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The Variable Characteristics of Human Papillomavirus in Squamous Cell Carcinoma and Adenocarcinoma of Cervix in China

Chen, Wen, PhD1; Sun, Haikui, PhD1; Molijn, Anco, PhD2; Zeng, Liang, MD3; Kang, Leni, PhD1; Jenkins, David, MD2; Zhang, Shaokai, PhD1; Cui, Jianfeng, BS1; Wu, Zeni, MPH1; Pirog, Edyta, MD4; Shen, Guihua, BS1; Zhang, Xun, MD1; Qiao, Youlin, MD, PhD1 Chinese HPV Typing Group

Journal of Lower Genital Tract Disease: October 2018 - Volume 22 - Issue 4 - p 355–361
doi: 10.1097/LGT.0000000000000408
Original Research Articles: Cervix and HPV

Objective A hospital-based multicenter, retrospective study was conducted to compare the distribution of human papillomavirus (HPV) in squamous cell carcinoma (SCC) and cervical adenocarcinoma (CADC) in China.

Methods Paraffin-embedded tissue blocks diagnosed as SCC and CADC across China were collected, as well as the total number of diagnosed invasive cervical cancer of the 9 selected centers. DNA enzyme immunoassay, reverse hybridization, and multiplex type-specific polymerase chain reaction were used for HPV genotyping.

Results The ratios of CADC to SCC were increasing from 2005 to 2010, in parallel with HPV prevalence in CADC. In 630 patients with SCC (mean ± SD age, 45.40 ± 10.30) and 718 patients with CADC (mean ± SD age, 46.09 ± 10.59) recruited, HPV prevalence rates were 97.6% and 74.5%, respectively. Human papillomavirus viral load for SCC is significantly higher than that for CADC. Most common HPV types distributed in SCC and CADC were HPV-16 (78.5%, 75.1%–81.6%; 47.1%, 42.9%–51.3%), HPV-18 (8.0%, 6.1%–10.4%; 41.1%, 37.0%–45.3%), HPV-52 (2.3%, 1.4%–3.8%; 5.6%, 4.0%–7.9%), and HPV-45 (1.1%, 0.6%–2.3%; 3.9%, 2.6%–5.9%). Different diagnostic mean ± SD age for HPV-16/HPV-18 versus other high-risk HPV types were observed: SCC (44.5 ± 9.94 vs 51.0 ± 10.83, p < .05) and CADC (44.1 ± 9.44 vs 47.4 ± 10.41, p = .006). For HPV-negative cases, mean ± SD age was 46.1 ± 10.73 in SCC and 50.3 ± 11.85 in CADC, which were older than the positive (45.4 ± 10.31, 44.5 ± 9.64). HPV-16 and HPV-18 were the most frequent HPV types in both histological types, and HPV-18 was more frequent in CADC than in SCC.

Conclusions Human papillomavirus infection was identified more often in SCC than in CADC. Women with HPV-associated cancers, especially HPV-16/HPV-18, were of a younger age at diagnosis when compared with non–HPV-associated cancers.

Evidence of HPV and specific HPV genotypes differed in frequency for cervical squamous cell carcinoma compared to adenocarcinoma in China.

1National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;

2DDL Diagnostic Laboratory, Rijswijk, the Netherlands;

3Hunan Cancer Hospital, Changsha, Hunan, China; and

4Weill Medical College of Cornell University, New York, NY

Reprint requests to: Xun Zhang, MD, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. E-mail:

Chinese HPV Typing Group members:

Li LY, Jiangxi Women and Children’s Hospital, Jiangxi, China

Wang J and Zeng L, Hunan Cancer Hospital, Hunan, China

Liu JH and Zhang Y, Sun Yat-sen University Cancer Hospital, Guangdong, China

Wang CYand Liu D, Liaoning Cancer Hospital, Liaoning, China

Cheng JX and Shen GQ, Xinjiang People’s Hospital, Xinjiang, China

Wang P and Yuan Y, Shaanxi Cancer Hospital, Shaanxi, China

Zhou Q and Tang Y, Chongqing Cancer Hospital, Chongqing, China

Xu M and Liao GD, Chongqing Medical College First Affiliated Hospital, Chongqing, China

Youlin Qiao and Anco Molijn received travel support from GlaxoSmithKline (GSK). David Jenkins is a former employee and consultant to GSK. All other authors have declared they have no conflicts of interest.

This work was supported by GlaxoSmithKline Biologicals SA. GSK was provided the opportunity to review a preliminary version of this manuscript for factual accuracy, but the authors were solely responsible for final content and interpretation.

Copyright © 2018 by the American Society for Colposcopy and Cervical Pathology