{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:30:31Z","timestamp":1790299831539,"version":"4.1.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Human papillomavirus (HPV) infection is the main cause of cervical cancer. Characteristics of HPV infections, including the HPV genotype and duration of infection, determine a patient\u2019s risk of high-grade lesions. Risk quantification of cervical lesions caused by different HPV genotypes is an important component of evaluation of cervical lesion. Data and evidence are necessary to gain a deeper understanding of the pathogenicity of different HPV genotypes. The present study investigated the clinical characteristics of patients infected with single human papillomavirus (HPV) 53.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This retrospective study analyzed the clinical data of patients who underwent cervical colposcopy guided biopsy between October 2015 and January 2021. The clinical outcomes and the follow-up results of the patients with single HPV53 infection were described.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>82.3% of the initial histological results of all 419 patients with single HPV53 infection showed negative (Neg). The number of patients with cervical intraepithelial neoplasia (CIN)1, CIN2, CIN3, vaginal intraepithelial neoplasia (VaIN)1, CIN1\u2009+\u2009VaIN1, CIN1\u2009+\u2009VaIN2, and CIN2\u2009+\u2009VaIN2 was 45, 10, 2, 9, 6, 1, and 1, respectively. Cancer was not detected in any patient. When the cytology was negative for intraepithelial lesion or malignancy (NILM), atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesion (LSIL), we observed a significant difference in the distribution of histological results (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). 95 patients underwent follow-up with cytology according to the exclusion criteria. No progression of high-grade lesions was observed during the follow-up period of 3\u201334\u00a0months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The lesion caused by HPV53 infection progressed slowly. The pathogenicity of a single HPV53 infection was low.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06853-7","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T10:03:29Z","timestamp":1636970609000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Clinical characteristics of single human papillomavirus 53 infection: a retrospective study of 419 cases"],"prefix":"10.1186","volume":"21","author":[{"given":"Ruizhe","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfeng","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingbing","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeli","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"issue":"3","key":"6853_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209\u201349. https:\/\/doi.org\/10.3322\/caac.21660.","journal-title":"CA Cancer J Clin"},{"key":"6853_CR2","unstructured":"Bruni L, Albero G, Serrano B, Mena M, G\u00f3mez D, Mu\u00f1oz J, et al. ICO\/IARC Information Centre on HPV and cancer (HPV Information Centre). Human papillomavirus and related diseases in China. Summary report 17 June 2019. Accessed 17 Mar 2021."},{"issue":"2","key":"6853_CR3","doi-asserted-by":"publisher","first-page":"115","DOI":"10.3322\/caac.21338","volume":"66","author":"W Chen","year":"2016","unstructured":"Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115\u201332. https:\/\/doi.org\/10.3322\/caac.21338.","journal-title":"CA Cancer J Clin"},{"issue":"6","key":"6853_CR4","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1046\/j.1525-1381.1999.99723.x","volume":"111","author":"H zur Hausen","year":"1999","unstructured":"zur Hausen H. Papillomaviruses in human cancers. Proc Assoc Am Physicians. 1999;111(6):581\u20137. https:\/\/doi.org\/10.1046\/j.1525-1381.1999.99723.x.","journal-title":"Proc Assoc Am Physicians"},{"issue":"6","key":"6853_CR5","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1056\/NEJMoa021641","volume":"348","author":"N Mu\u00f1oz","year":"2003","unstructured":"Mu\u00f1oz N, Bosch FX, de Sanjos\u00e9 S, Herrero R, Castellsagu\u00e9 X, Shah KV, et al. International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003;348(6):518\u201327. https:\/\/doi.org\/10.1056\/NEJMoa021641.","journal-title":"N Engl J Med"},{"issue":"4","key":"6853_CR6","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/s1470-2045(09)70096-8","volume":"10","author":"V Bouvard","year":"2009","unstructured":"Bouvard V, Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, et al. WHO International Agency for Research on Cancer Monograph Working Group. A review of human carcinogens\u2014part B: biological agents. Lancet Oncol. 