[Show abstract][Hide abstract] ABSTRACT: To investigate the prevalence of high risk human papillomavirus (HPV) genital infection and cervical cancer in adult women from Shenzhen.
Cluster sampling was used to investigate the prevalence of HPV infection and cervical cancer from women aged 20 - 59 years old living in Luohu, Futian, Nanshan, Longgang and Baoan districts in Shenzhen from April 2006 to April 2010. All women were detected for liquid-based cytology test (LCT) or Thinprep cytologic test (TCT) and high-risk HPV-DNA test with hybrid capture II (HC-II). All women with ≥ ASC-US by cytology and/or a positive HC-II test were asked to return for colposcopy and four-quadrant biopsy. Endocervical curettage was performed. Pathological finding were used as the gold standard of the diagnosis of cervical intraepithelial neoplasia.
10 210 women were involved in the study and 10 017 of them having completed data. The overall positive rate of high-risk HPV-DNA was 16.29%. HPV positive rates in 20-, 30-, 35-, 40-, 45-, 50-59 age groups were 17.37%, 15.59%, 16.33%, 14.74%, 17.16% and 17.98%, respectively. The curve of HPV infection rates in different age groups appeared a 'W' shape. HPV infection rates in the 25-years-olds and 50-59 year-olds groups were significantly higher than the other age groups (χ(2) = 4.50, P = 0.03). The overall prevalence rate of cervical intraepithelial lesions (CIN) was 7.52%, of which the prevalence rates of low-grade cervical intraepithelial lesions (CIN I) was 5.32% high-grade cervical intraepithelial lesions (CIN II/III) was 2.21%, cervical cancer was 0.12%. The prevalence of CIN I was significantly higher than the CIN II/III (χ(2) = 134.15, P < 0.001). The prevalence of cervical cancer in 45-age group was 0.12%, the highest. HPV infection rates increased with the grades of cervical lesions including women without CIN as 44.31%, in CINI as 70.73%, in CINII as 86.73%, and in CIN III as 96.75% and in cancer as 100.00%. The HPV infection rates were different in districts (χ(2) = 17.81, P = 0.03), with Futian and Luohu higher than those of Nanshan, Longgang and Baoan district. The prevalence rate of CIN in Baoan was lower than other districts. The CIN prevalence rates were not significantly different among the other districts of Shenzhen (χ(2) = 4.84, P = 0.18).
The prevalence of cervical cancer was low in adult women living in Shenzhen, with cervical lesions still in the early stage. Prevention of HPV infection and treatment of CIN were the key points for the prevention of cervical cancer.
No preview · Article · Aug 2012 · Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
[Show abstract][Hide abstract] ABSTRACT: To investigate the prevalence of high-risk human papillomavirus (HPV) and incidence of cervical intraepithelial neoplasia (CIN) in female populations in Shenzhen, Guangdong Province, China.
Totally 1137 women aged 15-59 from Shahe Community, Nanshan District, Shenzhen were investigated for cervical cancer during an population-based epidemiological screening from November 2004 to December 2004. Visual inspection with acetic acid (VIA), colposcopy, liquid-based cytology test (LCT), and hybrid capture 2 (HC-) were performed to detect the high-risk HPV types in cervical secretions. Biopsy under colposcope was performed in women who were HPV-positive with LCT >or= atypical squamous cells of undetermined sign (ASCUS) or HPV-negative with LCT >or= low grade squamous intraepithelial lesion (LSIL), with the pathological results as the golden standards.
