Human papillomavirus type-distribution in cervical cancer in China: the importance of HPV 16 and 18.
Prophylactic vaccination against HPV 16 and 18 has the potential for effective prevention of high-grade precancer (cervical intraepithelial neoplasia [CIN)] 2/3) and ICC caused by these viruses (globally 50 and 70%, respectively) when employed in women prior to starting sexual activity. To provide data for decisions on HPV vaccination in China, we determined HPV type-distribution in ICC and CIN 2/3 from women of different regions within China. A multicenter study was conducted by randomized sampling of paraffin blocks of 664 ICC (630 squamous cell carcinoma [SCC]; 34 adenocarcinoma [ADC]), 569 CIN 2/3 cases from seven regions of China. Histological diagnosis was confirmed in 1,233 cases by consensus review. HPV DNA was detected using the SPF10 LiPA25 version 1 assay. HPV prevalence was 97.6% in SCC, 85.3% in adenocarcinoma, and 98.9% in CIN 2/3. HPV 16 (76.7%) and HPV 18 (7.8%) were the most common, together accounting for 84.5% of SCC, followed by HPV 31 (3.2%), HPV 52 (2.2%), and HPV 58 (2.2%). HPV positivity in SCC did not differ notably by region. However, SCC cases from women <or=34 years had higher HPV 16 positivity than women over 50 years, among whom HPV 52, 58, and 39 were more common. HPV 16 and 18 were under-represented, whereas HPV 31, 52, and 58 were over-represented in CIN2/3 compared to SCC. The potential impact of vaccines against oncogenic HPV types 16 and 18 is estimated to be high (84.5%) against total SCC. These data are critical for China's future evaluation of the cost-effectiveness of current cervical cancer vaccines and of HPV-based screening guidelines.
Chen
Wen
W
Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.
Zhang
Xun
X
Molijn
Anco
A
Jenkins
David
D
Shi
Ju-Fang
JF
Quint
Wim
W
Schmidt
Johannes E
JE
Wang
Ping
P
Liu
Yu-Ling
YL
Li
Lian-Kun
LK
Shi
Hong
H
Liu
Ji-Hong
JH
Xie
Xing
X
Niyazi
Mayinuer
M
Yang
Pei
P
Wei
Li-Hui
LH
Li
Long-Yu
LY
Li
Jie
J
Liu
Jin-Feng
JF
Zhou
Qi
Q
Hong
Ying
Y
Li
Li
L
Li
Qing
Q
Zhou
Hong-Lin
HL
Bian
Mei-Lu
ML
Chen
Jing
J
Qiao
You-Lin
YL
Smith
Jennifer S
JS
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D002681:China; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology / Q000821:virology*