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Updated: May 23, 2025

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HPV 疫苗的影响:子宫癌前期的基因型特异性变化与子宫癌查细胞学的变化有相似之处

Rachael Adcock¹, Cosette M Wheeler^1,2, William C Hunt¹

¹UNM Comprehensive Cancer Center, Center for HPV Prevention, Albuquerque, NM, USA.

Journal of the National Cancer Institute

|March 12, 2025

概括

人类乳头瘤病毒 (HPV) 疫苗显著降低了HPV类型特定的宫内皮瘤 (CIN2/CIN3/AIS) 发生率,用于HPV16/18类型的疫苗和其他类型,如HPV31/33. 持续的随访对于监测疫苗对宫病变中的HPV基因型的长期影响至关重要.

科学领域:

妇科妇科妇科妇科
在瘤学瘤学.
疫苗学疫苗学疫苗学

背景情况:

有限的美国数据存在于HPV疫苗引入后宫内皮质瘤 (CIN) 2-3级和adenocarcinoma in situ (CIN2/CIN3/AIS) 宫内皮质瘤的HPV类型特定变化.
在查细胞学中观察到的HPV疫苗类型的下降值得进一步调查CIN2/CIN3/AIS.
这项研究解决了对美国CIN2/CIN3/AIS的详细HPV类型特定数据的需求.

研究的目的:

分析在HPV疫苗引入后CIN2/CIN3/AIS中的HPV类型特定发病率和流行率变化.
为了比较HPV类型特定的CIN2 / CIN3 / AIS率在疫苗实施前后的不同时间段.
评估HPV疫苗对年轻人特定高风险HPV (hrHPV) 类型的影响.

主要方法:

一个全州范围的宫活检样本接受了广泛的HPV基因定型.
在15-29岁的个体中,针对特定类型的hrHPV计算了CIN2/CIN3/AIS发病率和流行率.
权重发病率比率 (IRR) 和流行率的相对差异 (RDP) 与三个队列进行了比较:2006-2009,2012-2015和2015-2018.

主要成果:

在21至25岁的人群中,观察到HPV类型特定的CIN2/CIN3/AIS发病率的显著降低,包括HPV16,HPV18,HPV31和HPV33 (比较2006年至2009年与2015年至2018年).
对HPV16/18阳性CIN2/CIN3/AIS的流行率 (RDP) 发现了-43.8%的相对差异,比较了最早和最新的队列 (P < .001).
除了所有 hrHPV 类型的 HPV16/18 或 HPV16/18/31/33 之外,RDP 分别为 +56.6% 和 +92.5% (P < .001),表明非疫苗型 HPV 类型流行率的转变.

结论:

hrHPV类型特定的CIN2/CIN3/AIS发病率在HPV疫苗类型 (16/18) 以及HPV31和HPV33中显著下降.
HPV 疫苗在预防 HPV 相关癌症方面具有很高的益处,是首要任务.
需要进行持续的跟踪,以评估疫苗对CIN2+病变和癌症的基因型特异分布的长期影响,特别是在接受4价值HPV疫苗的队列中.

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