Sexually active young women have higher rates of HPV infection

2021-01-29 fuweiwei1 39 Health Network

"It is already invasive cancer, and the chance of radical surgery is very small!"

Deng Li (pseudonym), who was only 16 years old, came to the Obstetrics and Gynecology Department of Peking University Shenzhen Hospital uneasy. She looked extremely thin, her face was pale, and her eyes were red and swollen as if she had just cried. , She kept her tone secretive, and she whispered to the doctor half a day later that she came to the hospital because of increased vaginal secretions and irregular bleeding.

Listening to Deng Li's description, the hand seemed to touch the mass, and a bad thought flashed in the doctor's mind - "cervical cancer".

Soon, through biopsy, Deng Li was diagnosed with cervical cancer and developed to the stage of invasive cancer. "Decades ago, cervical cancer still belonged to middle-aged and elderly women's tumors, but now the proportion of young women suffering from cervical cancer is increasing." Professor Wu Ruifang, director of the Obstetrics and Gynecology Center of Peking University Shenzhen Hospital, said that after inquiring, it was found that they had sex too early , Multiple sexual partners is an important reason for Deng Li suffering from cervical cancer.

In China, one woman dies from cervical cancer every 10 minutes. In the past 30 years, the proportion of young women aged ≤ 35 in cervical cancer patients has gradually increased, which has to be noticed. Wu Ruifang said that the data shows that the number of patients with The younger trend is mainly related to the lifestyle of young people, with the highest rate of HPV infection among young sexually active women.

"I have seen a woman in her 30s who was trying to conceive after a successful career. She was found to have advanced cervical cancer during pre-pregnancy examination. After a series of preoperative chemotherapy, she underwent a total hysterectomy and bilateral appendectomy. But forever lost fertility,"

And such a tragedy, in fact, women can completely avoid it!

Persistent infection of high-risk HPV is the root cause of cervical cancer

Among all the malignant tumors in the world, only cervical cancer has been found by medical scientists for the real cause, which is simply persistent infection of high-risk HPV.

Professor Wu Ruifang introduced that because the HPV virus is mainly transmitted through sex, the infection rate of HPV among young people is not low. According to foreign research statistics, the cumulative infection rate of a woman's lifetime can reach more than 90%, but it does not mean that as long as the HPV virus is infected, it will eventually lead to the occurrence of cervical cancer. Only persistent infection of high-risk HPV can cause cervical cancer. It is currently recognized that There are 14 subtypes associated with cervical cancer.

"Even if they are infected with high-risk HPV, many people are also transiently infected. Among young people with good immunity, 90% of them can naturally detoxify after infection, and only less than 10% cause persistent infection, usually from infection. It takes at least 6-8 years for HPV virus to develop cervical cancer, and some even take 10-20 years to develop cervical cancer."

Professor Wu Ruifang said that clinically, there is a stage of precancerous lesions from HPV infection to cervical cancer. Precancerous lesions are more specific for HPV to infect cells at the junction of cervical squamous cell carcinoma columns, and cause squamous intraepithelial neoplasia, squamous cell carcinoma. CIN-like intraepithelial neoplasia is CIN, it is divided into CIN1, CIN2, CIN3, CIN2 and CIN3 are considered to occur in precancerous lesions, most of CIN1 can be reversed naturally. "Can be detected early before CIN3, women can stifle cervical cancer in the cradle."

Most cervical cancers are found to be in the middle and late stages by symptoms

Many women hope to detect cancer at an early stage through clinical symptoms, but unfortunately, there are almost no clinical symptoms in the early stage of cervical cancer.

Professor Wu pointed out that the clinical manifestations of cervical cancer include increased secretions, irregular bleeding, and lumps in the late stage. None of these symptoms are in the early stage.

To detect cervical cancer early, screening must be carried out, including cytology and HPV testing. "Cytological detection is to find those abnormal cells that may develop into cancer in the future. When such abnormal cells are seen, further diagnosis is made to see if there are early lesions or early cancer." Wu Ruifang introduced.

The detection of HPV is to use the exfoliated cells of cervical cancer to detect the virus in it. If there is a virus and a positive patient, there is a cause of cervical cancer, and cervical cancer may occur in the future. The negative predictive value of the HPV test can reach more than 99%, which means that the chance of a person with a negative HPV test is less than 1%.

For patients with positive screening, it is necessary to further confirm whether there is precancerous lesions or cancer through colposcopy biopsy.

Women aged 9-14 should be vaccinated against HPV

Early screening is already a secondary prevention, and HPV vaccination for women is a primary prevention. The combination of the two can achieve the best preventive effect.

Wu Ruifang said that it is best to get the cervical cancer vaccine before the first sexual life without exposure to the HPV virus, and women after the age of 9 can be vaccinated. Because natural infection also produces antibodies, but the antibodies produced by natural infection have no protective effect, and the vaccine immunogenicity is stronger than the natural HPV virus, so it has better immunogenicity.

In addition, the vaccine also has an adjuvant. After the adjuvant and the antigen are made together and injected, the adjuvant can strengthen the immune response and have better immunogenicity, which means that people can develop stronger resistance. effect.

"We have always emphasized the need for early screening. After so many years, we found that the coverage of cervical cancer screening is less than 30% in the country, which is far from enough. Early cervical cancer vaccination is a good remedy. "Professor Wu Ruifang reminded that in addition to the lack of awareness of vaccination among women in remote and impoverished areas, it is clinically found that many urban white-collar workers often neglect vaccination or cervical cancer screening.

The Human Papillomavirus Real Time PCR Kit is an in-vitro diagnostic (IVD) kit, based on real-time PCR technology, for the detection of 18 HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 73, 53, 82, and 26) in cervical exfoliated cells in one reaction well. The kit identifies HPV16, HPV18, other HPV types and internal control (β-globin) using fluorescence channels: FAM, VIC, ROX and CY5. This kit contains primers and probes that are designed to target the L1, L2, and E1 genes of 18 HPV types. The amplicon length of each HPV type does not exceed 200 bp. A PCR fluorescence detection system is used to record the change in fluorescence emitted by the fluorescent probe at each PCR cycle during PCR amplification, which directly reflects the change in the PCR amplification yield.