SEARCH FOR HERPES SIMPLEX VIRUS TYPE2（HSV－2）AND HUMAN PAPILLOMAVIRUS（HPV）IN THE NORMAL AND ABNORMAL CERVICAL SAMPLES

The specimens of 111 cervical carcinomas. 68 chronic cervicitis and 43 normal cervical exfoliated epithelial cells were examined for the presence of HSV2 DNA sequences with DNA hybridization using HSV2 BgL Ⅱ N fragment probe labelled by 32PdCTP. The result showed that the infection rates of HSV2 in the samples of cervical cancer.chronic cervicitis and normal epithelial cells were 1 4. 41 %(16/111). 27.94%( 19/68) and 25.58% ( 11/43),respectively. It was implied that early stages carcinogenesis of cervical epithelial cells might be correlated with the HSV2 infection.Sixteen HSV 2 positive samples of cervical carcinomas were also examined for the presence of the sequences homologous to human papillomavirus (HPV) type 6B/11. 16 and 18 DNA using dot blot hybridization (Tm17℃). The result indicated that 13 out of 16 were HPV 16 DNA hybridization positive accounting for 81. 2% of all HSV-2 positive samples and none of them were positive for HPV type 6B/11 and 18. The result indicated that double infection of HSV 2 and HPV16 in the same cervical carcinoma tissues may provide a strong evidence of the viral synergistic interaction in the induction of female cervical

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。

山东省滕州地区女性HPV亚型分布特点及其与女性宫颈病变的关系

目的 对山东省滕州地区女性人乳头瘤病毒(HPV)亚型分布特点及其与女性宫颈病变的关系进行分析和探讨。方法 选取2023年1月至2023年10月于我院行HPV检查的20 378例女性为研究对象,收集其HPV检查结果、薄层液基细胞学检查检查结果以及宫颈组织活检结果,探讨HPV亚型分布特点及其与女性宫颈病变的关系。结果 20 378例受检者中,HPV阳性率34.81%,其中,高危型感染5989例(84.42%),低危型感染2095例(29.53%)。宫颈病变率39.34%,其中,HPV高危型感染患者占比高于HPV低危型感染患者(P <0.05),且HPV 16型感染率随着病变程度的加深显著提高(P <0.05)。不同宫颈病变患者中,多重感染与单一感染率占比相当(P> 0.05)。结论 在宫颈病变患者中,最常见的HPV基因亚型为HPV 52、58、16、18,其中,HPV 16的检出率与病变程度之间存在正相关关系。多重感染不会对宫颈病变程度产生显著影响。在临床实践中,必须高度重视高危HPV 16、52、58亚型患者的阴道镜分流管理。

宫颈癌患者血清IL-10、CD4表达及其与HPV分型的关系

目的探讨宫颈癌患者血清白介素10(IL-10)、分化决定簇抗原4(CD4)表达情况,并分析其与人乳头状瘤病毒(HPV)分型的关系。方法收集80例宫颈癌患者临床病历资料归入宫颈癌组,另收集同期就诊的80例宫颈癌前病变患者和80例健康体检女性资料分别归入癌前病变组和健康对照组。对比3组患者血清IL-10、CD4表达、宫颈癌患者不同病理分型间血清IL-10、CD4表达、癌前病变组和宫颈癌组HPV分型、不同HPV分型间血清IL-10、CD4表达。结果3组IL-10水平:宫颈癌组>癌前病变组>健康对照组(P<0.05);3组CD4水平:宫颈癌组<癌前病变组<健康对照组(P<0.05)。Ⅲ~Ⅳ期患者血清IL-10水平高于Ⅰ~Ⅱ期患者,CD4水平低于Ⅰ~Ⅱ期患者(P<0.05);发生淋巴结转移患者血清IL-10水平高于未发生淋巴结转移患者,CD4水平低于未发生淋巴结转移患者(P<0.05)。宫颈癌组高危型HPV感染占比显著高于癌前病变组(P<0.05)。经卡方检验Phi系数分析显示,高危HPV分型与宫颈癌发生间有关(Phi=0.016,P=0.032)。高危型血清IL-10水平高于低危型,CD4水平低于低危型(P<0.05)。结论血清IL-10、CD4与宫颈癌发生、HPV分型间存在密切关系,且IL-10水平越高、CD4水平越低,则患者发生高危HPV感染几率越大,宫颈癌发生风险越高。