2009;10(4):321\u20132. https:\/\/doi.org\/10.1016\/s1470-2045(09)70096-8.","journal-title":"Lancet Oncol"},{"issue":"4","key":"6853_CR7","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2019.30.e52","volume":"30","author":"KA So","year":"2019","unstructured":"So KA, Lee IH, Lee KH, Hong SR, Kim YJ, Seo HH, et al. Human papillomavirus genotype-specific risk in cervical carcinogenesis. J Gynecol Oncol. 2019;30(4): e52. https:\/\/doi.org\/10.3802\/jgo.2019.30.e52.","journal-title":"J Gynecol Oncol"},{"issue":"10","key":"6853_CR8","doi-asserted-by":"publisher","first-page":"1739","DOI":"10.1002\/jmv.21870","volume":"82","author":"KC Tsao","year":"2010","unstructured":"Tsao KC, Huang CG, Kuo YB, Chang TC, Sun CF, Chang CA, et al. Prevalence of human papillomavirus genotypes in northern Taiwanese women. J Med Virol. 2010;82(10):1739\u201345. https:\/\/doi.org\/10.1002\/jmv.21870.","journal-title":"J Med Virol"},{"key":"6853_CR9","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268818003539","volume":"147","author":"R Del Prete","year":"2019","unstructured":"Del Prete R, Ronga L, Magrone R, Addati G, Abbasciano A, Di Carlo D, et al. Epidemiological evaluation of human papillomavirus genotypes and their associations in multiple infections. Epidemiol Infect. 2019;147: e132. https:\/\/doi.org\/10.1017\/S0950268818003539.","journal-title":"Epidemiol Infect"},{"issue":"1","key":"6853_CR10","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2018.29.e14","volume":"29","author":"YT Ouh","year":"2018","unstructured":"Ouh YT, Min KJ, Cho HW, Ki M, Oh JK, Shin SY, et al. Prevalence of human papillomavirus genotypes and precancerous cervical lesions in a screening population in the Republic of Korea, 2014\u20132016. J Gynecol Oncol. 2018;29(1): e14. https:\/\/doi.org\/10.3802\/jgo.2018.29.e14.","journal-title":"J Gynecol Oncol"},{"issue":"11","key":"6853_CR11","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1016\/S1470-2045(10)70230-8","volume":"11","author":"S de Sanjose","year":"2010","unstructured":"de Sanjose S, Quint WG, Alemany L, Geraets DT, Klaustermeier JE, Lloveras B, et al. Retrospective International Survey and HPV Time Trends Study Group. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol. 2010;11(11):1048\u201356. https:\/\/doi.org\/10.1016\/S1470-2045(10)70230-8.","journal-title":"Lancet Oncol"},{"issue":"4","key":"6853_CR12","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1002\/ijc.25396","volume":"128","author":"N Li","year":"2011","unstructured":"Li N, Franceschi S, Howell-Jones R, Snijders PJ, Clifford GM. Human papillomavirus type distribution in 30,848 invasive cervical cancers worldwide: variation by geographical region, histological type and year of publication. Int J Cancer. 2011;128(4):927\u201335. https:\/\/doi.org\/10.1002\/ijc.25396.","journal-title":"Int J Cancer"},{"issue":"3","key":"6853_CR13","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1007\/s00705-021-04960-z","volume":"166","author":"J Li","year":"2021","unstructured":"Li J, Gao JJ, Li N, Wang YW. Distribution of human papillomavirus genotypes in western China and their association with cervical cancer and precancerous lesions. Arch Virol. 2021;166(3):853\u201362. https:\/\/doi.org\/10.1007\/s00705-021-04960-z.","journal-title":"Arch Virol"},{"issue":"16","key":"6853_CR14","doi-asserted-by":"publisher","first-page":"2114","DOI":"10.1001\/jama.287.16.2114","volume":"287","author":"D Solomon","year":"2002","unstructured":"Solomon D, Davey D, Kurman R, Moriarty A, O\u2019Connor D, Prey M, et al. Bethesda 2001 Workshop. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA. 2002;287(16):2114\u20139. https:\/\/doi.org\/10.1001\/jama.287.16.2114.","journal-title":"JAMA"},{"issue":"4","key":"6853_CR15","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1002\/ijc.23969","volume":"124","author":"N Wentzensen","year":"2009","unstructured":"Wentzensen N, Schiffman M, Dunn ST, Zuna RE, Walker J, Allen RA, et al. Grading the severity of cervical neoplasia based on combined histopathology, cytopathology, and HPV genotype distribution among 1,700 women referred to colposcopy in Oklahoma. Int J Cancer. 