郴州市人乳头瘤病毒感染现状及其与宫颈癌发病的相关性研究  

Study on the prevalence of human papilloma virus infection in Chenzhou and its correlation with cervical cancer

作　　者：肖杭 彭丽秀[2] 李乐 Xiao Hang;Peng Lixiu;Li Le(Department of Gynecology,Yueyang No.2 People’s Hospital,Yueyang,Hunan 414000,China)

机构地区：[1]岳阳市二医院妇科,湖南岳阳414000 [2]郴州市第一人民医院妇科,湖南郴州423000

出　　处：《湘南学院学报（医学版）》2020年第2期13-18,共6页Journal of Xiangnan University（Medical Sciences）

基　　金：郴州市科学技术局项目(czkj2016046)。

摘　　要：目的探讨郴州市妇女人乳头瘤病毒(HPV)的感染情况及其与宫颈癌发病的关系,为预测宫颈癌发病风险、制定临床干预措施以及疫苗的研发和使用提供依据。方法收集2014年1月~2015年12月就诊于郴州市八家医院妇科门诊共56648例女性HPV检测结果,以及同期郴州市第一人民医院住院部和门诊宫颈上皮内瘤变(CIN)和宫颈鳞癌患者共1067例HPV检测结果(其中CINⅠ287例、CINⅡ248例、CINⅢ278例、宫颈鳞癌254例)分别进行分析。结果门诊56648例患者HPV感染率为19.30%,排前十位的HPV感染亚型依次为(递减)HPV52、16、58、cp8304、53、39、51、68、33、18型。不同程度宫颈病变患者HPV感染情况:CINⅠ组感染率为55.05%,CINⅡ组感染率为72.18%,CINⅢ组感染率为80.22%,宫颈鳞癌组为85.83%。随宫颈病变严重程度的增加,HPV感染率递增,不同程度宫颈病变组HPV感染率比较差异有统计学意义(χ^2=34.54,P<0.05)。不同程度宫颈病变组感染HPV的型别比较,HPV16、18、33、52、58型的感染率比较差异均有统计学意义(P<0.05);HPV各亚型在CIN及宫颈鳞癌中的有序Logistic回归分析,HPV16、18、52型是影响CIN病变程度及宫颈鳞癌的主要危险因素(P<0.05),其中导致宫颈病变最主要的危险因素是HPV16型的感染(OR=3.476,95%CI:2.726~4.433)。结论本市HPV感染以HPV52型最常见,其次为16、58、cp8304、53、39、51、68、33、18型等。HPV感染与宫颈病变关系密切,应加大对女性HPV的检测,特别是对HPV16型易致病变进展的HPV感染患者应高度重视。Objective To study the prevalence of human papillomavirus(HPV)infection in Chenzhou and its correlation with the pathogenesis of cervical cancer,to provide clues and evidence for predicting the risk of cervical cancer,formulating clinical intervention measures,and developing and using vaccines.Methods The subjects included 56648 women with HPV who visited department of gynecology of eight different hospital of Chenzhou and 1067 women who had been diagnosed with cervical intraepithelial neoplasia(CIN)from January 2014 to December 2015,among which there were 287 CIN I cases,248 CINⅡcases,278 CINⅢcases and 254 cases of cervical squamous carcinoma.Results Among 56648 women,the HPV infection rates were 19.30%.The top ten HPV types were HPV 52,16,58,cp8304,53,39,51,68,33.HPV infection in patients with cervical lesions of different degrees is as follows:the infection rate of CINⅠgroup,CINⅡgroup,CINⅢgroup and the cervical squamous carcinoma group were 55.05%,72.18%,80.22%and 85.83%.With the increase of the severity of cervical lesions,the HPV infection rate increased,and the difference of HPV infection rate in different degrees of cervical lesions was statistically significant(χ^2=34.54,P<0.05).Comparison of HPV types in different degrees of cervical lesions showed statistically significant differences in the infection rates of HPV 16,18,33,52 and 58(P<0.05).The ordered logistic regression analysis of HPV subtypes in CIN and cervical squamous cell carcinoma showed that HPV 16,18 and 52 were the main risk factors(P<0.05),of which the most important risk factor was infection of HPV 16(OR=3.476,95%CI:2.726~4.433).Conclusion HPV 52 is the most common type of HPV infection in this city,followed by 16,58,cp8304,53,39,51,68,33,18.HPV infection is closely related to cervical lesions,so the detection of HPV in women should be increased,especially for HPV infection patients with HPV16 prone to lesion progression.

关 键 词：人乳头瘤病毒 宫颈上皮内瘤变 宫颈鳞癌 危险因素 

分 类 号：R737.3[医药卫生—肿瘤]