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。

头颈部黏膜病损中拭子HPV半定量检测的应用研究

目的比较头颈部黏膜病损HPV E6/E7 mRNA的半定量检测与组织中p16免疫组织化学染色及E6/E7RNA原位杂交检测的一致性,探讨应用咽拭子检出头颈部黏膜病损中高危型HPV感染的可行性。方法收集2022年9月~2023年8月首都医科大学附属北京同仁医院头颈外科经治的头颈部黏膜病损患者100例,进行口咽、病损表面拭子和病损组织标本HPV E6/E7 mRNA的半定量检测和病损组织的p16免疫组织化学染色、E6/E7 mRNA原位杂交检测,并对不同检测结果的一致性和差异性进行研究。结果100例患者中,符合纳排标准者共83例,其中乳头状瘤21例、息肉/慢性炎症10例、喉癌19例、口咽癌13例、下咽癌20例。口咽拭子和病损表面拭子的HPV E6/E7 mRNA半定量检测结果与p16免疫组织化学染色结果表现为中度或接近高度的一致性,而病损组织的HPV E6/E7 mRNA半定量检测结果与p16免疫组织化学染色表现为高度的一致性(Kappa=0.780);在诊断效能分析中,两种拭子均表现出与HPVE6/E7mRNA原位杂交高度的一致性(Kappa=0.690、0.708)。结论在头颈部黏膜病损中,口咽和病损表面拭子的HPV半定量检测结果与经典的p16免疫组织化学染色及“金标准”HPV E6/E7 mRNA原位杂交相比较具有较好的一致性,是一种简便可靠的临床高危型HPV检出方法,有助于头颈部黏膜病损HPV感染的筛查和个体化精准防控。

Lymphocyte subsets predictive value and possible involvement of human papilloma virus infection on breast cancer molecular subtypes

AIM To detect human papilloma virus(HPV) presence and to characterize cellular immune response in breast cancer patients. METHODS A total of 74 women were included, of which 48 samples were from patients diagnosed with breast cancer and 26 patients with benign pathology of the breast. Molecular subtype classification was performed based on the immunohistochemical reports of the tumor piece. HPV genome detection and genotyping from fresh breast biopsies was performed using the INNO-LIPA HPV Genotyping Extra test(Innogenetics, Ghent, Belgium). CD3+, CD4+, CD8+ and natural killer(NK)+ cells levels from peripheral blood samples from patients with breast cancer and benign pathology were measured by flow cytometry. RESULTS Luminal A was the most frequent breast cancer molecular subtype(33.33%). HPV was detected in 25% of the breast cancer patients, and genotype 18 was the most frequent in the studied population. The mean of CD3+, CD4+ and CD8+ subpopulations were decreased in patients with breast cancer, in relation to those with benign pathology, with a statistically significant difference in CD8+ values(P = 0.048). The mean of NK+ cells was increased in the benign pathology group. The average level of CD3+, CD4+, CD8+ and NK+ cells decreased as the disease progressed. HER2+ and Luminal B HER2+ tumors had the lowest counts of cell subsets. HPV breast cancer patients had elevated counts of cellular subsets. CONCLUSION Determining level changes in cellular subsets in breast cancer patients is a useful tool to evaluate treatment response.

