Mother-to-Child Transmission of Human Papillomavirus in Burkina Faso

Introduction: Human papillomavirus (HPV) infection is the most widespread sexually transmitted infection in the world. Today, there is growing evidence that HPV can be transmitted early in life, and one potential route is mother-to-child transmission. Data on this route of HPV transmission are scarce in Africa and particularly in Burkina Faso, where no data on the subject are yet available. The aim of our study was to estimate the rate of mother-to-child transmission of HPV infection and to identify circulating genotypes. Methodology: Cervico-uterine samples were collected from 100 full-term pregnant women and, buccal samples were obtained from their newborns at Hopital Saint Camille de Ouagadougou (HOSCO) by the specialist physician. HPV DNA amplification and genotyping were performed by PCR followed by hybridization using the HPV Direct Flow Chips kit, detecting 36 genotypes including 18 high-risk and 18 low-risk. Results: The prevalence of HPV in newborns was 8% (8/100). Six (6) HPV-positive neonates had HPV-positive mothers, while 2 HPV-positive neonates had HPV-negative mothers. The vertical transmission rate was 26.09% (6/23). Mother-newborn genotypes were concordant. However, the genotype profile of the newborns was more restricted than that of the mothers. Conclusion: HPV DNA was found in 8% of newborns in our study. The genotype profile of the mother-newborn pair was concordant. Asymptomatic HPV infection in a pregnant woman could constitute a risk factor for vertical transmission.

Traditional Chinese Medicine Erhuang Suppository for Treatment of Persistent High-risk Human Papillomavirus Infection and Its Impact on Transcriptome of Uterine Cervix

Objective High-risk human papillomavirus(HR-HPV)infection is the chief cause of cervical intraepithelial neoplasia(CIN)and cervical carcinoma.The Erhuang suppository(EHS)is a traditional Chinese medicine(TCM)prepared from realgar(As_(2)S_(2)),Coptidis rhizoma,alumen,and borneolum syntheticum and has been used for antiviral and antitumor purposes.However,whether EHS can efficiently alleviate HR-HPV infection remains unclear.This study was conducted to evaluate the efficacy of EHS for the treatment of persistent HR-HPV infection in the uterine cervix.Methods In this study,we evaluated the therapeutic efficacy of EHS in a randomized controlled clinical trial with a 3-month follow-up.Totally,70 patients with persistent HR-HPV infection were randomly assigned to receive intravaginal administration of EHS or placebo.HPV DNA,ThinPrep cytologic test(TCT),colposcopy,and safety evaluation were carried out after treatment.Microarray analysis was performed to compare transcriptome profiles before and after EHS treatment.A K14-HPV16 mouse model was generated to confirm the efficiency of EHS.Results After 3 months,74.3%(26/35)of the patients in the treatment group were HPV negative,compared to 6.9%(2/29)in the placebo group.High-throughput microarrays revealed distinct transcriptome profiles after treatment.The differentially expressed genes were significantly enriched in complement activation,immune response,and apoptotic processes.The K14-HPV16 mouse model also validated the remarkable efficacy of EHS.Conclusion This study demonstrated that EHS is effective against HR-HPV infection and cervical lesions.Additionally,no obvious systemic toxicity was observed in patients during the trial.The superior efficacy and safety of EHS demonstrated its considerable value as a potential cost-effective drug for the treatment of HPV infection and HPV-related cervical diseases.

