Differences in human papillomavirus type distribution in high-grade cervical intraepithelial neoplasia and invasive cervical cancer in Europe
A partir des données histopathologiques de deux études transversales incluant au total 6 265 femmes européennes présentant une néoplasie intraépithéliale de haut grade (âge médian : 39 ans) ou un cancer invasif du col de l'utérus (âge médian : 49 ans), cette étude évalue la prévalence d'une infection cervicale par le papillomavirus humain en fonction des génotypes viraux et de la catégorie d'âge des patientes
Knowledge of differences in human papillomavirus (HPV)-type prevalence between high-grade cervical intraepithelial neoplasia (HG-CIN) and invasive cervical cancer (ICC) is crucial for understanding the natural history of HPV-infected cervical lesions and the potential impact of HPV vaccination on cervical cancer prevention. More than 6000 women diagnosed with HG-CIN or ICC from 17 European countries were enrolled in two parallel cross-sectional studies (108288/108290). Centralised histopathology review and standardised HPV-DNA typing were applied to formalin-fixed paraffin-embedded cervical specimens dated 2001-2008. The pooled prevalence of individual HPV types was estimated, using meta-analytic methods. 3103 women were diagnosed with HG-CIN and 3162 with ICC (median ages: 34y and 49y, respectively), of which 98.5% and 91.8% were HPV-positive. The most common HPV types in women with HG-CIN were HPV16/33/31 (59.9%/10.5%/9.0%); and in ICC, HPV16/18/45 (63.3%/15.2%/5.3%). In squamous cell carcinomas, HPV16/18/33 were most frequent (66.2%/10.8%/5.3%), and in adenocarcinomas, HPV16/18/45 (54.2%/40.4%/8.3%). The prevalences of HPV16/18/45 were 1.1/3.5/2.5 times higher in ICC than in HG-CIN. The difference in age at diagnosis between CIN3 and SCC for HPV18 (9y) was significantly less compared to HPV31/33/'other' (23y/20y/17y), and for HPV45 (1y) than HPV16/31/33/'other' (15y/23y/20y/17y). In Europe, HPV16 predominates in both HG-CIN and ICC while HPV18/45 are associated with a low median age of ICC. HPV18/45 are more frequent in ICC than HG-CIN and associated with a high median age of HG-CIN, with a narrow age interval between HG-CIN and ICC detection. These findings support the need for primary prevention of HPV16/18/45-related cervical lesions. (c) 2012 Wiley Periodicals, Inc.