Correlation between Physical Status of Human Papilloma Virus and Cervical Carcinogenesis

The prevalence of human papilloma virus (HPV)-16 in patients with cervical cancer,the physical status of HPV-16 in patients with cervical lesions,and the role of HPV-16 integration in cervi-cal carcinogenesis were investigated.HPV genotyping was performed by using PCR approach with the primer GP5+/GP6+ and type-specific primer on biopsy specimens taken operatively from 198 women.Multiple PCR was done to detect physical status of HPV-16 in a series of cervical liquid-based cytology samples and biopsy specimens obtained from different cervical lesions with HPV-16 infection,includ-ing 112 specimens with cervical cancer,151 specimens with CINⅠ,246 specimens with CINⅡ and 120 specimens with CINⅢ.The results showed that there were 112 cervical cancer samples (56.57% of total cervical cancer patients) with HPV-16 infection.The frequency of HPV-16 pure integration was 65.18% (73/112),56.57% (47/120),23.58% (58/246) and 7.95% (12/151) in cervical cancer,CINⅢ,CINⅡand CINⅠ patients respectively.In situ hybridization was performed on some paraffin-embedded sections of CINⅡ,CINⅢ and cervical cancer to verify the physical status of HPV-16 infection.Sig-nificant difference was observed between cervical cancer and CINⅠ,CINⅡ,CINⅢ in the frequency of HPV-16 integration (P<0.01).It is suggested that HPV-16 is the most prevalent type and is associated with cervical cancer.In the case of HPV-16 infection there are close associations between the severity of cervical lesions and the frequency of HPV-16 integration.The application of testing HPV genotyping and physical status based on detection of HC-Ⅱ HPV DNA would be in favor of predicting the progno-sis of cervical precancerosis and enhancing the screening accuracy of cervical cancer.

Clinical and scientific impact of human papillomavirus on head and neck cancer

Head and neck cancer(HNC) arises from the skull base to the clavicles and is the fifth most common cancer in the world by incidence. Historically, in the developed world HNC was associated with tobacco use and alcohol consumption, and the combination of the two produced a synergistic increase in risk. However, beginning in 1983, investigators have found a significant and growing proportion of HNC patients with human papillomavirus-positive(HPV) tumors who neither drank nor used tobacco. Since that time, there has been increased interest in the molecular biology of HPV-positive HNC. Multiple studies now show that HPV has shifted the epidemiological landscape and prognosis of head and neck squamous cell carcinoma(HNSCC). These studies provide strong evidence for improved survival outcomes in patients with HPV-positive HNSCC compared to those with HPV-negative HNSCC. In many reports, HPV status is the strongest predictor of locoregional control, disease specific survival and overall survival. In response to these findings, there has been significant interest in the best management of HPV-positive disease. Discussions within major cooperative groups consider new trials designed to maintain the current strong survival outcomes while reducing the long-term treatment-re-lated toxicities. This review will highlight the epidemiological, clinical and molecular discoveries surrounding HPV-related HNSCC over the recent decades and we conclude by suggesting how these findings may guide future treatment approaches.

Potential role of human papilloma virus in the pathogenesis of gastric cancer

AIM:To demonstrate the presence and biological activity of human papilloma virus(HPV)in gastric cancer(GAC)tissues.METHODS:The study involved 84 surgically treated patients with gastric adenocarcinoma,regardless of the clinical stage of the disease.The presence of HPV DNA of high oncogenic risk types in formalin-fixed,paraffinembedded tumor samples was determined using quantitative polymerase chain reaction analysis.A stringentprotocol of prevention of cross-and environmental contamination was applied during DNA isolation,and amplification,as well as confirmation of the biological activity of the virus in tumor cells,was implemented.The study utilized the Real-time High Risk HPV test,which detects the DNA of 14 HPV subtypes that are considered to have high oncogenic potential.The overexpression of the p16INK4a protein assessed immunohistochemically was considered confirmation of the HPV infection.RESULTS:Among the 89 patients initially included in the study group,diagnostic results were obtained for84 individuals.In five cases,either the histopathological material was too scant to isolate the necessary amount of DNA,or the isolated DNA was significantly degraded,resulting in the failure of internal control amplification within the predefined number of 35 cycles.Those patients were excluded from further analysis.The amplification of HPV DNA was demonstrated in none of the84 tissue samples;thus,all cases were considered to have a negative DNA status of highly oncogenic HPV subtypes.Immunohistochemical staining provided diagnostic results for all of the examined tissue samples,and excluded the accumulation of the p16INK4a protein in tumor cells,thus confirming the lack of active HPV infection in all of the individuals.CONCLUSION:The study does not confirm the presence or biological activity of HPV in tumor tissues.Thus,the relationship between GAC and HPV infection,in the Central European population seems doubtful.

