高危型HPV感染及宫颈恶性病变与年龄的相关分析  

Correlation analysis on the high-risk HPV infection and cervical malignant lesions with age

作　　者：熊煌果 吴屏 卢婉容 吴鹏[3] 邢辉[4] 尹平[1] Xiong Huangguo;Wu Ping;Lu Wanrong(Department of Epidemiology and Biostatistics,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030;The Key Laboratory of Cancer Invasion and Metastasis of the Ministry of Education of China;Department of Gynecologic Oncology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030)

机构地区：[1]华中科技大学同济医学院公共卫生学院流行病与卫生统计学系,武汉430030 [2]华中科技大学同济医学院附属同济医院中国教育部肿瘤侵袭转移重点实验室,武汉430030 [3]华中科技大学同济医学院附属同济医院妇科肿瘤科,武汉430030 [4]湖北省文理学院附属襄阳市中心医院妇产科,襄阳441021

出　　处：《现代妇产科进展》2020年第7期503-508,共6页Progress in Obstetrics and Gynecology

基　　金：国家自然科学基金项目(No:81573262,No:81972449);湖北省科技厅创新群体项目(No:2019CFA016)。

摘　　要：目的:探讨自然人群中年龄与女性高危型HPV感染及宫颈恶性病变之间的关系。方法:选取2017年1月至2018年2月在襄阳地区行宫颈癌筛查的30岁及以上女性自然人群311382例,采用高危型HPV初筛为基础的宫颈癌筛查方法,结合年龄对HPV感染及宫颈恶性病变状况进行探索研究。结果:受试女性高危型HPV的总感染率为7.79%(24274/311382)。随着年龄层增加,高危型HPV的感染率由6.65%(30~35岁)升至9.85%(>60岁);HPV16/18型感染率(r1=0.96,P=0.0005)、其他高危型HPV感染率(r2=0.90,P=0.0055)均与年龄呈正相关。受试女性的CIN总阳性率为0.56%,CINⅠ患病率0.27%,CINⅡ患病率0.12%,CINⅢ患病率0.17%。6681例行阴道镜及病理活检的女性中,41~45岁年龄组CINⅡ(17.15%)和CINⅢ(10.02%)的患病率最高。Logistic回归结果显示,41~45岁年龄组发生CINⅡ和CINⅢ的OR值均最高,分别是1.47(95%CI为1.05~2.07)和1.75(95%CI为1.10~2.79),HPV16/18型感染女性相较于其他高危型感染女性发生CINⅡ和CINⅢ的OR值分别为1.43(95%CI为1.20~1.70)和2.02(95%CI为1.58~2.58)。结论:筛查人群中,高危型HPV感染率随年龄增大而升高,大于60岁老年女性仍存在较高的高危型HPV感染率,41~45岁年龄段女性有最高的CINⅡ及CINⅢ的发病风险。Objective:To explore the relationship between age and high-risk HPV(hr HPV)infection and cervical malignant lesions in the natural female population.Methods:311382 natural women aged 30 and over who were participated in cervical cancer screening in Xiangyang city from Jan.2017 to Feb.2018 were selected as samples.The cervical cancer screening method based on primary hrHPV screening was used,and we investigated the status of HPV infection and cervical malignant lesions in combination with age.Results:The total infection rate of hrHPV infection was 7.79%(24274/311382).With the increase of age group,the infection rate of hrHPV increased from 6.65%(30~35 years old)to 9.85%(>60 years old).There was a positive correlation between the infection rate of HPV16 or 18(r1=0.96,P=0.0005)and that of other hrHPV types(r2=0.90,P=0.0055)and age.The total positive rate of CIN was 0.56%among the women with histological results,the prevalence of CINⅠwas 0.27%,the prevalence of CINⅡwas 0.12%,and the prevalence of CINⅢwas 0.17%.The prevalence of CINⅡ(17.15%)and CINⅢ(10.02%)in the 41~45 age group were the highest among 6681 women who underwent colposcopy and biopsy.Logistic regression analysis showed that the OR values were the highest in the 41~45 age group in CINⅡand CINⅢ,1.47(95%CI:1.05~2.07)and 1.754(95%CI:1.10~2.79),respectively.The OR values of CINⅡand CINⅢin HPV16/18-infected women compared with other high-risk women were 1.4(95%CI:1.20~1.70)and 2.017(95%CI:1.58~2.58).Conclusions:In the screening population,the hrHPV infection rate was increased with age,the elderly women over 60 years old still have a high hrHPV infection rate,women in the 41~45 age group have the highest risk of CINⅡ+and CINⅢ+.

关 键 词：高危型人乳头瘤病毒(hrHPV)感染 宫颈恶性病变 年龄 

分 类 号：R737.33[医药卫生—肿瘤]