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Abstract
The infections by human papillomaviruses (HPVs) are clearly associated with the subsequent development of cervical cancer. In this study, HPV genotype distribution and prevalence were detected in Korean women from January to December 2008 using PCR-DNA sequencing. A total of 2,562 cervical samples from Korean women having routine Pap smear cytology screening were used. HPV DNA was extracted from cervical swab samples and amplified by PCR in L1 region of HPV. HPV DNA was detected in 23.2% and 65.5% from the groups of normal and abnormal Pap cytology, respectively. The prevalence of high-risk types of HPV had the highest frequency in the <30 year-olds' group (50.6%). The prevalence of HPV in normal, ASCUS, LSIL and HSIL groups was 23.2%, 58.1%, 96.3% and 97.0%, respectively. Moreover, the frequencies of the high-risk types of HPV were 16.2% in the normal Pap cytology, 44.7% in the ASCUS, 76.1% in the LSIL and 94.1% in the HSIL groups. The prevalence of the high-risk types of HPV increased in proportion to the severity of the cytological classification. In the HSIL group, HPV type 16 was the most frequently found at 32.4%, followed by types 58, 53 and 33 at 17.6%, 14.7% and 11.8%, respectively. HPV type 82 was found in 5.6% of the HSIL group and was not detected in the normal Pap cytology group. The frequency of high-risk type of HPV 82 is firstly reported in Korean women. This finding could be an informative basis for the development of future HPV vaccination strategies in Korean women.
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Figure 1.
Distribution of carcinogenic HPV types in cytological normal women and abnormal women, including ASCUS, LSIL and HSIL, respectively.
∗ ASCUS: atypical squamous cells undetermined significance, LSIL: low–grade squamous intraepithelial lesion, HSIL: high–grade squamous intraepithelial lesion.
Table 1.
Age distribution and prevalence of high- or low-risk HPVs in Koreans
| >30 years | 31~40 years | 41~50 years | >50 years | |
|---|---|---|---|---|
| High-risk types HPVa | 37.8% (220/582) | 31.3% (271/867) | 29.8% (207/699) | 23.0% (85/369) |
| Low-risk types HPVb | 10.3% (60/582) | 5.4% (47/867) | 5.6% (39/699) | 7.9% (29/369) |
| Uncharacterized | 2.6% (15/582) | 2.4% (21/867) | 2.0% (14/699) | 3.0% (11/369) |
| Total % of HPV | 50.6% (295/582) | 39.1% (339/867) | 37.4% (261/699) | 34.7% (125/369) |
Table 2.
Type-specific HPV prevalence determined by PCR-sequencing in normal and abnormal cytology groups
| Pap-normal | Pap-abnormal | ASCUS | LSIL | HSIL | Total | P value | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | N | % | n | % | ||
| Total No | 1529 | 59.7 | 1033 | 40.3 | 836 | 32.6 | 163 | 6.4 | 34 | 1.3 | 2562 | 100 | <0.05 |
| Any type | 355 | 23.2 | 676 | 65.5 | 486 | 58.1 | 157 | 96.3 | 33 | 97.0 | 1031 | 40.2 | |
| High risk types of HPV (Carcinogenic types) | |||||||||||||
