老年子宫颈高危型HPV感染与子宫颈病变的相关性分析  

Correlation Analysis between HPV Infection and Cervical Lesions in the Elderly Females

作　　者：赵丽雅[1] 庞晓燕[1] 陈青青[1] 孟祥凯[1] 张颐[1] 王化丽[2] 

机构地区：[1]中国医科大学附属第一医院妇科,沈阳110001 [2]大连市妇产医院妇科,辽宁大连116033

出　　处：《中国医科大学学报》2014年第8期691-693,共3页Journal of China Medical University

基　　金：辽宁省自然科学基金(201202282)

摘　　要：目的 探讨人乳头瘤病毒（HPV）在老年妇女（≥60岁）的感染状态及其在老年子宫颈病变中的意义.方法 对2013年1月至2013年10月于中国医科大学附属第一医院妇科门诊自愿行子宫颈病变筛查的老年妇女（502例）行子宫颈HPV筛查,并对高危型HPV阳性且肉眼可疑子宫颈病变或子宫颈液基薄层细胞学检查（TCT）提示异常者行阴道镜下子宫颈活检.结果 84例检出高危型HPV感染,总感染率为16.73％（84/502）.39例行阴道镜下子宫颈活检,其中确诊子宫颈癌5例（5.62％）;CINⅡ～Ⅲ10例（11.24％）;CIN Ⅰ 5例（5.62％）;湿疣1例（1.12％）;正常或慢性子宫颈炎18例（20.22％）.引起CIN以上级别的子宫颈病变HPV亚型感染主要为HPV 16、31、33、52和53;其中5例子宫颈癌中均存在HPV16感染.结论 由于老年个体的特殊性,在老年患者中HPV感染阳性率下降的同时,其致病率明显上升,故对老年HPV阳性患者应引起足够重视.Objective To investigate the infection condition and the clinic significance of human papillomavirus （HPV） testing in the screening of cervical lesions in the elderly females （≥ 60 years old）.Methods From January 2013 to October 2013,502 elderly females received HPV DNA detection in the First Affiliated Hospital of China Medical University gynecological clinic.Patients with HPV DNA （＋） and abnormal cytological or highly suspected abnormal in clinic were further examined by colposcopy biopsy.Results A total of 84 individuals （84/502,16.73％） were proved to be infected by high-risk （HR） HPV.Among the patients with positive HR-HPV,39 people received colposcopy biopsy,and the results were as follow：5 cases of invasive carcinoma （5.62％）,10 cases of CIN Ⅱ-Ⅲ （1 1.24％）,5 cases of CIN Ⅰ （5.62％）,1 cases of condyloma （1.12％） and 18 cases of inflammation （20.22％）.Different types of HPV subtypes were strongly associated with the risk of all grades of CIN and cancer.Types of 16,31,33,52 and 53 HPVs were the most common in women diagnosed with CIN Ⅱ-Ⅲ and cancer,and 5 cases of cervical cancer presented HPV16 infection.Conclusion Due to the special nature of elderly individuals,the morbidity increases when the HPV infection rate declines,so sufficient attention should be paid to the old patients with HPV infection.

关 键 词：老年妇女 子宫颈癌 筛查 人乳头瘤病毒 子宫颈活检 

分 类 号：R737.33[医药卫生—肿瘤]