Study on the Correlation between Human Papillomavirus and Mycoplasma genitalium Combined with TCT Detection

Objective: This study aims to explore the correlation between human papillomavirus (HPV) and Mycoplasma genitalium (CT) combined with TCT detection in cervical cancer screening. Method: A cross-sectional study design was adopted, and a total of 609 women who came to seek medical treatment were recruited as the study subjects. Combination testing was evaluated on cervical cancer screening by testing the women for HPV, CT with TCT detection and analyzing the relationship of cervical lesions with HPV and CT infection. Results: The study results showed that 21.57% of the subjects were infected with both HPV and CT, and 48.42% of the cases had abnormal TCT results at the same time. Further data analysis showed that HPV infection was significantly associated with abnormal TCT outcomes (p < 0.05), suggesting a possible synergistic effect of the two infections in cervical lesions. The combined sensitivity and specificity of HPV, CT and TCT detection were 21.57% and 48.42%, respectively, which were significantly higher than that of single detection. Conclusion: In summary, the results of this study support the importance of combined HPV, CT, and TCT testing in cervical cancer screening, and propose the hypothesis that combined testing may improve screening effectiveness. However, further large sample studies are needed to confirm this conclusion and explore the prospects of combined testing in clinical practice.

Prevalence of Precancerous Lesions Based on Digital Cervicography with VIA/VILI among Women Positive for High-Risk Human Papillomavirus Serotypes: A Screening Center-Based Study in Cameroon

Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.

Hysteroscopic cervical biopsy for women with persistent human papillomavirus infection after loop electrosurgical excision procedure: A case report

BACKGROUNDAlmost all cases of cervical cancer can be attributed to human papillomavirus(HPV) infection. The loop electrosurgical excision procedure (LEEP) is widelyused to treat HPV-mediated disease;thus, cervical cancer is highly preventable.However, LEEP does not necessarily clear HPV rapidly and may affect theaccuracy of the results of ThinPrep cytology test (TCT) and cervical biopsy due tothe formation of cervical scars.CASE SUMMARYA 40-year-old woman underwent LEEP for cervical intraepithelial neoplasia grade1 approximately 10 years ago. Subsequent standard cervical cancer screeningsuggested persistent HPV-52 infection, but TCT results were negative. Cervicalbiopsy under colposcopy was performed thrice over a 10-year period, yieldingnegative pathology results. She developed abnormal vaginal bleeding after sexualactivity, persisting for approximately 1 year, and underwent hysteroscopy in ourhospital. Histopathologic evaluation confirmed adenocarcinoma in situ of theuterine cervix.CONCLUSIONPatients with long-term persistent, high-risk HPV infection and negative pathologyresults of cervical biopsy after LEEP are at risk of cervical cancer. Hysteroscopicresection of cervical canal tissue is recommended as a supplement tocervical biopsy because it helps define the lesion site and may yield a pathologicdiagnosis.

A study on the cognitive status of human papillomavirus among adult males in Tianjin based on the health belief model

Background:To understand the health beliefs and knowledge of human papillomavirus among adult males in Tianjin.Methods:An online questionnaire survey was conducted from 18 January 2023 to 6 March 2023 using snowball sampling method.Analyze the health belief scores and human papillomavirus(HPV)and HPV vaccine knowledge scores of adult males in Tianjin,and analyze their influencing factors.Results:A total of 388 adult males in Tianjin were surveyed,with an average total score of 3.23±0.04 for their health beliefs.Among them,the average scores for perceived severity,perceived susceptibility,perceived impairment,perceived benefit,and self-efficacy were 3.41±1.05,2.37±1.20,2.96±1.00,3.51±0.90,and 3.36±1.08,respectively.Multiple linear regression analyses showed education was a factor influencing health beliefs.The average total score of knowledge is 64.09±15.62,with 277 people scoring above 60,and a pass rate of 71.4%.Through multiple linear regression analysis,education level,emotional status,whether disease testing has been done,and whether family and friends have been diagnosed with HPV positive are the main influencing factors.Conclusion:The awareness rate of HPV among adult males in Tianjin is still acceptable,but there are still misconceptions.The overall level of health beliefs is moderate,and the perceived susceptibility level is low.It is necessary to strengthen health education on HPV related knowledge for males and improve their cognitive level.