Incidence of human papilloma virus in esophageal squamous cell carcinoma in patients from the Lublin region

AIM:To assess the prevalence of human papilloma virus(HPV) in esophageal squamous cell carcinoma(ESCC) in the south-eastern region of Poland.METHODS:The study population consisted of 56 ESCC patients and 35 controls.The controls were patients referred to our department due to other nonesophageal and non-oncological disorders with no gross or microscopic esophageal pathology as confirmed by endoscopy and histopathology.In the ESCC patients,samples were taken from normal mucosa(56 mucosa samples) and from the tumor(56 tumor samples).Tissue samples from the controls were taken from normal mucosa of the middle esophagus(35 control samples).Quantitative determination of DNA was carried out using a spectrophotometric method.Genomic DNA was isolated using the QIAamp DNA Midi Kit.HPV infection was identified following PCR amplification of the HPV gene sequence,using primers MY09 and MY11 complementary to the genome sequence of at least 33 types of HPV.The sequencing results were computationally analyzed using the basic local alignment search tool database.RESULTS:In tumor samples,HPV DNA was identified in 28 of 56 patients(50%).High risk HPV phenotypes(16 or/and 18) were found in 5 of 56 patients(8.9%),low risk in 19 of 56 patients(33.9%) and other types of HPV(37,81,97,CP6108) in 4 of 56 patients(7.1%).In mucosa samples,HPV DNA was isolated in 21 of 56 patients(37.5%).High risk HPV DNA was confirmed in 3 of 56 patients(5.3%),low risk HPV DNA in 12 of 56 patients(21.4%),and other types of HPV in 6 of 56 patients(10.7%).In control samples,HPV DNA was identified in 4 of 35 patients(11.4%) with no high risk HPV.The occurrence of HPV in ESCC patients was significantly higher than in the controls [28 of 56(50%) vs 4 of 35(11.4%),P < 0.001].In esophageal cancer patients,both in tumor and mucosa samples,the predominant HPV phenotypes were low risk HPV,isolated 4 times more frequently than high risk phenotypes [19 of 56(33.9%) vs 5 of 56(8.9%),P < 0.001].A higher prevalence of HPV was identified in female patients(71.4% vs 46.9%).Accordingly,the high risk phenotypes were isolated more frequently in female patients and this difference reached statistical significance [3 of 7(42.9%) vs 2 of 49(4.1%),P < 0.05].Of the pathological characteristics,only an infiltrative pattern of macroscopic tumor type significantly correlated with the presence of HPV DNA in ESCC samples [20 of 27(74.1%) vs 8 of 29(27.6%) for ulcerative or protruding macroscopic type,P < 0.05].The occurrence of total HPV DNA and both HPV high or low risk phenotypes did not significantly differ with regard to particular grades of cellular differentiation,phases in depth of tumor infiltration,grades of nodal involvement and stages of tumor progression.CONCLUSION:Low risk HPV phenotypes could be one of the co-activators or/and co-carcinogens in complex,progressive,multifactorial and multistep esophageal carcinogenesis.

