Significance of human papillomavirus test to screen for early cervical cancer

  [Abstract]: Objective To study the human papillomavirus (HPV) subtype infection and to explore the significance of HPV DNA testing in the prevention and treatment of cervical cancer. Methods DNA hybridization technique was applied to detect HPV genotyping in 3700 gynecological outpatients. Results Among 3700 patients, 1071 patients were infected with HPV, and the HPV infection rate was 28.95%, with 1400 HPV infections. Among the patients, there were 1124 cases of high-risk HPV (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), accounting for 80.29% of the total number of infections; 151 cases of low-risk HPV (6, 11, 42, 43, 44), accounting for 10.79% of the total number of infections; 125 cases of common HPV (53, 66, P8304) in the Chinese population, accounting for 1.5% of the total number of infections. The number of patients with multiple infections of 21 HPV genotypes was 250, accounting for 23.34% of the total number of HPV infections. Among them, dual infections accounted for 77.6% of the multiply infected patients. Conclusion DNA hybridization technology for HPV genotyping can detect multiple subtypes in 1 time, which is beneficial for the diagnosis of HPV multiple infections and prevention of cervical cancer, and can be used as a means of cervical cancer screening.  Discussion HPV infection is very common in the general population, and the prevalence of HPV infection in normal women is 20% to 46% [3], and it has also been reported that the lifetime chance of HPV infection in sexually active individuals is as high as 75-80% [4]. In the present study, the prevalence of HPV infection was 28.95%, which is similar to that reported in the literature. When the body is infected with HPV, the viral genes can integrate into the cervical cells and the normal immune system of the body can recognize the infected cells and remove them. If the infected cells continue to survive and proliferate, they may develop into precancerous lesions or cervical cancer. Persistent or recurrent infection with high-risk subtypes of HPV has been identified as the most important cause of cervical carcinogenesis in the literature [5], while Lee et al [6] further investigated the relationship between multiple HPV infections and cervical cancer and found that single HPV infection increased the risk of developing cervical cancer by 19.9-fold, while multiple HPV infections increased this risk to 31.8-fold. In view of the close correlation between high-risk HPV and cervical cancer, high-risk HPV has been used clinically as an important marker for screening early cervical cancer, and clinical data also prove that high-risk HPV testing can further narrow the range of people at high risk of cervical cancer and make early screening for cervical cancer more targeted.  Some studies have shown the potential use of HPV testing in cervical cancer screening programs and in the follow-up of patients with mild cytologic abnormalities [7]. Cytological and histological tests can determine the presence of HPV infection, but not the genotype of HPV. Nucleic acid blotting is the gold standard for HPV genotyping and is suitable for HPV typing and HPV -DNA molecular quality identification with high sensitivity, but the operation is complicated and requires fresh tissue specimens, which is not convenient for clinical promotion.DNA hybridization technology is developed in recent years and is a high-throughput genetic testing technique to detect HPV genotyping, which can detect multiple HPV subtypes in 1 time and is beneficial for the diagnosis of HPV multiple infections It can detect multiple HPV subtypes at one time, which is beneficial to the diagnosis of multiple HPV infections and the analysis of HPV types before and after treatment, thus facilitating the prevention and treatment of cervical cancer, and is currently considered a better method for HPV DNA detection and typing.  In this study, HPV testing was performed on 3700 gynecological outpatients, and all types of HPV -DNA of 21 types were detected. 1071 patients (1400) with HPV infection were detected, and 1124 patients were infected with high-risk types, accounting for 80.29% of the total number of infections, which shows the seriousness of the problem of high-risk HPV infection. High-risk patients were infected with HPV subtypes from high to low: 16, 58, 52, 33, 18, 31, 68, 39, 56, 59, 35, 45 and 51. The low-risk types are HPV 11, 6, 42, 43, and 44 in that order. The high-risk genotypes were mainly HPV -16 and HPV-58, followed by HPV: 52, 33 and 18, which accounted for 29.36%, 18.32%, 17.97%, 9.88% and 5.61% of high-risk infections, respectively. In contrast, the distribution of high-risk types in the present study was different, with HPV -58 types being second only to HPV -16, which is consistent with the report of Yang Yingjie [9] et al. in China, and may be related to the vast geographical area of China and the differences between different ethnic groups and regions.  In this study, we used DNA hybridization, a high-throughput genetic testing technique, to detect 21 high- and low-risk types of HPV and common types of HPV in the Chinese population with only one amplification.This method has the advantages of high throughput, high sensitivity, good specificity, and can detect multiple infections, which can be used for early warning and diagnosis of cervical cancer and other diseases, and is suitable for prevention and treatment of cervical cancer and understanding the regression of HPV infection. It is suitable for large-scale clinical screening.