中国不同地区宫颈癌中HPV型别分布数据横向比较分析  

Horizontal comparison analysis of the type-specific HPV prevalence in cervical cancer in different areas of china

作　　者：乌恩奇[1] 赵焕虎[1] 刘微[2] 乌日丽歌[3] 

机构地区：[1]中央民族大学中国少数民族传统医学国家民委-教育部重点实验室,北京100081 [2]吉林大学生命科学学院,吉林长春130023 [3]内蒙古民族大学经济管理学院,内蒙古通辽028000

出　　处：《中华肿瘤防治杂志》2013年第23期1845-1851,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家民委科研项目(12ZYZ018)

摘　　要：目的：了解我国整体水平上人乳头瘤病毒（human papilloma virus，HPV）型别分布特征及各个地区HPV型别分布特点。方法：从2000-2012年发表关于我国HPV分布的研究中提取宫颈癌高危型HPV分布数据，分别按省份和行政地区对HPV型别数据进行加权合并和比较，以了解各个地区HPV型别的分布特点。并根据地区预计年宫颈癌死亡人数对HPV型别数据进行权重调整，推算出全国宫颈癌HPV整体阳性率和各型别阳性比率。结果：共有31篇研究符合纳入标准，包括18个省直辖市或地区的5081例宫颈癌样品。加权合并后HPV整体感染率为89．6％（95％CI：87．4oA～91．7％；12—88．9％），各省间差异较大（78．7％～97．2％）。有16篇研究给出了HPVl6和（或）18感染的具体数据，加权合并后，HPV阳性样品中HPVl6／18感染比率为86．1％（95％CI：82．9％～89．4％；I2=81．0％）。根据地区年预期死亡人数对HPV感染率进行权重调整后，全国水平上HPV整体阳性率达到87．7％。HPV16、HPV18、HPV58、HPV33、HPV52、HPV31、HPV45和HPV59是我国宫颈癌中最主要的8个高危HPV型别。在所有地区HPV16均为最主要感染型别，HPVl8在多数地区为第二主要感染型别。HPV45、HPV52和HPV58分别为内蒙古、甘肃和四川省的第二主要感染型别。8个主要HPV型别的阳性比率在地区间的差异明显。结论：在我国整体水平上，HPVl6和HPVl8为宫颈癌中最主要型别，HPV58、HPV33、HPV52、HPV31、HPV45和HPV59等型别在个别地区的宫颈癌中分别有着很高的感染率。OBJECTIVE： To explore the nationwide prevalence and type specific distribution of HPV in cervical cancer specimens in China and its geographical differences. METHODS： A meta analysis was performed based on the studies with HPV distribution data in invasive cervical cancer specimens from China published between 2000--2012. The pooled prevalence of overall and each high risk HPV type for each province and administrative region in China was calculated by combining the data from the included studies. The regionally combined HPV prevalence was further standardized by the province-specific cervical cancer mortality size to estimate the nationwide HPV prevalence. RESULTS： A total of 31 studies meet the inclusion criteria,including 5 081 samples from 18 provinces and areas. The pooled prevalence of overall HPV in these studies is 89.6 % （95 %CI： 87.4 G- 91.7 %;I2= 88.9 %）, with noticeable differences between different provinces or areas,ranging from 78.7% to 97.2G. A total of 16 studies presented the type-specific data for HPV16 and/or HPV18, and the pooled proportion of HPV16 and/or HPV18 in HPV positive cases was 86.1% （95GCI：82.9%-89.4%;I2= 81.0 G）. After standardized by the province-specific cervical cancer mortality size, the nationwide overall HPV prevalence rate in ICC is 87. 7%. Nationwide overall HPV prevalence rate in ICC standardized by the mortality size was 87. 7%.The eight most prevalent types were HPV HPV16,18,58,33,52,31,45 and 59. HPV16 is the most common type in all area, HPV18 is the second most common type in most area and HPV45, HPV52 and HPV58 is the second most common type in Inner Mongolia,Gansu and Sichuan respectively. The pattern of HPV type distribution differed significantly across areas. CONCLUSION： In the nationwide level, HPV16 and HPV18 are the most common types in the cervical cancer sample from China, HPV58,33,52,31,45 and 59 are shown to have high prevalence in some areas of China.

关 键 词：中国 宫颈肿瘤 人乳头瘤病毒 型别 分布 

分 类 号：R737.33[医药卫生—肿瘤]