绍兴地区妇科就诊妇女高危型人乳头瘤病毒感染及亚型分布调查  

An investigation on high-risk HPV infections and subtype distribution in women from Shaoxing area

作　　者：金秀萍 凌伟江 俞月萍[2] 刘小香[2] 孙爱华[2] 

机构地区：[1]浙江省绍兴市柯桥区中医医院妇科,312030 [2]浙江医学高等专科学校基础医学部,杭州市310053

出　　处：《中华全科医学》2015年第1期66-68,71,共4页Chinese Journal of General Practice

基　　金：浙江省卫生高层次创新人才培养工程项目(2012-141);浙江省医药卫生科学研究基金(2004A018)

摘　　要：目的人乳头瘤病毒(human papilloma virus,HPV)感染与宫颈癌的发生密切相关,然而绍兴地区关于HPV感染率与宫颈病发生报道很少,本研究的目的是确定该地区宫颈病妇女宫颈部位人乳头瘤病毒感染率及亚型分布特点。方法选择2010年1月—2013年9月在浙江省绍兴县中医院妇科就诊妇女4273例,常规行薄层液基细胞学检查,并采用PCR-反向点杂交法进行HPV 23种亚型检测,采用统计软件分析HPV和高危型HPV(HRHPV)感染率及不同HPV亚型在不同人群中的分布。结果 HPV感染率为21.8%(932/4273)。未见上皮内病变细胞或恶性细胞(NILM)、非典型鳞状上皮细胞(ASC)和癌前病变(SIL)患者HPV感染率分别为15.5%(601/3888)、83.7%(236/282)和92.2%(95/103);HPV阳性的NILM、ASC和SIL患者中HR-HPV构成比分别为83.0%(601/724)、94.8%(274/289)和96.7%(118/122);不同人群HR-HPV型排在前五位分别为:NILM患者是HPV-16、HPV-52、HPV-58、HPV-33和HPV-68,ASC患者是HPV-16、HPV-58、HPV-52、HPV-18和HPV-33,SIL患者是HPV-16、HPV-58、HPV-33、HPV-52和HPV-31。NILM、ASC和SIL患者重叠HPV感染率分别为17.6%(106/601)、16.9%(40/236)和18.9%(18/95),不同人群重叠HPV感染率差异无统计学意义(χ2≤0.2,P>0.05)。结论本地区HPV感染率和HR-HPV构成比与宫颈上皮内瘤变程度密切相关,而HPV重叠感染与瘤变严重程度无关,与欧美国家不同,HPV-16、HPV-58和HPV-52是该地区最常见的HR-HPV亚型。Objective To explore the rate of high-risk Human papillomavirus （HPV） infections and genotypes distribution in women with cervical lesions from Shaoxing area. Methods 4273 patients in our hospital from Jan. 2010 to Sep. 2013 were enrolled in this study. The thinprep cytology tests were performed in all patients. The subgroup of HPV was deter- mined by PCR-based reverse blot hybridization（ PCR-RDB）, HPV and high-risk HPV （HR-HPV） infection rate and the distribution of genotypes were compared among different groups by the statistical analysis. Results The positive rate of HPV was 21.8% （932/4273）. The infection ratio of HPV were 15.5% （ 601/3888 ）, 83.7% （236/282） and 92.2% （95/103） in woman with NILM, ASC and SIL, respectively. The constituent ratio of HR-HPV were 83.0% （601/724）, 94.8% （274/289） and 96.7% （118/122） in NILM,ASC mad SIL,respectively;The five most common prevalent HR- HPV were HPV-16, HPV-52, HPV-58 ,HPV-33 and HPV-68 in NILM, HPV-16, HPV-58, HPV-52, HPV-18 and HPV-33 in ASC patients, and HPV-16, HPV-58, HPV-33, HPV-52 and HPV-31 in SIL patients. HPV multiple infection rate of in HPV-positive women with NILM（ 17.6%, 106/601 ） was no significant difference that of HPV-positive women with ASC （ 16.9% ,40/236） and with SIL（ 18.9%, 18/95 ） ,χ2 ≤0.2 ,P 〉 0.05. Conclusion The infection ratio of HPV and con- stituent ratio of HR-HPV were closely related to the degree of cervical diseases. Multiple infection of HPV cannot aggra- vate the cervical lesions. HPV-16, HPV-58 and HPV-52 were the most common prevalent HR-HPV in HPV-positive women with cervical lesions, which is different with European mad American countries.

关 键 词：人乳头瘤病毒 宫颈病变 高危型HPV 基因型 

分 类 号：R737.33[医药卫生—肿瘤] R373[医药卫生—临床医学]