Evaluating the Association between Human Papillomavirus and Vulvar Cancer:A Comprehensive Analysis Using Bradford Hill Criteria

Background:The role of human papillomavirus(HPV)in the development of vulvar cancer(VC)has been widely studied,but findings have been inconsistent.Despite numerous meta-analyses exploring the potential link between HPV and VC,the association remains controversial due to inherent limitations in meta-analytic methods.Objectives:To address this controversy,the study aims to investigate the potential link between HPV and VC using the Bradford Hill criteria,which offer a more comprehensive framework for establishing causation.Methodology:The study began by extracting all relevant studies on the association between HPV and VC from the PubMed database.The potential links were then assessed by examining the data using the major postulates of the Bradford Hill criteria.To ensure the reliability of the findings,the methodologies of the identified studies were critically evaluated to account for possible false-negative and false-positive results.Results:The assessment of previous studies against the Bradford Hill criteria revealed that the major postulates were not fulfilled.Conclusion:Based on the findings,it can concluded that there is no causal association between HPV and VC.

乌鲁木齐市11654例女性HPV分型及定量检测结果分析

目的分析新疆乌鲁木齐市女性人乳头瘤病毒(HPV)感染特点及HPV分型定量检测对宫颈病变的预测性能。方法收集2022年1-12月于新疆医科大学第一附属医院妇科就诊并进行HPV检测的11654例女性的HPV检测结果。根据年龄将所有就诊者分为低龄组(≤29岁)、青龄组(>29~39岁)、中龄组(>39~49岁)、中老龄组(>49~59岁)和老龄组(>59岁)。其中1483例患者同时进行阴道镜活检和宫颈组织病理学检测,根据组织病理学诊断结果,将1483例患者分为宫颈炎、宫颈上皮内瘤变(CIN)Ⅰ、CINⅡ、CINⅢ和宫颈癌,将CINⅠ及以上命名为CIN阳性,CINⅡ及以上命名为CINⅡ+,CINⅢ及以上命名为CINⅢ+。采用实时荧光定量PCR检测HPV亚型及病毒载量,比较不同民族、年龄、宫颈疾病女性HPV的检测结果,比较不同宫颈病变患者主要的HPV亚型病毒载量水平,采用受试者工作特征(ROC)曲线确定主要的HPV亚型预测CINⅡ+的病毒载量阈值。结果在11654例就诊者中,HPV感染率为30.60%,单一亚型感染占77.73%。HPV16、52、58是CIN阳性患者感染的主要型别,分别占38.89%、14.90%、11.11%。汉族、维吾尔族、回族和哈萨克族女性HPV感染率分别为31.89%、24.39%、31.76%和27.88%,4个民族HPV感染率比较,差异有统计学意义(χ^(2)=40.929,P<0.001)。在11654例就诊者中,老龄组HPV感染率最高(34.04%),中龄组HPV感染率最低(26.41%),不同年龄组间HPV感染率比较,差异有统计学意义(χ^(2)=37.754,P<0.001)。在396例CIN阳性患者中,高危型HPV和单一亚型感染率随CIN级别升高而升高(χ^(2)趋势=9.994、7.233,P<0.01)。CINⅡ+患者HPV16、52、58病毒载量与宫颈炎患者相比,差异均有统计学意义(P<0.05);且HPV16、52、58病毒载量预测CINⅡ+的最佳截断值分别为4.382、3.694、4.114 copy/104个细胞(经lg转化)。结论新疆乌鲁木齐市女性HPV感染以单一亚型感染为主,HPV16、52、58是主要的感染型别,并且HPV标准化定量具有作为宫颈高级病变预测标志物的潜力。