| 16a | 60 | 3.9 | 143 | 13.8 | 95 | 11.4 | 37 | 22.7 | 11 | 32.4 | 203 | 7.9 | <0.05 |
| 18 | 19 | 1.2 | 31 | 3.0 | 27 | 3.2 | 3 | 1.8 | 1 | 2.9 | 50 | 2.0 | cNS |
| 26 | 1 | 0.1 | 2 | 0.2 | 2 | 0.2 | 0 | 0.0 | 0 | 0.0 | 3 | 0.1 | NS |
| 30 | 0 | 0.0 | 3 | 0.3 | 1 | 0.1 | 2 | 1.2 | 0 | 0.0 | 3 | 0.1 | NS |
| 31 | 3 | 0.2 | 17 | 1.6 | 14 | 1.7 | 3 | 1.8 | 0 | 0.0 | 20 | 0.8 | NS |
| 33a | 1 | 0.1 | 28 | 2.7 | 19 | 2.3 | 5 | 3.1 | 4 | 11.8 | 29 | 1.1 | <0.05 |
| 35 | 14 | 0.9 | 20 | 1.9 | 14 | 1.7 | 6 | 3.7 | 0 | 0.0 | 34 | 1.3 | NS |
| 39 | 1 | 0.1 | 13 | 1.3 | 12 | 1.4 | 1 | 0.6 | 0 | 0.0 | 14 | 0.5 | NS |
| 51 | 9 | 0.6 | 22 | 2.1 | 14 | 1.7 | 7 | 4.3 | 1 | 2.9 | 31 | 1.2 | NS |
| 52a | 40 | 2.6 | 73 | 7.1 | 56 | 6.7 | 12 | 7.4 | 5 | 14.7 | 113 | 4.4 | <0.05 |
| 53 | 19 | 1.2 | 35 | 3.4 | 27 | 3.2 | 8 | 4.9 | 0 | 0.0 | 54 | 2.1 | NS |
| 56 | 16 | 1.0 | 29 | 2.8 | 19 | 2.3 | 9 | 5.5 | 1 | 2.9 | 45 | 1.8 | NS |
| 58a | 38 | 2.5 | 60 | 5.8 | 43 | 5.1 | 11 | 6.7 | 6 | 17.6 | 98 | 3.8 | <0.05 |
| 59 | 1 | 0.1 | 8 | 0.8 | 6 | 0.7 | 2 | 1.2 | 0 | 0.0 | 9 | 0.4 | NS |
| 66 | 8 | 0.5 | 19 | 1.8 | 9 | 1.1 | 9 | 5.5 | 1 | 2.9 | 27 | 1.1 | NS |
| 68 | 18 | 1.2 | 18 | 1.7 | 12 | 1.4 | 6 | 3.7 | 0 | 0.0 | 36 | 1.4 | NS |
| 82a | 0 | 0.0 | 9 | 0.9 | 4 | 0.5 | 3 | 1.8 | 2 | 5.9 | 9 | 0.4 | <0.05 |
| subtotal | 248 | 16.2 | 530 | 51.3 | 374 | 44.7 | 124 | 76.1 | 32 | 94.1 | 778 | 30.4 | b<0.0001 |
| Low risk types of HPV | |||||||||||||
| 6 | 10 | 0.7 | 7 | 0.7 | 2 | 0.2 | 5 | 3.1 | 0 | 0.0 | 17 | 0.7 | NS |
| 11 | 1 | 0.1 | 4 | 0.4 | 1 | 0.1 | 3 | 1.8 | 0 | 0.0 | 5 | 0.2 | NS |
| 32 | 2 | 0.1 | 1 | 0.1 | 1 | 0.1 | 0 | 0.0 | 0 | 0.0 | 3 | 0.1 | NS |
| 34 | 2 | 0.1 | 4 | 0.4 | 4 | 0.5 | 0 | 0.0 | 0 | 0.0 | 6 | 0.2 | NS |
| 40 | 2 | 0.1 | 2 | 0.2 | 2 | 0.2 | 0 | 0.0 | 0 | 0.0 | 4 | 0.2 | NS |
| 42 | 0 | 0.0 | 4 | 0.4 | 2 | 0.2 | 2 | 1.2 | 0 | 0.0 | 4 | 0.2 | NS |
| 43 | 0 | 0.0 | 9 | 0.9 | 8 | 1.0 | 1 | 0.6 | 0 | 0.0 | 9 | 0.4 | NS |
| 54 | 14 | 0.9 | 7 | 0.7 | 6 | 0.7 | 0 | 0.0 | 1 | 2.9 | 21 | 0.8 | NS |
| 61 | 12 | 0.8 | 16 | 1.5 | 12 | 1.4 | 4 | 2.5 | 0 | 0.0 | 28 | 1.1 | NS |
| 62 | 16 | 1.0 | 17 | 1.6 | 13 | 1.6 | 4 | 2.5 | 0 | 0.0 | 33 | 1.3 | NS |
| 70 | 21 | 1.4 | 19 | 1.8 | 15 | 1.8 | 4 | 2.5 | 0 | 0.0 | 40 | 1.6 | NS |
| Low risk types of HPV | |||||||||||||
| 81 | 3 | 0.2 | 8 | 0.8 | 6 | 0.7 | 2 | 1.2 | 0 | 0.0 | 11 | 0.4 | NS |
| 84 | 2 | 0.1 | 3 | 0.3 | 3 | 0.4 | 0 | 0.0 | 0 | 0.0 | 5 | 0.2 | NS |
| subtotal | 85 | 5.6 | 101 | 9.8 | 75 | 9.0 | 25 | 15.3 | 1 | 2.9 | 186 | 7.3 | NS |
| Uncharacterized | 22 | 1.4 | 45 | 4.4 | 37 | 4.4 | 8 | 4.9 | 0 | 0.0 | 67 | 2.6 | |
Note: ASCUS; atypical squamous cells undetermined significance, LSIL; low-grade squamous intraepithelial lesion, HSIL; high-grade squamous intraepithelial lesion.
a : P value was observed between normal cytology group and HSIL group. Five high-risk types of HPV (HPV-16, 33, 52, 58, 82) were statistically significant between two groups.
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