2009;124(4):964\u20139. https:\/\/doi.org\/10.1002\/ijc.23969.","journal-title":"Int J Cancer"},{"issue":"3","key":"6853_CR16","doi-asserted-by":"publisher","first-page":"264.e1","DOI":"10.1016\/j.ajog.2016.10.042","volume":"216","author":"K Elfgren","year":"2017","unstructured":"Elfgren K, Elfstr\u00f6m KM, Naucler P, Arnheim-Dahlstr\u00f6m L, Dillner J. Management of women with human papillomavirus persistence: long-term follow-up of a randomized clinical trial. Am J Obstet Gynecol. 2017;216(3):264.e1-264.e7. https:\/\/doi.org\/10.1016\/j.ajog.2016.10.042.","journal-title":"Am J Obstet Gynecol"},{"issue":"10","key":"6853_CR17","doi-asserted-by":"publisher","first-page":"2469","DOI":"10.1158\/1055-9965.EPI-10-0424","volume":"19","author":"K Sundstr\u00f6m","year":"2010","unstructured":"Sundstr\u00f6m K, Eloranta S, Spar\u00e9n P, Arnheim Dahlstr\u00f6m L, Gunnell A, Lindgren A, et al. Prospective study of human papillomavirus (HPV) types, HPV persistence, and risk of squamous cell carcinoma of the cervix. Cancer Epidemiol Biomark Prev. 2010;19(10):2469\u201378. https:\/\/doi.org\/10.1158\/1055-9965.EPI-10-0424.","journal-title":"Cancer Epidemiol Biomark Prev"},{"issue":"6","key":"6853_CR18","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1016\/j.jiph.2016.10.006","volume":"10","author":"A Sohrabi","year":"2017","unstructured":"Sohrabi A, Hajia M, Jamali F, Kharazi F. Is incidence of multiple HPV genotypes rising in genital infections? J Infect Public Health. 2017;10(6):730\u20133. https:\/\/doi.org\/10.1016\/j.jiph.2016.10.006.","journal-title":"J Infect Public Health"},{"issue":"3","key":"6853_CR19","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1046\/j.1525-1438.2001.01009.x","volume":"11","author":"T Meyer","year":"2001","unstructured":"Meyer T, Arndt R, Beckmann ER, Padberg B, Christophers E, Stockfleth E. Distribution of HPV 53, HPV 73 and CP8304 in genital epithelial lesions with different grades of dysplasia. Int J Gynecol Cancer. 2001;11(3):198\u2013204. https:\/\/doi.org\/10.1046\/j.1525-1438.2001.01009.x.","journal-title":"Int J Gynecol Cancer"},{"key":"6853_CR20","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.ejogrb.2015.04.004","volume":"191","author":"E Padalko","year":"2015","unstructured":"Padalko E, Ali-Risasi C, Van Renterghem L, Bamelis M, De Mey A, Sturtewagen Y, et al. Evaluation of the clinical significance of human papillomavirus (HPV) 53. Eur J Obstet Gynecol Reprod Biol. 2015;191:7\u20139. https:\/\/doi.org\/10.1016\/j.ejogrb.2015.04.004.","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"6853_CR21","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s13027-015-0001-5","volume":"10","author":"N Kantathavorn","year":"2015","unstructured":"Kantathavorn N, Mahidol C, Sritana N, Sricharunrat T, Phoolcharoen N, Auewarakul C, et al. Genotypic distribution of human papillomavirus (HPV) and cervical cytology findings in 5906 Thai women undergoing cervical cancer screening programs. Infect Agent Cancer. 2015;10:7. https:\/\/doi.org\/10.1186\/s13027-015-0001-5.","journal-title":"Infect Agent Cancer"},{"issue":"1","key":"6853_CR22","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12905-020-01035-0","volume":"20","author":"RL da Silva","year":"2020","unstructured":"da Silva RL, da Silva BZ, Bastos GR, Cunha APA, Figueiredo FV, de Castro LO, et al. Role of HPV 16 variants among cervical carcinoma samples from Northeastern Brazil. BMC Women\u2019s Health. 2020;20(1):162. https:\/\/doi.org\/10.1186\/s12905-020-01035-0.","journal-title":"BMC Women\u2019s Health"},{"issue":"11","key":"6853_CR23","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.1002\/jmv.24044","volume":"86","author":"X Ding","year":"2014","unstructured":"Ding X, Liu Z, Su J, Yan D, Sun W, Zeng Z. Human papillomavirus type-specific prevalence in women referred for colposcopic examination in Beijing. J Med Virol. 2014;86(11):1937\u201343. https:\/\/doi.org\/10.1002\/jmv.24044.","journal-title":"J Med Virol"},{"issue":"4","key":"6853_CR24","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2017.28.e30","volume":"28","author":"XL Zhao","year":"2017","unstructured":"Zhao XL, Hu SY, Zhang Q, Dong L, Feng RM, Han R, et al. High-risk human papillomavirus genotype distribution and attribution to cervical cancer and precancerous lesions in a rural Chinese population. J Gynecol Oncol. 