不同治疗方案对宫颈高危型HPV感染患者的治疗效果分析

目的:探讨多种治疗方案对宫颈高危型人乳头瘤病毒(HPV)感染患者的临床治疗效果,为HPV患者的临床治疗提供新思路。方法:采用回顾性研究方法纳入2022年1月—2023年1月在宜昌市中心人民医院治疗的宫颈高危型HPV感染患者501例,根据患者选取的治疗方法分为三组,A组患者给予保妇康栓治疗(n=167),B组患者给予重组人干扰素α-2b凝胶治疗(n=167),C组给予抗HPV生物蛋白敷料治疗(n=167)。比较三组HPV患者治疗有效率、HPV-DNA水平、治疗后HPV阳性率和治疗过程中不良反应发生率,评价临床治疗效果。结果:C组患者治疗总有效率明显高于A组(90.42%vs 74.85%)和B组(90.42%vs 77.25%)(均P<0.05)。三组患者治疗3个月及6个月HPV-DNA水平较治疗前明显下降,且治疗3个月及6个月时,C组患者的HPV-DNA水平较A组和B组明显降低(均P<0.05)。治疗后C组HPV阳性率明显低于A组(6.60%vs 22.75%)和B组(6.60%vs 20.96%)(均P<0.05)。三组患者不良反应发生情况无明显统计学差异(P>0.05)。结论:抗HPV生物蛋白敷料对于宫颈高危型HPV感染患者的治疗效果优于保妇康栓及重组人干扰素α-2b凝胶,且不良反应发生少,值得临床上进一步推广。

团体认知行为干预对高危型HPV持续感染患者临床转归的影响

目的 探讨团体认知行为干预(cognitive behavioral therapy, CBT)对宫颈高危型人乳头瘤病毒(high risk human papillomavirus, HR-HPV)持续感染患者临床转归的影响,构建针对情绪障碍的HR-HPV持续感染患者的系统性心理干预治疗方案。方法 选取HR-HPV持续感染合并情绪障碍患者,按照随机数字表法分为干预组(n=44)和对照组(n=45):对照组给予健康宣教、随访监测,干预组在此基础上给予CBT干预,比较两组的临床转归及心理量表评分。结果 随访6月及12月,HR-HPV感染消退率干预组高于对照组;而HR-HPV持续感染率及进展率干预组低于对照组(P<0.05)。抑郁症筛查量表(PHQ-9)及广泛性焦虑量表(GAD-7)评分,干预结束后即刻、随访6月及12月,干预组均低于对照组(P<0.05);干预组干预结束后即刻、随访6月及12月评分均低于干预前(P<0.05);对照组干预前后评分差异无统计学意义(P>0.05)。结论 HR-HPV持续感染患者进行系统性心理干预治疗,有助于HR-HPV感染消退。

治疗性HPV疫苗研究开发策略专家共识

人乳头瘤病毒(HPV)是双链DNA病毒,高危HPV感染易引发宫颈癌及癌前病变风险。近年来,已有超过400多种不同亚型的HPV被鉴定出,大多数HPV感染是无症状的,可以自行消退。免疫系统正常的女性,从感染高危HPV开始,通常需要15~20年才能发展为宫颈癌;但是对于免疫系统较弱的女性,如未经治疗的HIV感染女性(WLHIV),宫颈癌可能发展得更快(可能5~10年)。2006年,预防性HPV疫苗研发上市,但对已感染HPV或癌前病变患者无治疗效果。治疗性HPV疫苗的开发可为目前预防和治疗宫颈癌的方法提供重要的补充。与预防性HPV疫苗不同,治疗性疫苗旨在诱导特异性细胞免疫而非体液免疫(中和抗体),用于清除或治疗现有的HPV感染及其引起相关的癌前病变和侵袭性宫颈癌。因此,制定合理的治疗性HPV疫苗开发策略,不仅可以让治疗性HPV疫苗产品开发企业少走弯路,提高转化效率,而且可以使HPV感染及相关病变甚至癌变患者及早受益。本课题组织领域内专家学者,参考有关文件,结合HPV临床特点和发展背景,特别编撰了《治疗性HPV疫苗研究开发策略专家共识》,明确了适应范围、相关术语等,重点阐述了治疗性HPV疫苗临床开发方向、研究人群及特性和接种规划,旨在加快和推进治疗性HPV疫苗的研发,为社会研究开发治疗性HPV疫苗产品以及国家制定治疗性HPV疫苗相关政策提供借鉴和参考。