HPV与宿主基因整合在宫颈病变发生发展中的作用机制研究进展

宫颈癌病死率较高,高危人乳头瘤病毒(HPV)持续感染是其主要致病原因,其中HPV与宿主基因整合在宫颈病变的发生发展中发挥关键作用。目前,以三代测序技术为代表的新兴技术已用于HPV整合位点及基因改变等的相关检测。HPV整合后可能通过基因扩增、染色体结构改变、改变DNA序列甲基化状态、形成染色体外DNA、导致宿主致癌基因激活和抑癌基因失活以及影响微RNA的表达等发挥促癌作用。因此,深入研究HPV与宿主基因整合在宫颈病变发生发展中的作用机制,可以为相关疾病的治疗提供新思路。

Human papilloma virus 16 E6 oncoprotein associated with p53 inactivation in colorectal cancer

AIM:To investigate the association between human papilloma virus(HPV) infection and colorectal cancer.METHODS:Sixty-nine patients with pathologically confirmed primary colorectal cancer including 6 stage Ⅰ,24 stage Ⅱ,21 stage Ⅲ,and 18 stage Ⅳ patients were enrolled in this study to investigate whether HPV 16 could be involved in colorectal tumorigenesis.Nested-polymerase chain reaction(nested-PCR) was used to detect HPV16 DNA in colorectal tumor tissues and further confirmed by in situ hybridization(ISH).In addition,immunohistochemistry analysis was performed to examine the E6 oncoprotein in colorectal tumors.To verify whether E6 could inactivate the p53 transcriptional function,the levels of p21 and Mdm2 mRNA expression were evaluated by real-time reverse transcription(RT)-PCR.RESULTS:Of the 69 colorectal tumors,HPV16 DNA was detected in 11(16%) by nested-PCR,and HPV16 DNA was present in 8 of the 11(73%) tumors which was confirmed by ISH.The presence of HPV16 DNA in colorectal tumors was not associated with patients' clinical parameters including age,gender,smoking status,tumor site;however,HPV16 infection was more common in stage Ⅰ patients than in late-stages patients(Ⅱ,Ⅲ and Ⅳ).We next asked whether HPV16 infection could be linked with colorectal cancer development.Immunohistochemical data indicated that 8 of the 11 HPV16 DNA-positive tumors had E6 oncoprotein expression.Moreover,we also observed that the adjacent normal tissues including endothelial cells,lymphocytes,fibroblasts,and gland cells in E6-positive tumors had E6 oncoprotein expression.In addition,3 of the 4(75%) E6-positive tumors carrying p53 wild-type had negative immunostaining,but one tumor had less p53 immunostaining.We further examined whether E6-positive and/or p53 mutated tumors reduce p53 transcriptional activity.Real-time RT-PCR analysis indicated that p21 and mdm2 mRNA expression levels in E6/p53-wildtype tumors were significantly lower than in their adjacent normal tissues;as expected,E6-positive/p53-mutated tumors had lower p21 and mdm2 mRNA expression levels compared with their adjacent normal tissues.These results clearly indicate that the E6 oncoprotein expressed in p53 wildtype tumors may reduce p21 and mdm2 expression via p53 inactivation.CONCLUSION:These results suggest that HPV16 infection may be involved in a subset of colorectal cancer,and we suggest that the transmission of HPV to the colon and rectum might occur through peripheral blood lymphocytes.

