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Title: Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study
Authors: de Sanjose, Silvia
Quint, Wim G.V.
Alemany, Laia
Geraets, Daan T.
Klaustermeier, Jo Ellen
Lloveras, Belen
Tous, Sara
Felix, Ana
Bravo, Luis Eduardo
Shin, Hai Rim
Vallejos, Carlos S.
de Ruiz, Patricia Alonso
Lima, Marcus Aurelho
Guimera, Nuria
Clavero, Omar
Alejo, Maria
Llombart-Bosch, Antonio
Cheng-Yang, Chou
Tatti, Silvio Alejandro
Kasamatsu, Elena
Iljazovic, Ermina
Odida, Michael
Prado, Rodrigo
Seoud, Muhieddine
Grce, Magdalena
Usubutun, Alp
Jain, Asha
Suarez, Gustavo Adolfo Hernandez
Lombardi, Luis Estuardo
Banjo, Aekunbiola
Menéndez, Clara
Domingo, Efrén Javier
Velasco, Julio
Nessa, Ashrafun
Chichareon, Saibua C.Bunnag
Qiao, You Lin
Lerma, Enrique
Garland, Suzanne M.
Sasagawa, Toshiyuki
Ferrera, Annabelle
Hammouda, Doudja
Mariani, Luciano
Pelayo, Adela
Steiner, Ivo
Oliva, Esther
Meijer, Chris J.L.M.
Al-Jassar, Waleed Fahad
Cruz, Eugenia
Wright, Thomas C.
Puras, Ana
Llave, Cecilia Ladines
Tzardi, Maria
Agorastos, Theodoros
Garcia-Barriola, Victoria
Clavel, Christine
Ordi, Jaume
Andújar, Miguel 
Castellsagué, Xavier
Sánchez, Gloria I.
Nowakowski, Andrzej Marcin
Bornstein, Jacob
Muñoz, Nubia
Bosch, F. Xavier
UNESCO Clasification: 32 Ciencias médicas
320713 Oncología
Keywords: Carcinoma
Linear models
Polymerase chain reaction
Issue Date: 2010
Journal: The Lancet Oncology 
Abstract: Background: Knowledge about the distribution of human papillomavirus (HPV) genotypes in invasive cervical cancer is crucial to guide the introduction of prophylactic vaccines. We aimed to provide novel and comprehensive data about the worldwide genotype distribution in patients with invasive cervical cancer. Methods: Paraffin-embedded samples of histologically confirmed cases of invasive cervical cancer were collected from 38 countries in Europe, North America, central South America, Africa, Asia, and Oceania. Inclusion criteria were a pathological confirmation of a primary invasive cervical cancer of epithelial origin in the tissue sample selected for analysis of HPV DNA, and information about the year of diagnosis. HPV detection was done by use of PCR with SPF-10 broad-spectrum primers followed by DNA enzyme immunoassay and genotyping with a reverse hybridisation line probe assay. Sequence analysis was done to characterise HPV-positive samples with unknown HPV types. Data analyses included algorithms of multiple infections to estimate type-specific relative contributions. Findings: 22,661 paraffin-embedded samples were obtained from 14,249 women. 10,575 cases of invasive cervical cancer were included in the study, and 8977 (85%) of these were positive for HPV DNA. The most common HPV types were 16, 18, 31, 33, 35, 45, 52, and 58 with a combined worldwide relative contribution of 8196 of 8977 (91%, 95% CI 90-92). HPV types 16 and 18 were detected in 6357 of 8977 of cases (71%, 70-72) of invasive cervical cancer. HPV types 16, 18, and 45 were detected in 443 of 470 cases (94%, 92-96) of cervical adenocarcinomas. Unknown HPV types that were identified with sequence analysis were 26, 30, 61, 67, 69, 82, and 91 in 103 (1%) of 8977 cases of invasive cervical cancer. Women with invasive cervical cancers related to HPV types 16, 18, or 45 presented at a younger mean age than did those with other HPV types (50·0 years [49·6-50·4], 48·2 years [47·3-49·2], 46·8 years [46·6-48·1], and 55·5 years [54·9-56·1], respectively). Interpretation: To our knowledge, this study is the largest assessment of HPV genotypes to date. HPV types 16, 18, 31, 33, 35, 45, 52, and 58 should be given priority when the cross-protective effects of current vaccines are assessed, and for formulation of recommendations for the use of second-generation polyvalent HPV vaccines. Our results also suggest that type-specific high-risk HPV-DNA-based screening tests and protocols should focus on HPV types 16, 18, and 45.
ISSN: 1470-2045
DOI: 10.1016/S1470-2045(10)70230-8
Source: The Lancet Oncology[ISSN 1470-2045],v. 11, p. 1048-1056
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