The detection rate of high-risk HPV-DNA was 14.0%. HPV detection rates in 15-24, 25-29, 30-34, 35-39, 40-44, 45-49, and 50-59 age groups were 15.5%, 17.7%, 12.6%, 8.8%, 10.2%, 15.3%, and 21.0%, respectively (P < 0.05). HPV detection rates in 25-29 years group and 50-59 years group were significantly higher than those in other groups (P < 0.05) and 35-39 group had the lowest detection rate. The curve of HPV infection rates in all groups was 'V' type. The overall incidence of CIN was 4.4%. The incidences of CIN , CIN , and CIN were 3.2%, 1.0%, and 0.3%, respectively, in which the incidence of CIN was significantly higher than those of CIN and . HPV detection rates increased with cervical lesion grades, which in >or=CIN groups and normal group were 100.0% and 8.3%, respectively. No cervical cancer was identified in this research. The sensitivities of VIA, colposcopy, LCT, and HC-II for high-risk HPV screening were 35.7%, 50.0%, 92.9%,and 100%, respectively, in detecting high-grade squamous intraepithelial lesion (HSIL), the specificities of these four methods were 96.0%, 87.2%, 88.4%, and 86.9%, respectively. Satisfactory negative predictive values were obtained for all methods.
HPV infection is the main risk factor for CIN. Cervical cancer among female populations in Shenzhen is still in early stages. Prevention of HPV infection and treatment of CIN are key for the prevention of cervical cancer.
No preview · Article · Feb 2010 · Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae
[Show abstract][Hide abstract] ABSTRACT: To investigate the significance of genomic amplification of the telomerase RNA component (TERC) gene to serve as a genetic biomarker in the screening of cervical lesions.
A total of 715 cases were recruited, with liquid-based cytology diagnosis as normal (n = 347), atypical squamous cells of undetermined significance (ASCUS, n = 180), atypical squamous cells cannot exclude a high-grade lesion (ASC-H, n = 13), low-grade squamous intraepithelial lesions (LSIL, n = 115), high-grade squamous intraepithelial lesions (HSIL, n = 59) and atypical glandular cells (AGC, n = 1). The remaining cervical cells in the cytological preserving fluid were analyzed using a two-color fluorescence in situ hybridization (FISH) probe targeted to chromosome 3q26 containing TERC gene. The TERC gene findings were compared to the cytological and histological detected results, as well as high-risk human papillomavirus (HPV) detected results.
Genomic amplification of TERC gene was found in 5.8% of normal specimens, 22.2% of ASCUS, 30.8% of ASC-H, 27.8% of LSIL, 86.4% of HSIL and 1/1 of AGC. The positive rate was significantly lower in normal, ASCUS, ASC-H and LSIL compared with HSIL (all P < 0.01). Significantly more cells with genomic amplification of TERC gene were found in cervical intraepithelial lesion (CIN) II-III than CINI (77.8% vs. 9.3%), as well as invasive cervical cancer (96.7% vs. 9.3%), both P < 0.01. The rate of TERC gene amplification was higher in HPV positive patients (33.5%) than in HPV negative patients (5.2%, P < 0.01). The sensitivity of TERC gene amplification was significantly higher than that of cytological screening (81.88% vs. 36.96%, P < 0.01) in the differentiation of CINII or higher and CINI or lower diseases, its specificity was higher than high-risk HPV test (93.32% vs. 33.93%, P < 0.01) and positive prediction value (81.29%) was similar with cytological method (86.44%, P > 0.05); but its negative prediction value (93.56%) was lower than HPV test (97.06%, P < 0.05).
The positive rates of TERC gene amplification increased as cervical diseases worsened. TERC gene amplification is related to HPV infection. The gain of chromosome 3q26 in cytological specimens is an effective molecular genetic biomarker in screening of CINII or higher and invasive cervical cancer.
No preview · Article · Dec 2009 · Zhonghua fu chan ke za zhi
[Show abstract][Hide abstract] ABSTRACT: To study the amplification of human telomerase RNA component (hTERC) gene in the cervical exfoliated cells from natural population in Shenzhen and to explore its relationship with human pappiloma-virus (HPV) infection, abnormal cervical cytology and cervical intraepithelial neoplasia (CIN).
Three hundred and eighty-eight women, 30 - 59 year-old and having normal intelligence in a community of Shenzhen, were examined with liquid-based cytology. Human pappiloma-virus (HR-HPV) was tested by hybrid capture II (HC-II) and hTERC gene detection by fluorescence in situ hybridization (FISH). Patients with ASCUS and above lesion, and/or positive HR-HPV results and/or amplification of hTERC gene were examined by colposcopy, multiple biopsies of cervical quadrant and pathology.