宜昌城区女性对HPV疫苗知晓率、接种意愿及影响因素调查

目的:调查宜昌城区女性人乳头瘤病毒(HPV)疫苗知晓率、接种意愿及影响接种意愿的因素。方法:选取2020年10月20日—2023年5月29日宜昌城区18~45周岁女性3700名进行调查,对上述研究对象发放调查问卷并对调研结果进行统计分析,对HPV及相关疾病知晓率、HPV疫苗接种意愿及影响HPV疫苗接种因素进行分析。结果:本次研究共发放调查问卷3700份,最终回收3592份,成功回收率为97.08%。3592例研究对象,HPV认知程度集中于中认知水平,占全部研究对象的59.99%,其中未听说过HPV的研究对象占比最低,仅4.79%;HPV感染导致疾病认知程度同样集中于中认知水平,占全部研究对象的38.34%,HPV感染导致疾病高认知水平的患者占比仅7.04%。HPV疫苗具有中等接种意愿的研究对象在全部受访者中占比最高,占58.55%,对HPV疫苗接种完全无意愿占比最低,仅1.06%。影响HPV疫苗接种意愿的主要因素为对疫苗安全信心不足、对疫苗效果信心不足,占比分别为37.00%、30.73%。结论:宜昌城区女性群体普遍具有较高的HPV知晓率及接种意愿,然而其对HPV的专业知识水平尚有待提升,研究对象对HPV疫苗安全性和有效性的顾虑是影响其接种意愿的主要影响因素。

Aptima HPV检测在宫颈癌前病变初筛中的优势

宫颈癌是最常见的威胁女性健康的生殖道恶性肿瘤,高危型人乳头瘤病毒(HR-HPV)感染是发生癌前病变和浸润性宫颈癌的先决条件。近年来其发病率持续上升,且感染患者呈年轻化趋势,不仅威胁着患者的身体健康,而且对患者造成巨大心理负面影响。因此,提高宫颈癌的筛查率以便尽早发现并干预疾病的发展极为重要,HPV筛查也成为了识别宫颈癌前病变和浸润性宫颈癌的关键策略。当HPV感染发展为持续性时,HPV基因组整合到宿主细胞基因组,E6、E7过度表达,同时造成基因组不稳定,最终导致宫颈组织发生癌前病变甚至演变为宫颈癌。当前,Aptima HPV检测是对HR-HPV E6/E7 mRNA表达量的定量检测手段,可以有效评估E6/E7癌基因在子宫颈上皮的活跃程度。本文主要分析Aptima HPV检测在宫颈癌前病变初筛中的优势,并对其相关研究进行综述,以期为临床HPV检测技术的合理应用提供参考。

Human papilloma virus and esophageal carcinoma in a Latin-American region

AIM:To investigate the presence of high-risk human papilloma virus (HPV) in esophageal squamous cell carcinomas (ESCCs) in a non-selected Mexican population.METHODS: Cases with a pathological diagnosis of squamous cell carcinoma of the esophagus were obtained from Department of Pathology files, at the National Cancer Institute in Mexico City during the period between 2000 and 2008. Slides from each case were reviewed and cases with sufficient neoplastic tissue were selected for molecular analysis. DNA was extracted from paraffin-embedded tissue samples for polymerase chain reaction analysis to detect HPV DNA sequences. Demographic and clinical data of each patient were retrieved from corresponding clinical records.RESULTS: HPV was detected in 15 (25%) of ESCCs. HPV-16 was the most frequently observed genotype, followed by HPV-18; HPV-59 was also detected in one case. Unfortunately, HPV genotype could not be established in three cases due to lack of material for direct sequencing, although universal primers detected the presence of HPV generic sequences. No low-risk HPV genotypes were found nor was HPV-16/18 co-infection. HPV presence in ESCC was not significantly associated with gender, age, alcohol consumption, smoking, anatomic location, or histologic grade. All patients belonged to low and very low socioeconomic strata, and were diagnosed at advanced disease stage. Male patients were most commonly affected and the male:female ratio in HPV-positive ESCC increased two- fold in comparison with HPV-negative cases (6.5:1 vs 3.1:1).CONCLUSION: High prevalence of high-risk HPV in ESCC in Mexico does not support the hypothesis that HPV-associated ESCC is more common in areas with higher ESCC incidence rates.

