子宫颈 ASCUS 女性 HPV 16 型患病率的种族差异,Cancer Cytopathology

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子宫颈 ASCUS 女性 HPV 16 型患病率的种族差异
Cancer Cytopathology ( IF 2.6 ) Pub Date : 2020-04-03 , DOI: 10.1002/cncy.22267
Carolann Risley _{1,

2} , Megan A Clarke ₂ , Kim R Geisinger ₁ , Mary W Stewart ₁ , Lei Zhang _{1,

3} , Kim W Hoover ₁ , Laree M Hiser ₁ , Kenyata Owens _{1,

4} , Maria DeMarco ₂ , Mark Schiffman ₂ , Nicolas Wentzensen ₂

Affiliation

背景通过全州人群的部分基因分型，了解种族对具有未确定意义的非典型鳞状细胞 (ASCUS) 细胞学的女性人乳头瘤病毒 (HPV) 分布的影响可以为基于 HPV 的预防工作提供信息。方法 2014 年 1 月 1 日至 2017 年 12 月 31 日期间具有任何细胞学结果和部分 HPV 基因分型的 21 至 65 岁女性，用于 ASCUS 分类。所有女性都参加了密西西比州卫生部的诊所。从电子健康记录中提取年龄、种族、细胞病理学和 HPV 数据并进行分析。使用 ThinPrep 处理细胞学标本，并使用 Cobas 4800 检测进行 HPV 检测。HPV 基因型在分层类别中进行评估。卡方检验和多项逻辑回归模型评估了种族和类型流行率之间的关联。结果共有 43,106 名女性接受了细胞学和 ASCUS 分类的宫颈癌筛查。其中，34363（80.2%）例细胞学正常，4672例（10.9%）ASCUS，2683例（6.3%）低级别鳞状上皮内病变，633例（1.5%）高级别鳞状上皮内病变。与白人 (5.6%) 相比，黑人占样本的 69.3%，并且具有更高比例的 HPV 阳性 ASCUS (6.5%)。黑人感染 HPV-16 的几率显着降低（优势比 [OR]，0.66；95% 置信区间 [CI]，0.6-0.9；P = .002），并显着增加了 12 种其他类型的几率（OR，1.37；95% CI, 1.2-1.5; P < .0001) 与白人相比。结论在多样化的人群中，HPV 基因型的显着差异按种族显示。重要的是，与白人相比，患有 ASCUS 的黑人不太可能对 HPV-16 呈阳性。正在进行的工作是按种族评估个体基因型患病率和基因型特定的癌前病变风险。

"点击查看英文标题和摘要"

Racial differences in HPV type 16 prevalence in women with ASCUS of the uterine cervix

BACKGROUND Understanding racial influences on human papillomavirus (HPV) distribution in women with atypical squamous cells of undetermined significance (ASCUS) cytology via partial genotyping in a statewide population can inform HPV-based prevention efforts. METHODS Women aged 21 to 65 years with any cytology result and partial HPV genotyping for ASCUS triage between January 1, 2014, and December 31, 2017, were included. All women attended a Mississippi State Department of Health clinic. Age, race, cytopathologic, and HPV data were extracted from the electronic health record and analyzed. Cytologic specimens were processed with ThinPrep and HPV testing with the Cobas 4800 assay. HPV genotypes were evaluated in hierarchical categories. Chi-square tests and multinomial logistic regression models evaluated associations between race and type prevalence. RESULTS There were 43,106 women who underwent cervical cancer screening with cytology and ASCUS triage. Of these, 34,363 (80.2%) had normal cytology, 4672 (10.9%) had ASCUS, 2683 (6.3%) had a low-grade squamous intraepithelial lesion, and 633 (1.5%) had a high-grade squamous intraepithelial lesion. Blacks represented 69.3% of the sample and had a higher proportion of HPV-positive ASCUS (6.5%) in comparison with whites (5.6%). Blacks had significantly decreased odds of HPV-16 (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.6-0.9; P = .002) and significantly increased odds for 12 other types (OR, 1.37; 95% CI, 1.2-1.5; P < .0001) in comparison with whites. CONCLUSIONS In a diverse population, significant differences in HPV genotypes are shown by race. Importantly, blacks with ASCUS are less likely to be positive for HPV-16 in comparison with whites. Ongoing work is evaluating the individual genotype prevalence and genotype-specific risk of precancer by race.

更新日期：2020-04-03

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