The frequencies of CIN I, II, III, cervical cancer were 55 (14.18%), 4 (1.03%), 9 (2.32%) and 1 (0.26%) respectively, with the rate of hTERC gene amplification as 8.76%. There were significantly differences of hTERC amplification among the samples with different cytological and histological lesions as well with HPV infection (P < 0.01). (1) The positive rate of HPV infection was 17.01%; the positive rates of hTERC gene amplification were 19.70% in HPV positive and 6.52% in HPV negative samples and the results were significantly different (P < 0.01). (2) Cytologically, the rates of hTERC gene amplification appeared to be as follows: NILM (5.97%), ASCUS (18.75%), LSIL (10.00%), ASC-H (66.67%), HSIL (100.00%). There was a marked increase of hTERC amplification in patients with HSIL and above lesions (P < 0.01). (3) On histology findings, the rates of hTERC gene amplification were as follows: NILM (0%), CIN I (5.45%), CIN II (50.00%), CIN III (77.78%), and invasive carcinoma (100.00%). There was a marked increase of hTERC amplification in patients with CIN II and above lesions (P < 0.01).
There was a close correlation between amplification of hTERC and histological as well cytological lesions which increased progressively along with the severity of cytological and histological grade. The evidence of hTERC, with or without amplification, might serve as a prognostic indicator to measure the grade of lesion.
No preview · Article · Sep 2009 · Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
[Show abstract][Hide abstract] ABSTRACT: To evaluate the value of cervical cytology and hybrid capture II (HC- II) human papillomavarus (HPV) test for screening cervical lesion.
Conventional papanicolaou (Pap) smear by improved take-samples, liquid-based cytology test (LCT) and HC- II human papillomavarus test were performed in 425 women in Shang Mei-lin community of Futian region in Shenzhen city, from December 2007 to March 2008 and the above methods were performed in 75 women in Shenzhen Hospital of Peking University at the same time. Age stratified sampling was used. Samples of Pap were taken a broom-type sampling device (take-samples used for LCT) with split-sampling method. Those women with HPV-positive, Pap> or =atypical squamous cells of undetermined sign (ASCUS) or LCT> or =ASCUS received multi-spot biopsy and endocervical curettage under colposcopy. Final diagnosis would depend on pathological findings as well, to evaluate the values of Pap, LCT, HC-II HPV, Pap-HPV parallel test, LCT-HPV parallel test, Pap-HPV serial test and LCT-HPV serial test for the screening program on cervical cancer.
(1) In this study, 7 women had cervical intraepithelial neoplasia (CIN) II, another 7 had CIN III, 1 had cervical cancer in the community; 9 had CIN II, 11 had CIN III, 3 had cervical cancer in the hospital, respectively. (2) The sensitivity of HC-II HPV and cytology-HPV parallel test for detecting > or =CIN II was >95.0% while negative pre-value were nearly 100.0%. (3) There were no significant differences of screening effectiveness and unsatisfactory rates between Pap of improved take-samples and LCT. (4) The cost-effectiveness ratio of Pap-HPV parallel test was higher than LCT-HPV parallel test.
It was suggested that the first choice for screening of cervical serious lesion were HC-II HPV and cytology-HPV parallel test while Pap-HPV parallel test was the best method for screening purposes.
No preview · Article · Jun 2009 · Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
[Show abstract][Hide abstract] ABSTRACT: To investigate the human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) morbidity of women from different occupations in Shenzhen city.
2045 women of five kinds of occupation in Shenzhen city, including 130 teachers, 385 workers, 316 service women, 199 poverish women, 420 doctors or nurses and 595 general residents were included. We screened these women by methods of detecting high risk HPV of hc2 combing with LCT. Women with screening positive results were diagnosed CIN by colposcopic biopsy.
