in glandular lesions. HPV16 was the most common genotype followed by HPV52 and HPV58 in CIN2/3. The most frequent hrHPV genotype in adenocarcinoma in situ (AIS) was HPV18, followed by HPV16, HPV45 and HPV52. In SCC cases, HPV16 was the most common type followed by HPV58, HPV52, HPV18 and HPV33. However, HPV18 showed significantly higher prevalence in adenocarcinoma and adenosquamous carcinoma than in that in SCC. Theoretically, the protective rates of 2/4-valent and 9-valent vaccine were 69.1% and 85.8% for cervical cancers.ConclusionsThe prevalence of HPV genotypes in Chinese population was different from that in Western population. Some hrHPV types were identified in cervical precancerous lesions and cancers, which are not included in current HPV vaccines. These data provide baseline knowledge for future HPV vaccine development.

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The clinical utility of extended high‐risk HPV genotyping in risk‐stratifying women with L‐SIL cytology: A retrospective study of 8726 cases

Cited by 15 publications

References 47 publications

Extensive HPV Genotyping Reveals High Association between Multiple Infections and Cervical Lesions in Chinese Women

Extensive HPV Genotyping Reveals High Association between Multiple Infections and Cervical Lesions in Chinese Women

Extended human papillomavirus genotype distribution in cervical intraepithelial neoplasia and cancer: Analysis of 40 352 cases from a large academic gynecologic center in China

HPV genotyping of cervical histologic specimens of 61, 422 patients from the largest women hospital in China

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