早期宫颈癌术后HPV持续感染的危险因素分析

目的分析早期宫颈癌根治术后高危型人乳头瘤病毒(HR-HPV)持续感染的相关危险因素。方法选取2021年1月至2023年11月之间,在昆明市妇幼保健院行开腹或腹腔镜下宫颈癌根治术的159例早期宫颈癌患者,根据术后1a返院复查HR-HPV持续感染情况分为2组:HR-HPV阳性组(n=41)和HR-HPV转阴组(n=118)。对2组患者的一般资料、阴道微生态情况、手术入路途径、术后病检结果等分析,研究早期宫颈癌患者术后HR-HPV持续阳性的相关危险因素。结果2组的单因素和多因素回归分析显示,绝经、手术期别晚、阴道微生态失调/亚失调是早期宫颈癌患者术后HR-HPV持续阳性的危险因素(P<0.05),而腹腔镜微创手术不是其危险因素。其中阴道微生态异常OR为12.574,绝经OR为3.510。结论绝经、阴道微生态失调为影响早期宫颈癌患者术后HR-HPV清除的重要危险因素。

7345例女性HPV感染状况及亚型分布特征分析

目的了解于日照市中医医院就诊的女性人乳头瘤病毒(HPV)感染状况及基因型分布特征,为宫颈癌早期筛查防治、疫苗接种提供数据参考。方法收集2020年1月至2022年12月于日照市中医医院行HPV基因分型的7345名女性的检测结果,分析总体及不同年龄组的HPV感染率、基因型分布及疫苗保护的HPV基因型感染情况。结果在7345份检测标本中,检测出阳性标本1563份,阳性率为21.28%。其中来自妇科门诊的标本阳性率25.54%(1097/4295),来自健康中心的标本阳性率15.28%(466/3050),门诊标本阳性率明显高于健康中心的标本阳性率,差异有统计学意义(χ^(2)=112.13,P<0.05)。单一高危型感染率为11.79%(866/7345),多重分型感染率为5.62%(413/7345)。感染率最高的5种高危型依次是HPV16(3.89%)、HPV52(3.05%)、HPV58(2.06%)、HPV 53(1.97%)、HPV 31(1.54%)。HPV感染率在年龄分组分析中出现两个高峰,分别为≤20岁组(39.06%)和≥61岁组(27.24%)。HPV九价疫苗涵盖的基因型感染占比为64.43%。结论于日照市中医医院就诊的女性HPV感染率为21.28%,以单一高危型感染为主,青少年女性感染率最高,适龄女性推荐选择九价疫苗。

备孕女性HPV筛查及其疫苗接种状况调查

目的:调查备孕女性人乳头瘤病毒(HPV)感染情况并分析HPV疫苗接种影响因素。方法:收集2022年1月-2023年1月本院健康检查的211例备孕女性宫颈样本,采用聚合酶链式反应-反向点杂交法进行HPV感染亚型分型,通过问卷调查备孕女性HPV疫苗接种情况,分析影响备孕女性HPV疫苗接种影响因素。结果:备孕女性HPV感染率为22.7%,其中高危型HPV感染率为81.25%,主要HPV感染亚型为HPV52(18.8%)、HPV16(10.4%)。HPV单一型感染率为20.6%,多重感染率为14.6%。211例HPV疫苗接种率为14.7%,文化水平低、不知道HPV疫苗是影响备孕女性HPV疫苗接种的影响因素(P<0.05)。结论:本次调查的备孕女性HPV感染率为22.7%,以HPV52、HPV16为主要感染亚型;HPV疫苗接种率较低,应加强对备孕女性相关知识宣传,提高HPV疫苗接种率。

