人乳头瘤病毒感染分型检出情况与宫颈细胞学异常程度的关系  

Relationship between detection of HPV infection subtypes and the degree of abnormal cervical cytology

作　　者：胡佳贞 

机构地区：[1]上海中医药大学附属普陀医院妇产科,上海200061

出　　处：《中国妇幼保健》2018年第4期767-770,共4页Maternal and Child Health Care of China

基　　金：上海市科委资助项目(10ZR1427401)

摘　　要：目的探讨不同型别人乳头瘤病毒(HPV)与宫颈癌发生的相关性,为预防和早期诊治宫颈癌提供理论依据。方法选取2015年1月-2016年6月在该院进行HPV筛查结果为阳性,同时行宫颈细胞学检测的女性2 582例,分析不同感染分型的HPV与细胞学异常程度的相关性。结果在2 582例HPV阳性妇女中细胞学异常检出率为24.48%,低级别型细胞学异常感染者所占比例为18.51%,不同型别HPV亚型检出情况包括HPV16型132例(27.62%)、HPV58型68例(14.23%)、HPV52型61例(12.76%%)、HPV53型51例(10.67%)、HPV66型44例(9.21%)、HPV33型38例(7.95%)、HPV31型27例(5.65%)、HPV68型24例(5.02%)、HPV18型22例(4.60%)等;高级别型细胞学异常者所占比例为5.96%,其中不同型别HPV亚型检出情况包括HPV16型78例(50.65%)、HPV58型25例(16.23%)、HPV33型20例(12.99%)、HPV52型11例(7.14%)、HPV18型9例(5.84%)等。Logistic回归分析发现,感染者年龄、高危型HPV16、31、33、53、58感染亚型与高级别细胞学异常程度具有显著相关性(OR值分别为:1.314、2.854、2.324、2.182、1.657、1.103),且差异有统计学意义(均P<0.05),而HPV39、52、66等亚型与低级别型细胞学异常程度相关,且差异有统计学意义(均P<0.05)。结论 HPV16、31、33、53、58亚型与细胞学高级别异常具有高度相关性,在宫颈癌筛查中应针对此类人群进行重点干预治疗。Objective To explore the correlations between different human papillomavirus（ HPV） subtypes and oncogenesis of cervical cancer,provide a theoretical basis for prevention,early diagnosis and treatment of cervical cancer. Methods A total of 2 582 women underwent HPV screening in Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2015 to June 2016,the screening results were positive,then cervical cytology test was performed. The correlations between different HPV infection subtypes and the degree of abnormal cervical cytology were analyzed. Results Among 2 582 women with positive HPV,the rate of abnormal cervical cytology was 24. 48%,the proportion of women with infection of low-grade HPV subtypes accounted for 18. 51%,the detection rates of HPV16,HPV58,HPV52,HPV53,HPV66,HPV33,HPV31,HPV68,and HPV18 were 27. 62%（ 132 women）,14. 23%（ 68 women）,12. 76%（ 61 women）,10. 67%（ 51 women）,9. 21%（ 44 women）,7. 95%（ 38 women）,5. 65%（ 27 women）,5. 02%（ 24 women）,and4. 60%（ 22 women）,respectively; the proportion of women with infection of high-grade HPV subtypes accounted for 5. 96%,the detection rates of HPV16,HPV58,HPV33,HPV52,and HPV18 were 50. 65%（ 78 women）,16. 23%（ 25 women）,12. 99%（ 20 women）,7. 14%（ 11 women）,and 5. 84%（ 9 women）,respectively. Logistic regression analysis showed that age,infection of high-grade HPV subtypes（ HPV16,HPV31,HPV33,HPV53,HPV58） were significantly correlated with high degree of abnormal cervical cytology（ OR：1. 314,2. 854,2. 324,2. 182,1. 657,1. 103,all P〈0. 05）. HPV39,HPV52,and HPV66 were significantly correlated with low degree of abnormal cervical cytology（ all P〈0. 05）. Conclusion HPV16,HPV31,HPV33,HPV53,HPV58 are significantly correlated with high degree of abnormal cervical cytology,and the target population should be given key intervention and treatment in cervical cancer screening.

关 键 词：人乳头瘤病毒 宫颈细胞学 宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]