| Objective:This study aims to address HPV infection common types of patients with cervical cancer in Northeastern China, at the same time, discuss the multiple HPVs infection cases of patients with cervical cancer in this region, besides explore the influence of multiple infection of HPV in cervical cancer onset time,progression and malignant degree and its differences between different racial/ethnic and pathological types, providing guidance for designing a optimal new generation vaccine for women in our country.Methods:1. From April 2011 to June 2015, 160 patients with a pathological diagnosis from the First Hospital of Jilin University of cervical squamous cell carcinoma,adenocarcinoma, adenosquamous carcinoma or neuroendocrine carcinoma were included in the study.2. DNA extraction was performed following the instructions provided by the manufacturer of the DNeasy Tissue Kit(Qiagen, Hilden, Germany).3. The HPV Genotyping kit(Yaneng Bio, Shenzhen, China) can be used for qualitative detection and genotyping of 23 HPV genotypes.4. Chi-square(χ2) tests were performed using the SPSS statistical software package version 12 to determine the relationship between HPV type and other parameters(age and histological differentiation degree). A P-value of < 0.05 was considered statistically significant.Results:1. Among the 160 specimens containing a single infection(106; 66.25%)and multiple infections(54; 33.75%), HPV 16(96.25%) was determined by the PCR-reverse dot hybridization method to be the most common genotype,followed by HPV 18(20.62%), 33(10%), 59(5%), 58(1.88%), 31(1.88%), 52(1.3%), 39(0.63%), 45(0.63%), 53(0.63%) and 56(0.63%). HPV 81(0.63%)was a low-risk type. Fifty-four multiple infections included 46 cases(85.19%) of double infections, 7 cases(12.96%) of triple infections and 1 case(1.85%) of quadruple infections. The most commonly found co-infection combination in double infections was HPV 16 with 18(n = 24), followed by HPV 16 with 33(n= 9) and HPV 16 with 59(n = 6). Overall, the co-infection of HPV 16 with other types was the most common(53 cases), followed by HPV 18(30), HPV 33(16),HPV 59(8), HPV 58(3) and HPV 31(2). The most frequent combination of triple infections was HPV 16/18/33(n = 4), which was 7.41% of the multiple infections. HPV 18 was found in three patients as single HPV infections(9.38%)and in 29 additional patients in the presence of multiple HPV types(90.62%).2. The numbers of single infections and multiple infections were 36(61%)and 23(39%) in the poor differentiation group, while they were 66(71%) and27(29%) in the moderate differentiation group, respectively. Thus, the proportion of multiple infections(39%) in the poor differentiation group was significantly higher than that in the moderate differentiation group(29%). From stage IA to IIB, the proportions of all cases which were multiple infections were100%, 38.89%, 30.43%, 20%, 28.21% and 40%, respectively. Whereas, the proportions of single infectious were 0%, 61.11%m 69.57%, 80%,71.79% and60%, respectively. The numbers of squamous carcinoma and adenocarcinoma cases with multiple infections were 52(35%) and 1(11%), and those with single infections were 96(65%) and 8(89%), respectively.3. HPV 16 was detected more frequently in invasive cervical cancer from women younger than 40 years at diagnosis(100%) compared with those 65 years or older(80%). Few differences were observed in HPV detection between ethnic groups. The proportions of multiple infections in the <35, 35-39,40-44, 45-49, 50-54, 55-59, 60-64 and >64 years old age groups were 25%,35.29%, 42.31%, 30.77%, 22.73%, 29.63%, 35.29% and 60%, respectively.The percentage of multiple infections in the Han women and Manchu/Mongolian women were 36.64% and 14.29%, respectively.4. Mean numbers of HPV types per specimen for the high, moderate and poor differentiation patient groups were 1.5, 1.28 and 1.42, respectively. Mean numbers of HPV types per specimen for the <35, 35-39, 40-44, 45-49, 50-54,55-59, 60-64 and >64 years old patient groups were 1.25, 1.41, 1.42, 1.38,1.15, 1.31, 1.53 and 1.8, respectively.Conclustion:1. HPV16 and 18 in our study were the most common types of infection,followed by orderly HPV33(16 cases), 59(8 cases), 58(3 cases) and 31(3cases).2. HPV16 was the main type in the single infection and multiple infection.But HPV18 had a higher frequency of infection in the multiple infection than in single. And HPV33, 59 and 58 only appeared in multiple infection.3. HPV31, 33,45,52,53 and 56 showed the trend of co-infection with HPV16.4. Multiple infection rate of squamous cell carcinoma was higher than adenocarcinoma.5. We speculated that multiple infections could affect the degree of malignancy of cervical cancer. |
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