2017;28(4): e30. https:\/\/doi.org\/10.3802\/jgo.2017.28.e30.","journal-title":"J Gynecol Oncol"},{"issue":"1","key":"6853_CR25","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1007\/s12250-010-3078-4","volume":"25","author":"XL Wu","year":"2010","unstructured":"Wu XL, Zhang CT, Zhu XK, Wang YC. Detection of HPV types and neutralizing antibodies in women with genital warts in Tianjin City, China. Virol Sin. 2010;25(1):8\u201317. https:\/\/doi.org\/10.1007\/s12250-010-3078-4.","journal-title":"Virol Sin"},{"issue":"1","key":"6853_CR26","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1097\/IGC.0b013e31827670fd","volume":"23","author":"SC Quek","year":"2013","unstructured":"Quek SC, Lim BK, Domingo E, Soon R, Park JS, Vu TN, et al. Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical intraepithelial neoplasia across 5 countries in Asia. Int J Gynecol Cancer. 2013;23(1):148\u201356. https:\/\/doi.org\/10.1097\/IGC.0b013e31827670fd.","journal-title":"Int J Gynecol Cancer"},{"issue":"12","key":"6853_CR27","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1002\/jmv.21025","volume":"79","author":"E Panotopoulou","year":"2007","unstructured":"Panotopoulou E, Tserkezoglou A, Kouvousi M, Tsiaousi I, Chatzieleftheriou G, Daskalopoulou D, et al. Prevalence of human papillomavirus types 6, 11, 16, 18, 31, and 33 in a cohort of Greek women. J Med Virol. 2007;79(12):1898\u2013905. https:\/\/doi.org\/10.1002\/jmv.21025.","journal-title":"J Med Virol"},{"issue":"7","key":"6853_CR28","doi-asserted-by":"publisher","first-page":"1274","DOI":"10.1158\/1055-9965.epi-06-0129","volume":"15","author":"H Trottier","year":"2006","unstructured":"Trottier H, Mahmud S, Costa MC, Sobrinho JP, Duarte-Franco E, Rohan TE, et al. Human papillomavirus infections with multiple types and risk of cervical neoplasia. Cancer Epidemiol Biomark Prev. 2006;15(7):1274\u201380. https:\/\/doi.org\/10.1158\/1055-9965.epi-06-0129.","journal-title":"Cancer Epidemiol Biomark Prev"},{"issue":"7","key":"6853_CR29","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1097\/IGC.0b013e31829e9fb4","volume":"23","author":"EL Dickson","year":"2013","unstructured":"Dickson EL, Vogel RI, Bliss RL, Downs LS Jr. Multiple-type human papillomavirus (HPV) infections: a cross-sectional analysis of the prevalence of specific types in 309,000 women referred for HPV testing at the time of cervical cytology. Int J Gynecol Cancer. 2013;23(7):1295\u2013302. https:\/\/doi.org\/10.1097\/IGC.0b013e31829e9fb4.","journal-title":"Int J Gynecol Cancer"},{"key":"6853_CR30","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/1471-2334-13-53","volume":"13","author":"E Argyri","year":"2013","unstructured":"Argyri E, Papaspyridakos S, Tsimplaki E, Michala L, Myriokefalitaki E, Papassideri I, et al. A cross sectional study of HPV type prevalence according to age and cytology. BMC Infect Dis. 2013;13:53. https:\/\/doi.org\/10.1186\/1471-2334-13-53.","journal-title":"BMC Infect Dis"},{"key":"6853_CR31","doi-asserted-by":"publisher","unstructured":"Clifford GM, Gon\u00e7alves MA, Franceschi S, HPV and HIV Study Group. Human papillomavirus types among women infected with HIV: a meta-analysis. AIDS. 2006;20(18):2337\u201344. https:\/\/doi.org\/10.1097\/01.aids.0000253361.63578.14","DOI":"10.1097\/01.aids.0000253361.63578.14"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06853-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06853-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06853-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T22:02:54Z","timestamp":1637013774000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06853-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,15]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6853"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06853-7","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,15]]},"assertion":[{"value":"2 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the ethics committee of the Women\u2019s Hospital, Zhejiang University School of Medicine (PRO2021-1292). This article does not contain any studies with animals performed by any of the authors. Furthermore, the consent of the study participants was deemed unnecessary as the study only concerned the retrospective review of the medical database. The need of informed consent was waived by the ethics committee {Medical Ethics Committee of the Women\u2019s Hospital, Zhejiang University School of Medicine} for this retrospective study. We confirm that all methods were performed in accordance with the 1964 Declaration of Helsinki and its later amendments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1158"}}