复方沙棘籽油栓治疗慢性宫颈炎合并高危型HPV感染有效性和安全性Meta分析

目的基于Meta分析系统评价复方沙棘籽油栓联合rhIFNα-2b栓治疗慢性宫颈炎(CC)合并高危型人乳头瘤病毒(HPV)感染的有效性与安全性。方法检索中国知识资源总库(CNKI)、中国生物医学文献服务系统(SinoMed)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(VIP)、中国临床试验注册中心、PubMed、Cochrane Library建库至2022年7月1日收录的复方沙棘籽油栓治疗CC合并高危型HPV感染的随机对照试验(RCT)文献,进行数据提取和文献质量评价,运用RevMan5.4软件进行Meta分析和亚组分析。结果共纳入RCT文献10篇,试验组和对照组患者共1432例。与单独使用重组人干扰素(rhIFN)α-2b栓相比,联用复方沙棘籽油栓可显著提高CC合并高危型HPV感染的临床总有效率(RR=1.20,95%CI[1.15,1.26],P=0.79,I^(2)=0%)和治愈率(RR=1.40,95%CI[1.18,1.66],P=0.67,I2=0%),差异均有统计学意义;复方沙棘籽油栓联合rhIFNα-2b栓治疗可提高HPV转阴率,疗程越长效应越大,54天组(RR=1.14,95%CI[1.06,1.22],P=0.32,I^(2)=14%)、60天组(RR=1.61,95%CI[1.26,2.06],P=0.75,I^(2)=0%),84天组(RR=1.83,95%CI[1.26,2.64],P=0.05,I2=66%)。结论复方沙棘籽油栓联合rhIFNα-2b栓治疗CC合并高危型HPV感染的临床总有效率、治愈率和HPV转阴率均优于单用rhIFNα-2b栓,且无不良反应事件发生。

HPV拓展基因分型检测在宫颈癌预防中的临床价值

人乳头瘤病毒(HPV)感染是导致宫颈病变的主要原因,以HPV检测为初筛是宫颈癌筛查的进步。HPV检测特异性低,基于HPV的筛查可能面临很多挑战。HPV拓展基因分型检测通过检测HPV基因型可更早预测持续性宫颈病变的风险,有助于提前采取预防和治疗干预措施,以减少相关疾病的发生,还可有效地区分低风险与高风险患者,以最大限度地优化医疗资源分配。早期进行HPV拓展基因分型检测是宫颈病变未来风险预测和分层的关键,其在宫颈癌预防中具有重要价值。

HPV感染导致宫颈癌发生的协同因素研究进展

宫颈癌作为严重影响女性健康的危害因素备受全世界关注。宫颈癌的发生与遗传、生活方式及生物因素等有关,其中人乳头瘤病毒(human papilloma virus,HPV)尤其是高危型HPV持续感染宫颈细胞被认为是宫颈癌发生、发展的重要因素,而HPV持续感染人群最终并不是全部发展成宫颈癌,如存在高危HPV持续感染伴阴道、宫颈微环境菌群紊乱等多因素协同作用,可能会发展为宫颈癌。本文就HPV感染导致宫颈癌发生的协同因素(HPV型别,E6、E7蛋白表达,阴道、宫颈微环境等)进行综述。

Prevalence and Genotype Distribution of Oncogenic-Risk Human Papilloma Virus in the Cervix of Climacteric Women with Normal Pap Smears

Objective: To find out the incidence of high-risk HPV infections on climacteric women within our area of influence;and to typify HPV genotypes on women with normal cytology that come to our hospitalary unit of menopausia. Material and Method: Cross-sectional study;with a random sample of 140 cases of climacteric women of ≥50 years of age, with normal Pap smears for the last 12 months. HPV determination was carried out by PCR for screening, and by hybrid capture for genotype typification. Results: The percentage of climacteric women who are carriers of oncogenic HPV and a normal Pap smear was of 11.43% (16/140 cases). The genotype found most frequently was HPV-16, followed by HPV-58, 51 and 18. Conclusions: We found a high prevalence of women who were carriers of oncogenic HPV in climacteric women with normal Pap smears (latent infections) in our health region. We consider that cervical cancer screening, either by PCR or conventional Pap smear, should not be minimized or ignored from 50 years of age onwards.