门诊患者阴道微生态特征与HPV感染的相关性分析

目的分析门诊就诊女性阴道微生态特征及人乳头瘤病毒(human papilloma virus,HPV)分布特点,探究阴道微生态特征与HPV感染的相关性。方法选取2020年4月至2023年4月在深圳市第二人民医院妇科门诊就诊并同期接受阴道微生态与HPV检查的22129例患者作为研究对象,分析其检查结果。结果22129例患者中,阴道微生态正常患者占1.17%(259/22129),阴道微生态失调患者占98.83%(21870/22129)。明确致病菌的微生态失调患者占10.87%(2405/22129)。单纯型阴道炎患者占96.42%(2319/2405),混合型阴道炎占3.58%(86/2405)。22129例患者中,HPV阳性率为16.52%(3655/22129)。阳性率最高的5种型别均为高危型HPV,分别为HPV52(3.75%,829/22129),HPV53(1.86%,411/22129),HPV51(1.70%,377/22129),HPV16(1.63%,360/22129),HPV58(1.53%,339/22129)。阴道微生态特征中,清洁度、pH值、白细胞酯酶、过氧化氢、唾液酸苷酶与HPV感染相关(P<0.01),此外,pH值与高危型HPV感染相关(P<0.05)。结论阴道微生态指标异常与HPV感染相关,临床应重视阴道微生态的相关检查结果。

HPVL1蛋白、TRIM22、HER-2联合检测在HPV阳性宫颈上皮内瘤变中的早期诊断价值

目的 探讨人乳头瘤病毒LI(HPVL1)蛋白、三结构域家族蛋白22(TRIM22)、人表皮生长因子受体-2(HER-2)联合检测在人乳头瘤病毒(HPV)阳性宫颈上皮内瘤变(CIN)中的早期诊断价值。方法 回顾性选取2021年1月至2023年6月承德医学院附属医院就诊的162例薄层液基细胞学(TCT)检查异常且HPV阳性的CIN患者为研究组,另选取同期经组织病理学诊断为正常宫颈组织的138名对象为对照组。免疫组织化学法检测宫颈组织中HPVL1蛋白、TRIM22、HER-2表达。比较对照组、研究组组织中HPVL1蛋白、TRIM22、HER-2表达,并比较不同分级CIN患者HPVL1蛋白、TRIM22、HER-2表达。多因素Logistic回归模型分析CIN发生的影响因素;受试者操作特征(ROC)曲线分析HPVL1蛋白、TRIM22、HER-2表达对CIN的早期诊断价值。结果 研究组组织中HPVL1蛋白及TRIM22蛋白阳性率分别为34.57%、32.72%,均显著低于对照组(74.64%、71.01%),HER-2阳性率为60.49%,显著高于对照组(10.87%),差异均有统计学意义(P<0.05)。CINⅠ级、CINⅡ级和CINⅢ级HPVL1蛋白和TRIM22阳性率呈下降趋势,HER-2阳性率呈上升趋势(P<0.05)。多因素Logistic回归分析结果显示,宫颈组织中HPVL1蛋白、TRIM22及HER-2表达均为CIN的影响因素(OR=5.110、5.231、9.652,P<0.05)。ROC曲线结果显示,HPVL1蛋白表达诊断CIN的曲线下面积(AUC)为0.700,敏感度为65.43%;TRIM22表达诊断CIN的AUC为0.691,敏感度为67.28%;HER-2表达诊断CIN的AUC为0.748,敏感度为60.49%。三者联合诊断CIN的AUC为0.814,显著高于单独诊断的AUC(P<0.05)。结论 宫颈组织中HPVL1蛋白、TRIM22及HER-2表达影响CIN的发生、发展,三者联合对CIN具有较高的诊断价值。