(1) High risk factors on HPV infection rate in different occupations were different with the highest in service occupation (19.3%) while the lowest appeared in medical workers (11.9%). (2) In those 2045 women, we found 199 cervical lesions including pathological HPV infection, CIN1, 2, 3 and cervical cancers, with morbidity rates as 4.11%, 3.28%, 1.67%, 0.54% and 0.15% respectively. Along with the progress of the cervical lesions, the morbidity decreased. (3) The morbidity rates of CIN in different occupations were different, with the highest of HSIL in service occupation and the lowest in teachers.
Women of different occupations in Shenzhen city had different high risk HPV infection rates and CIN morbidity. The HPV infection rate and HSIL morbidity were highest among women having service related jobs.
No preview · Article · Nov 2007 · Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
[Show abstract][Hide abstract] ABSTRACT: To study the rate of concordance between positive cervical cytologic interpretation based on liquid-based preparations and subsequent histologic diagnosis.
Liquid-based cervical cytology (SurePath) was carried out in 15,393 patients. Cases with the cytologic diagnosis of epithelial cell abnormality were further investigated by human papillomavirus (HPV) DNA testing (Hybrid Capture II) for the high-risk HPV DNA, colposcopic examination and multiple cervical biopsies. The 2001 version of The Bethesda System for reporting gynecologic cytology was applied. Positive cytologic diagnosis included atypical squamous cells of undetermined significance (ASC-US) or above. Histologic correlation was available in some of the patients. The rate of concordance between positive cytologic interpretation and subsequent histologic diagnosis was calculated.
Amongst the 15,393 liquid-based cytology cases studied, the cytologic diagnosis of 7 cases squamous cell carcinoma were all concordance with histologic diagnosis, while the rates for high-grade and low-grade squamous intraepithelial lesions were 93.6% (103/110) and 82.0% (443/540), respectively. A positive correlation was also demonstrated between detection of high-risk HPV DNA, positive cytologic interpretation and positive histologic diagnosis.
Liquid-based cytologic preparation, when coupled with standardized reporting using the Bethesda System 2001, can achieve a high diagnostic accuracy of cervical epithelial abnormalities.
No preview · Article · Aug 2007 · Zhonghua bing li xue za zhi Chinese journal of pathology
[Show abstract][Hide abstract] ABSTRACT: To investigate the clinical value of gene chips technology for human papillomavirus (HPV) in cervical cancer screening.
A population-based cross-sectional screening study was conducted among 1137 women aged 15-59 in a community, Shenzhen city. Hybrid capture 2 (hc2) and gene chip technology were performed to examine the high risk type human papillomavirus in the exfoliated cervical cells. Liquid-based cytology test (LCT) was also performed at the same time. The HPV-positive women with LCT > or = atypical squamous cells of undetermined sign (ASCUS) and the HPV-negative women with LCT > or = low grade squamous intraepithelial lesion (LSIL) underwent biopsy under colposcopy. The pathological results were used as the gold standard to evaluate the two HPV test methods.
Totally 122 biopsy specimens were obtained. Pathological examination showed no cervical cancer case, 3 cases of grade III cervical intraepithelial neoplasia (CIN), 11 cases of grade II CIN, 36 cases of grade I CIN, 69 cases of chronic cervicitis and metaplasia of squamous epithelium, and 3 cases of normal cervix. The HPV-positive rate was 14.0% by hc2 and 9.8% by gene chips with a HPV-positive rate by hc2 higher than that by gene chips (P < 0.001) and an mediocre accordance rate between these methods (kappa = 0.498). The. HPV-positive rate increased along with the increase of the grade of cervical lesions (P < 0.05). The sensitivity, specificity, accuracy, positive prevalue, negative prevalue, positive likelihood ratio and negative likelihood ratio of hc2 for high-risk HPV were 100%, 87.1%, 87.3%, 8.8%, 100%, 7.7 and 0.000, respectively; and those of gene chips were 78.6%, 91.1%, 90.9%, 9.9%, 99.7%, 8.8 and 0.235 respectively.
At present hc2 high risk HPV testing is still the better method for cervical cancer screening. Gene chips technology is able to rival hc2 except that its sensitivity for cervical high grade lesions need be improved.
No preview · Article · Feb 2006 · Zhonghua yi xue za zhi