Associations of multi-human papillomavirus infections with expression of p16 in a cohort of women who underwent colposcopy: a retrospective study of 5165 patients

Yulong Zhang; Haibo Li; Xiaowen Li; Zelong Li; Qianru You; Hanwen Liu; Zhiyan Zhao; Yanzhao Su; Xiangqin Zheng; Yusha Chen; Jiancui Chen; Huan Yi

doi:10.3389/fonc.2023.1265726

Associations of multi-human papillomavirus infections with expression of p16 in a cohort of women who underwent colposcopy: a retrospective study of 5165 patients

Front Oncol. 2023 Oct 26:13:1265726. doi: 10.3389/fonc.2023.1265726. eCollection 2023.

Authors

Yulong Zhang^#¹, Haibo Li^#², Xiaowen Li^#¹, Zelong Li¹, Qianru You¹, Hanwen Liu¹, Zhiyan Zhao³, Yanzhao Su¹, Xiangqin Zheng¹, Yusha Chen⁴, Jiancui Chen⁴, Huan Yi¹

Affiliations

¹ Department of Gynecology, Fujian Maternity and Child Health Hospital College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
² Division of Birth Cohort Study, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
³ Integrated Biology, University of California, Berkeley, Berkeley, CA, United States.
⁴ Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.

^# Contributed equally.

Abstract

Objective: Investigate HPV types in cervical specimens, their correlation with p16 expression in lesions, and diagnostic value for cervical lesions. Enhance clinical diagnosis reliability.

Methods: Retrospective cross-sectional study at Fujian Maternity and Child Health Hospital's Cervical Disease Center (Jun 2019-Dec 2021). Patients with abnormal cervical screening underwent colposcopy and conization. Pathological diagnosis based on colposcopy, cervical biopsy, ECC, and conization. Analyzed HPV genotyping (18 HR-HPV, 5 LR-HPV) and p16 expression correlation. Statistical analysis used R software.

Results: he expression of p16 is significantly associated with the infection of high-risk HPV types, such as 16, 33, 52, and 58, with an increased risk of 1.4 times or higher (OR=1.91, 3.14, 1.40, and 1.78, respectively). The risk of p16 expression increased 4-fold for multiple high-risk HPV types [adjusted OR (95% CI) = 4 (2.92~5.5), P-value <0.001]. Compared to the p16(-) group, the p16(+) group had a higher association with cervical lesions worse than HSIL (High-grade Squamous Intraepithelial Lesions).In the group with multiple Human Papillomavirus Infections with types 16, 33, 52, and 58, the risk of cervical lesions worse than HSIL increased by up to 660-fold compared to the negative group (adjusted OR=660.62, 95% CI: 91.39~4775.53, P<0.001), indicating that this combination of HPV types posed the greatest risk for cervical lesions above HSIL.

Conclusions: p16 plays a crucial role in cervical lesion progression, linked to high-risk HPV. Combining p16 with HPV screening improves cervical cancer detection. Studying multiple HPV infections will enhance prevention and management.

Keywords: HPV; cervical cancer; cervical lesions; p16; retrospective study.

Grants and funding

This study was supported by grants from Fujian Medical University Education and Teaching Reform Research Project (No. J21055), Young and Middle-Aged Key Talents Training Project in Fujian Province (2019-ZQN-23), Fujian Maternity and Child Health Hospital (YCXQ 18-17) and the Natural Science Foundation of Fujian Province, China (2020J01331).