[Study on the distribution of human papillomavirus types in cervix among Chinese women: a meta-analysis]

To explore the distribution the tyes- of human papillomavirus (HPV) in cervical biopsy tissue or exfoliated cell specimen of Chinese women and to estimate the perspective of HPV prophylactic vaccine in China.

A total of 18 studies using polymerase chain reaction to detect HPV types were included in this Meta-analysis. There were 1335, 394, 381 and 2584 cases included in invasive cervical cancer (ICC), high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL) and normal group respectively. The overall HPV prevalence was estimated by adjusting the variables using unconditional multiple logistic regression model. HPV type-specific HPV prevalence rates of 18 types including HPV6, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 70, 73 and 82 were estimated, after stratified by cervical lesion of Chinese women.

In ICC, HSIL, LSIL and normal group, the overall HPV prevalence rates were 82.7%, 88.5%, 69.3% and 13.1% respectively, and the HPV16 type-specific prevalence were 61.9%, 46.7%, 21.0% and 3.1%. HIPV16 was the predominant type in all cervical lesion specimen followed by HPV18 and 58 in ICC group, then HPV58 and 52 in HSIL, LSIL and normal. The estimated HPV16/18-positive fractions were 69.6%, 59.1%, 32.3% and 4.4% respectively in ICC, HSIL and normal. Data from the Meta-analysis showed that the top five common HPV types in ICC women were HPV16, 18, 58, 52 and 31 which contributed for 82.9% of the ICC. Thus the HPV16, 18, 31, 33, 35, 45, 52 and 58 were accounted for 87.7% ICC in China mainland.

The proportional impact of HPV16/18 vaccine on ICC was estimated as high as 69.6% in China. HPV58 seemed the priority HPV type and should be emphasized enough to be included in the development of new generation HPV vaccine. However, more uniform standardized multi center studies were necessary to get more exact figure about HPV distribution in China.