宫颈病变患者HPV基因分型检测及其临床意义分析

目的:分析宫颈病变患者人乳头瘤病毒(HPV)基因分型检测及临床意义。方法:回顾性分析2021年5月—2023年5月泰兴市人民医院收治的125例宫颈病变患者的临床资料,均进行HPV基因分型检测。统计125例宫颈病变患者HPV感染阳性率、HPV基因分型情况(多重感染重复计算)。比较不同程度宫颈病变患者中HPV感染阳性率、高危型HPV感染阳性率。以病理检查为“金标准”,分析并比较液基薄层细胞学检查(TCT)单独诊断、TCT联合HPV基因分型诊断子宫颈癌的准确度、敏感度、特异度。结果:125例宫颈病变患者中,HPV感染阳性率为51.20%(64/125),HPV感染阳性患者中HPV基因型总数为92株,其中高危型HPV为63.04%(58/92),低危型HPV为36.96%(34/92)。高危型HPV感染阳性率最高的前5位基因型分别为HPV16(16.30%)、HPV18(11.96%)、HPV58(8.70%)、HPV53(6.52%)、HPV51(4.35%);低危型HPV感染阳性率最高的前3位基因型分别为HPV6(8.70%)、HPV11(7.61%)、HPV40(4.35%)。不同级别宫颈病变患者HPV感染阳性率、高危型HPV感染阳性率比较,差异有统计学意义(P<0.05)。TCT单独诊断子宫颈癌的准确度为78.40%(98/125),敏感度为66.67%(18/27),特异度为81.63%(80/98),阳性预测值为50.00%(18/36),阴性预测值为89.89%(80/89),Kappa值为0.431;TCT联合HPV基因分型诊断子宫颈癌的准确度为88.00%(110/125),敏感度为59.26%(16/27),特异度为95.92%(94/98),阳性预测值为80.00%(16/20),阴性预测值为89.52%(94/105),Kappa值为0.609;TCT联合HPV基因分型诊断子宫颈癌的准确度、特异度均显著高于TCT单独诊断,差异有统计学意义(P<0.05);TCT联合HPV基因分型诊断子宫颈癌的敏感度低于TCT单独诊断,但差异无统计学意义(P>0.05)。结论:宫颈病变类型与HPV基因分型密切相关,且不同宫颈病变恶性程度患者HPV感染阳性率、高危型HPV感染阳性率存在显著差异,因此HPV基因分型用于辅助子子宫颈癌筛查具有重要意义。

不同HPV感染亚型对不孕女性阴道微生态及辅助生殖助孕结局的影响

目的探讨不同人乳头瘤病毒(HPV)感染亚型对不孕女性阴道微生态及辅助生殖(ART)助孕结局的影响。方法选取2020年1月至2022年3月期间于宝鸡市中心医院进行ART助孕的HPV阳性不孕女性190例,对所有患者均进行了HPV分型检查,根据患者感染HPV的不同亚型将其分为高危组(151例)与低危组(39例),选取同期进行ART助孕的HPV阴性不孕女性纳入对照组(95例)。检查患者阴道微生态情况及阴道病原菌感染情况,记录患者ART助孕结局(获卵数、可移植胚胎数及优质胚胎数)和妊娠结局(临床妊娠率、活产分娩率及流产率),并对各组数据进行统计分析。结果高危组、低危组、对照组的H_(2)O_(2)阳性率比较差异无统计学意义(P>0.05);高危组、低危组、对照组的乳酸杆菌、唾液酸苷酶、白细胞酯酶的阳性率及阴道微生态失衡率比较差异均有统计学意义(χ^(2)值分别为7.604、9.086、6.825、8.502,P<0.05);高危组的乳酸杆菌、唾液酸苷酶、白细胞酯酶的阳性率及阴道微生态失衡率均明显高于对照组,经比较差异均有统计学意义(χ^(2)值分别为7.087、9.038、6.767、8.373,P<0.05)。高危组、低危组、对照组的外阴阴道假丝酵母菌病(VVC)、细菌性阴道病(BV)的感染率比较差异均无统计学意义(P>0.05),高危组、低危组、对照组的混合型阴道感染率比较差异有统计学意义(χ^(2)=15.258,P<0.05);高危组的混合型阴道感染率均明显高于低危组和对照组,经比较差异均有统计学意义(χ^(2)值分别为4.808、12.002,P<0.05)。高危组、低危组、对照组患者的获卵数、可移植胚胎数及优质胚胎数比较差异均无统计学意义(P>0.05)。高危组、低危组、对照组患者的临床妊娠率比较差异无统计学意义(P>0.05),三组的活产分娩率和流产率比较差异均有统计学意义(χ^(2)值分别为2.841、2.936,P<0.05);高危组的活产分娩率明显低于对照组,流产率明显高于对照组,经比较差异均有统计学意义(χ^(2)值分别为7.981、5.123,P<0.05)。结论不同HPV感染亚型对不孕患者阴道微生态情况、ART助孕结局、临床妊娠率及活产分娩率的影响较小,但高危HPV感染会增加不孕患者混合型阴道感染的风险。

