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J Cancer 2021; 12(10):2815-2824. doi:10.7150/jca.55771 This issue Cite

Research Paper

Efficient combination of Human Papillomavirus Genotyping for the triage of women with Atypical Squamous Cells of Undetermined Significance in Chinese rural population: A population-based study

Wei Wang1, Huina Zhang2*, Leqian Lin1, Aimin Yang3,4, Jing Yang1, Weihong Zhao1, Zhilian Wang1, Lili Zhang1, Xiaoqiang Su1, Zhe Wang1, Chen Wang5, Haitao Zhang1, Bo Feng1, Dongyan Li1, Huiqiang Liu1, Xiaofen Niu1, Jintao Wang6, Jinghui Song7, Li Li8, Weiguo Lv9, Chengquan Zhao10✉, Min Hao1✉

1. Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China.
2. Department of Pathology, University of Rochester Medical Center, Rochester, NY 14642, USA.
3. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
4. Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China.
5. Department of pathology, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China.
6. Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China.
7. Department of Obstetrics and Gynecology, Affiliated Hospital of Inner Mongolia, Medical University, Huhhot 010000, China.
8. Department of Obstetrics and Gynecology, Affiliated Tumor Hospital of Guangxi, Medical University, Nanning 530000, China.
9. Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China.
10. Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA 16066, USA.
*Co-first author.

✉ Corresponding authors: Min Hao, MD, PhD. Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, 382 Wuyi Rd, Taiyuan, 030001 China. Tel/fax: +86-03513362 866, E-mail: eryuanhaominedu.cn; Chengquan Zhao, MD. Depa More

Citation:
Wang W, Zhang H, Lin L, Yang A, Yang J, Zhao W, Wang Z, Zhang L, Su X, Wang Z, Wang C, Zhang H, Feng B, Li D, Liu H, Niu X, Wang J, Song J, Li L, Lv W, Zhao C, Hao M. Efficient combination of Human Papillomavirus Genotyping for the triage of women with Atypical Squamous Cells of Undetermined Significance in Chinese rural population: A population-based study. J Cancer 2021; 12(10):2815-2824. doi:10.7150/jca.55771. https://www.jcancer.org/v12p2815.htm
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Abstract

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Objective: In this prospective, population-based study, we evaluated the utility of high-risk human papillomavirus (HR-HPV) genotyping for triaging women with atypical squamous cells of undetermined significance (ASC-US) in the Chinese rural area.

Methods: A total of 40,000 women were recruited from rural areas of Shanxi Province, China, between June 2014 and December 2014. Women with Pap results of ASC-US underwent HPV genotyping, colposcopy and histopathological examination. For those with normal cervixes or cervical intraepithelial neoplasia (CIN) 1 on the initial evaluation, a 2-year follow-up study was performed.

Results: The reporting rate of ASC-US was 5.76% (2,304/40,000) in the study population. The detection rates of CIN 2 or above (CIN2+) and CIN 3 or above (CIN3+) in women with ASC-US were 7.28% and 1.75%, respectively. HPV 16 (39.53%), HPV 58 (17.83%), and HPV 52 (15.50%) were the three most prevalent HR-HPV genotypes among all women with ASC-US cytology. The five most common HR-HPV genotypes in CIN3+ lesions were HPV16, HPV58, HPV33, HPV31 and HPV18. Compared with the 15 HR-HPV testing, genotyping for a combination of HPV16/18/31/33/58 increased specificity significantly with virtually no loss of sensitivity for detecting CIN2+ and CIN3+ lesions, as well as significantly reduced colposcopy referral rate (23.15% vs 33.70%, p<0.01). In addition, in the 2-year follow-up period, women with infection of HPV16, 18, 31, 33 or 58 genotypes were the most likely population (92%, 23/25) to develop CIN2 lesion.

Conclusion: Our results demonstrate that genotyping for a combination of HPV16/18/31/33/58 provides a more efficient and cost-effective model to risk-stratify women with ASC-US in the Chinese rural population.

Keywords: Human Papillomavirus (HPV) genotyping, Atypical Squamous Cells of Undetermined Significance (ASC-US), cervical cancer screening, Pap test, cervical intraepithelial neoplasia

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APA
Wang, W., Zhang, H., Lin, L., Yang, A., Yang, J., Zhao, W., Wang, Z., Zhang, L., Su, X., Wang, Z., Wang, C., Zhang, H., Feng, B., Li, D., Liu, H., Niu, X., Wang, J., Song, J., Li, L., Lv, W., Zhao, C., Hao, M. (2021). Efficient combination of Human Papillomavirus Genotyping for the triage of women with Atypical Squamous Cells of Undetermined Significance in Chinese rural population: A population-based study. Journal of Cancer, 12(10), 2815-2824. https://doi.org/10.7150/jca.55771.

ACS
Wang, W.; Zhang, H.; Lin, L.; Yang, A.; Yang, J.; Zhao, W.; Wang, Z.; Zhang, L.; Su, X.; Wang, Z.; Wang, C.; Zhang, H.; Feng, B.; Li, D.; Liu, H.; Niu, X.; Wang, J.; Song, J.; Li, L.; Lv, W.; Zhao, C.; Hao, M. Efficient combination of Human Papillomavirus Genotyping for the triage of women with Atypical Squamous Cells of Undetermined Significance in Chinese rural population: A population-based study. J. Cancer 2021, 12 (10), 2815-2824. DOI: 10.7150/jca.55771.

NLM
Wang W, Zhang H, Lin L, Yang A, Yang J, Zhao W, Wang Z, Zhang L, Su X, Wang Z, Wang C, Zhang H, Feng B, Li D, Liu H, Niu X, Wang J, Song J, Li L, Lv W, Zhao C, Hao M. Efficient combination of Human Papillomavirus Genotyping for the triage of women with Atypical Squamous Cells of Undetermined Significance in Chinese rural population: A population-based study. J Cancer 2021; 12(10):2815-2824. doi:10.7150/jca.55771. https://www.jcancer.org/v12p2815.htm

CSE
Wang W, Zhang H, Lin L, Yang A, Yang J, Zhao W, Wang Z, Zhang L, Su X, Wang Z, Wang C, Zhang H, Feng B, Li D, Liu H, Niu X, Wang J, Song J, Li L, Lv W, Zhao C, Hao M. 2021. Efficient combination of Human Papillomavirus Genotyping for the triage of women with Atypical Squamous Cells of Undetermined Significance in Chinese rural population: A population-based study. J Cancer. 12(10):2815-2824.

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