Prevalence of Human Papillomavirus Genotypes Among Women With High-Grade Cervical Lesions in Beijing, China

Abstract

The aim of the study is to investigate the prevalence of high-risk human papillomavirus (hr-HPV) genotypes among Han women with high-grade cervical lesions in Beijing, China.Cervical cell specimens from patients with histopathologically confirmed cervical lesions at 7 hospitals in Beijing were examined with a validated HPV kit for 13 hr-HPV genotypes during the study period. The patients were divided into a low-grade cervical lesions group (cervical intraepithelial neoplasia grade 1, CIN1) and a high-grade cervical lesions group (CIN2+, including cervical intraepithelial neoplasia grade 2, CIN2; cervical intraepithelial neoplasia grade 3, CIN3; squamous cervical cancer, SCC; and adenocarcinoma of the cervix, ACC) based on the histopathology results.A total of 2817 eligible patients were enrolled, including 610 cases identified as CIN1 and 2207 as CIN2+. The hr-HPV positive rates in the CIN1 and CIN2+ groups were 78.2% (477/610) and 93.3% (2060/2207), respectively. The most frequently detected genotypes were HPV16, 58, 52 and18 in the CIN1 group and HPV16, 58, 33, and 52 in the CIN2+ group, in descending order of prevalence. In addition, the prevalence of HPV18 among the patients with ACC was 28.6% (14/49), significantly >7.2% (54/752) prevalence among the SCC patients (P < 0.001). Additionally, significantly more women in the CIN2+ group had multiple infections compared with those in the CIN1 group (38.1% and 24.9%, respectively; P < 0.001). However, as the cervical lesion grade increased, the prevalence of multiple hr-HPV infections gradually deceased to 44.2% in the CIN2 patients, 36.7% in the CIN3 patients, and 35.3% in the cervical cancer (CC) patients, which included SCC and ACC patients. In cases of multiple hr-HPV infections in the CIN2+ group, double infections accounted for ∼76.6%, and HPV16+58, HPV16+52, and HPV16+18 were the most common combinations, in descending order. The most frequent combination for triple infections was HPV16+58+31, with a rate of 4.2%. The highest positive rate occurred in the ≤24 year-old group for all types of cervical lesions.The prevalence of HPV genotypes in the targeted population with high-grade cervical lesions differs from that of other countries. This information could be helpful for the prevention of CC in Beijing, China.

FIGURE 1

Distribution of high-risk human papillomavirus (hr-HPV) in CIN1 (cervical intraepithelial neoplasia grade 1), CIN2 (cervical intraepithelial neoplasia grade 2), CIN3 (cervical intraepithelial neoplasia grade 3), SCC (squamous cervical cancer), ACC (adenocarcinoma of the cervix), and CIN2+ (high-grade cervical lesions, including CIN2, CIN3, SCC, and ACC) patients. ACC = adenocarcinoma of the cervix, CIN1 = cervical intraepithelial neoplasia grade 1, CIN2 = cervical intraepithelial neoplasia grade 2, CIN2+ = (high-grade cervical lesions, including CIN2, CIN3, SCC, and ACC) patients, CIN3 = cervical intraepithelial neoplasia grade 3, hr-HPV = high-risk human papillomavirus, SCC = squamous cervical cancer.

FIGURE 2

(A) Simple and multiple infections by high-risk human papillomavirus (hr-HPV) genotypes in cervical lesions; (B) simple and multiple infections by hr-HPV genotypes in CIN2+ (high-grade cervical lesions, including cervical intraepithelial neoplasia grade 2 [CIN2]), cervical intraepithelial neoplasia grade 3 (CIN3), cervical cancer (CC, including squamous cervical cancer [SCC] and adenocarcinoma of the cervix [ACC]) lesions. ACC = adenocarcinoma of the cervix, CC = cervical cancer, CIN2 = cervical intraepithelial neoplasia grade 2, CIN2+ = (high-grade cervical lesions, including CIN2, CIN3, SCC, and ACC) patients, CIN3 = cervical intraepithelial neoplasia grade 3, hr-HPV = high-risk human papillomavirus, SCC = squamous cervical cancer.

FIGURE 3

(A) Prevalence of high-risk human papillomavirus (hr-HPV) by age group in CIN1 (cervical intraepithelial neoplasia grade 1) and CIN2+ (high-grade cervical lesions, including cervical intraepithelial neoplasia grade 2 [CIN2], cervical intraepithelial neoplasia grade 3 [CIN3], squamous cervical cancer [SCC], and adenocarcinoma of the cervix [ACC]) patients; (B) age-specific distributions of hr-HPV genotypes in CIN2+ patients; (C) age-specific distributions of hr-HPV genotypes in CIN2 patients; (D) age-specific distributions of hr-HPV genotypes in CIN3 patients; (E) age-specific distributions of hr-HPV genotypes in SCC patients; (F) age-specific distributions of hr-HPV genotypes in ACC patients. ACC = adenocarcinoma of the cervix, CC = cervical cancer, CIN2 = cervical intraepithelial neoplasia grade 2, CIN2+ = (high-grade cervical lesions, including CIN2, CIN3, SCC, and ACC) patients, CIN3 = cervical intraepithelial neoplasia grade 3, hr-HPV = high-risk human papillomavirus, SCC = squamous cervical cancer.