12691例妇科门诊患者HPV感染的状况分析  

Status Analysis of Cervical HPV Infection in 12 691 Outpatients

作　　者：田凌君 吴素慧[1] 胡龙华 武小芹 李颖[1] 孙静汾 尚海霞[1] TIAN Lingjun;WU Suhui;HU Longhua;WU Xiaoqin;LI Ying;SUN Jingfen;SHANG Haixia(Department of Gynecology and Obstetrics,Shanxi Academy of Medical Sciences/ Shanxi Dayi Hospital,Taiyuan 032300,Chin)

机构地区：[1]山西医学科学院山西大医院妇产科,太原032300

出　　处：《医学综述》2018年第10期1952-1955,1960,共5页Medical Recapitulate

基　　金：山西省科技攻关项目(20130313019-3)

摘　　要：目的通过门诊女性宫颈人乳头瘤病毒(HPV)感染检查,了解就诊女性宫颈HPV感染基因型的分布情况,为山西省宫颈癌及癌前病变的筛查策略制定提供依据。方法对2015年7月至2017年2月在山西大医院妇产科门诊就诊的12 691例女性进行HPV筛查,使用HPV核酸扩增及杂交技术对宫颈HPV进行基因分型检测,同时收集相应病检结果作为明确诊断的金标准。结果 12 691例检测样本中HPV总检出率25.86%(3 282例),其中高危型HPV检出率为23.54%(2 988/12 691),前5位是HPV16,58,52,53,39。低危型检出率为4.41%(560/12 691),前5位依次为81,6,11,44,42。HPV在不同年龄组其检出率不同:绝经后女性高于育龄期女性(P<0.05);≤24岁与≥66岁女性高于25~65岁女性(P<0.05)。HPV阳性患者中,有17.06%的患者(560例)病检结果为宫颈上皮内瘤变Ⅱ级及以上级别,其中主要感染亚型为HPV16、58、52、33、18。结论我院门诊机会性筛查妇女宫颈HPV检出率略高于目前报道的门诊机会性筛查的平均水平,高危亚型排名前5位的是HPV16、58、52、53、39,最常见的低危型是HPV81,中老年女性为HPV感染的好发年龄,临床值得重视。Objective To investigate the genotype distribution of human papillomavirus（ HPV） and provide guideline for cervical cancer and precancerous lesions screening in Shanxi province through performing opportunistic screening of cervical HPV infection in outpatient department. Methods A total of 12 691 outpatients from Shanxi Dayi Hospital from Jul. 2015 to Feb. 2017 were included. Polymerase chain raction and hybridization were performed to analyze the genotype of cervical HPV. Meanwhile,pathological results were used as diagnostic goldstandard. Results The total detection rate of HPV was 25. 86%（ 3 282/12 691）. The detection rate of high-risk HPV（ HR-HPV） was 23. 54%（ 2 988/12 691）,with HPV16,58,52,53,39 as top five subtypes. The detection rate of low-risk type was about 4. 41%（ 560/12 691） with HPV81,6,11,44,42 as top five subtypes. The detection rates of HPV in different age groups were different,that postmenopausal women had higher HPV infection rate than childbearing age women（ P〈0. 05）; the HPV detection rate was lower in women between 25 and 65 years old than women in the other ages（ P〈0. 05）. In HPV positive patients,17. 06%（ 560 cases） was pathologically diagnosed above cervical intraepithelial neoplasia Ⅱ and the main infection subtypes were HPV 16,58,52,33,18. Conclusion Our results of HPV detection rate was slightly higher than the reported average level. The top five high-risk subtypes are HPV16,58,52,53,39. HPV81 is the most common low-risk type. More attention should be paid to middle and old aged women since they are susceptible to HPV infection.

关 键 词：人乳头瘤病毒 筛查 基因分型 宫颈癌 

分 类 号：R711.74[医药卫生—妇产科学]