阴道微生态与宫颈HR-HPV感染及宫颈病变关系的研究进展

高危型人乳头瘤病毒(HR-HPV)感染是导致宫颈上皮瘤变(CIN)及宫颈癌的关键因素。阴道内环境在正常情况下由于各菌群的动态平衡而处于稳定状态,由此构成女性生殖系统健康的重要基础,其中乳酸杆菌为优势菌群,在各种致病因素的作用下,各菌群间此消彼长,平衡状态由此被打破,导致阴道炎症病发率和HR-HPV感染率上升,并引发一系列宫颈病变,如无有效预防及干预手段,将进一步发展为宫颈癌。本文综述阴道微生态与宫颈HR-HPV感染及宫颈病变的关系的最新研究成果,以期为临床降低HR-HPV感染率及干预宫颈病变提供一定借鉴。

ZNF772甲基化及HR-HPV检测在意义不明的非典型鳞状细胞病人分流中的意义

目的:探讨锌指蛋白(ZNF)772甲基化及高危型人乳头瘤病毒(HR-HPV)检测在意义不明的非典型鳞状细胞(ASCUS)病人分流中的意义。方法:选取初筛ASCUS病人195例,均接受HC2-HPV-DNA检测及ZNF772基因DNA甲基化检测;比较宫颈上皮内瘤样变(CIN)Ⅱ及以上与CINⅡ以下、CINⅢ及以上及CINⅢ以下病人ZNF772基因位点甲基化水平的差异,并评估ZNF772甲基化水平及HR-HPV对ASCUS病人CINⅡ及以上、CINⅢ及以上的分流价值。结果:病理学检查显示,195例ASCUS病人中炎症80例(41.03%)、CINⅠ64例(32.82%)、CINⅡ29例(14.87%)、CINⅢ/CIS/AIS 18例(9.23%)、SCC/AC 4例(2.05%)。HR-HPV(HC2)阳性141例(72.31%)、HR-HPV(HC2)阴性54例(27.69%);CINⅡ及以上病人HR-HPV(HC2)阳性检出率高于CINⅡ以下(P<0.05);CINⅢ及以上病人HR-HPV(HC2)阳性检出率高于CINⅢ以下(P<0.05)。CINⅡ及以上、CINⅢ及以上病人ZNF772基因-420、-422位点甲基化水平分别高于CINⅡ以下、CINⅢ以下病人(P<0.05)。ZNF772基因-420、-422位点甲基化水平及HR-HPV诊断CINⅡ及以上的AUC(95%CI)分别为0.867(0.811~0.911)、0.806(0.743~0.859)、0.777(0.712~0.834),诊断CINⅢ及以上的AUC(95%CI)分别为0.891(0.838~0.931)、0.868(0.813~0.912)、0.780(0.716~0.836)。ZNF772基因-420位点甲基化水平诊断CINⅡ及以上、CINⅢ及以上的AUC面积最大。结论:相较于HC2-HPV-DNA检测,ZNF772甲基化检测更能准确地识别ASCUS中CINⅡ及以上、CINⅢ及以上病变病人,有望成为分流ASCUS的有效替代手段。