Cervical human papillomavirus infection, genotyping and the relationship with the results of Thinprep Cytology Test in 9174 female physical examinees in Xi’an, China

Objective: To investigate the infection status of human papillomavirus (HPV) in the cervix of women in Xi’an of China, the genotyping characteristics and the correlation with the results of TCT (Thinprep Cytology Test), in order to provide the basis for the prevention and treatment of cervical lesions in Xi’an of China. Methods: The data of 9174 women who were screened by HPV and TCT in the First Affiliated Hospital of Xi’an Jiaotong University from June 2017 to June 2019 were collected and analyzed statistically. Results: Among 9174 patients, 1045 (10.76%) patients were HPV positive, and the highest infection rate reached 12.26% (116/1045) over 60 years old. In HPV positive patients, the infection rate of single genotype (76.56%, 800/1045) was higher than that of multiple genotype (23.44%, 245/1045) (P $<$ 0.01). The top four genotypes were 52, 53, 58 and 16, accounting for 16.24% (214/1318), 11.31% (149/1318), 11.08% (146/1318), and 11.00% (145/1318), respectively. The positive rate of TCT was 10.61% (26/345) in patients with multiple HPV infection and 9.25% (74/800) in patients with single HPV infection. Among the 100 patients with positive HPV and TCT, the top four genotypes were 58, 52, 53 and 16, which were consistent with the overall HPV infection. Limitations and Conclusion: The main subtype of HPV infection in physical examination of women in Xi’an is 52, 58, 53 and 16. This work is valuable for achieving early detection and treatment and thus reducing the incidence of cervical cancer in this area. The combined detection of HPV typing and TCT can improve the effectiveness of cervical disease screening.

Human papillomavirus; Liquid based cytology; Genotype; Cervical intraepithelial lesions; Xi'an, China

[1] Tian PF, Chou LX. Research progress in the treatment of cervical cancer. Cancer Research and Clinic. 2018; 30: 211–214.

[2] Waggoner SE. Cervical cancer. The Lancet. 2003; 361: 2217–2225.

[3] Fernandes K, Chicco D, Cardoso JS, Fernandes J. Supervised deep learning embeddings for the prediction of cervical cancer diagnosis. PeerJ Computer Science. 2018; 4: e154.

[4] Parkin DM, Bray F. Chapter 2: the burden of HPV-related cancers. Vaccine. 2006; 24: S11–S25.

[5] Swangvaree SS, Kongkaew P, Rugsuj P, Saruk O. Prevalence of high-risk human papillomavirus infection and cytologic results in Thailand. Asian Pacific Journal of Cancer Prevention. 2010; 11: 1465–1468.

[6] Decker K, Singh H. Reducing inequities in colorectal cancer screening in North America. Journal of Carcinogenesis. 2014; 13: 12.

[7] Yuan Y. A survey and evaluation of population-based screening for gastric cancer. Cancer Biology & Medicine. 2013; 10: 72–80.

[8] Shen J, Sun LX. Progress in the discovery of cervical cancer with accidental findings. Cancer Research and Clinic. 2019; 31: 69–72.

[9] Shi YH, Wang BW, Tuokan T, Li QZ, Zhang YJ. Association between micronucleus frequency and cervical intraepithelial neoplasia grade in Thinprep cytological test and its significance. International Journal of Clinical & Experimental Pathology. 2015; 8: 8426– 8432.

[10] Camuglia AC, Syed J, Garg P, Kiaii B, Chu M, Jones PM, et al. TCT- 733 coronary flow reserve pre and post transcatheter aortic valve implantation in severe aortic stenosis: an invasive evaluation study of coronary flow dynamics. Journal of the American College of Cardiology. 2013; 62: B223–B224.

[11] Elfström KM, Smelov V, Johansson ALV, Eklund C, Naucler P, Arnheim-Dahlström L, et al. Long-term HPV type-specific risks for ASCUS and LSIL: a 14-year follow-up of a randomized primary HPV screening trial. International Journal of Cancer. 2015; 136: 350–359.

[12] Firmino N, Martinez VD, Rowbotham DA, Enfield KSS, Bennewith KL, Lam WL. HPV status is associated with altered PIWI-interacting RNA expression pattern in head and neck cancer. Oral Oncology. 2016; 55: 43–48.

[13] Ji J, Zhang HM, Li N, Wang YL. Analysis of HPV infection status in women screening outpatients in Xi’an area. Hainan Medical Journal. 2017; 28: 3004–3006.

[14] Zhang LH, Chang XH, Fan YL, Guo CX. Analysis of human papillomavirus type and related factors in gynecological patients from 2012 to 2015. Chinese Journal of Pathogenic Biology. 2017; 12: 83–86.

[15] Lo KW, Wong YF, Chan MK, Li JC, Poon JS, Wang VW, et al. Prevlence of human papillomavirus in cervical cancer: a multicenter study in China. International Journal of Cancer. 2002; 100: 327– 331.

[16] Hu LF. Application of TCT combined with HR-HPV in screening of cervical precancerous lesions. Chinese Journal of Maternal and Child Health. 2018; 33: 205–208.

[17] Shan W, Zhang T, Zhang TJ, Zhao GM. Epidemiological status of female human papillomavirus (HPV) infection in China. Chinese Journal of Disease Control. 2017; 21: 89–93.

[18] Boda D, Neagu M, Constantin C, Voinescu RN, Caruntu C, ZuracS, et al. HPV strain distribution in patients with genital warts in a female population sample. Oncology Letters. 2016; 12: 1779–1782.

[19] Harper DM, Demars LR. Primary strategies for HPV infection and cervical cancer prevention. Clinical Obstetrics and Gynecology. 2014; 57: 256–278.