临沂市人民医院自然就诊女性患者9227例HPV感染状况分析  

Prevalence of human papilloma virus infection of 9227 female patients in Linyi People’s Hospital

作　　者：杨翠翠 徐琪琪 张丽[1] 王家银[1] 田莲莲 战雪梅[1] YANG Cui-cui;XU Qi-qi;ZHANG Li;WANG Jia-yin;TIAN Lian-lian;ZHAN Xue-mei(Department of Pathology,Linyi People’s Hospital,Linyi 276003,P.R.China)

机构地区：[1]临沂市人民医院病理科,山东临沂276003

出　　处：《中华肿瘤防治杂志》2020年第14期1113-1118,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省重点研发计划(2017GSF218104)。

摘　　要：目的人乳头状瘤病毒(human papilloma virus,HPV)亚型众多,其感染率及亚型分布也存在显著的地区差异,本研究调研分析临沂市人民医院自然就诊女性患者HPV感染现状,为本地区宫颈癌的防治及预防性HPV疫苗接种提供理论参考依据。方法选取2015-08-04-2019-08-28在临沂市人民医院因妇科症状就诊的9 227例女性患者HPV分型检测病例资料,所有病例均采用通用引物多重PCR扩增、流式荧光杂交法进行27种HPV DNA分型检测,其中3 712例HPV阳性患者中有615例有活检病理结果,回顾性分析不同年龄组和不同宫颈病变组患者HPV感染状况。结果 HPV总感染率为40.23%(3 712/9 227),不同年龄组间感染率差异有统计学意义,χ2=108.475,P<0.001。HPV感染年龄分布呈U形,存在2个感染高峰,≥56岁年龄组(54.82%,108/197)和≤25岁年龄组(48.44%,885/1 827);高危型HPV感染率最高的5个型别依次为HPV16(10.39%,655/6 302)、HPV52(7.38%,465/6 302)、HPV58(6.59%,415/6 302)、HPV51(4.92%,310/6 302)和HPV53(4.76%,300/6 302);低危型HPV感染率最高的5个型别依次为HPV6(9.66%,609/6 302)、HPV11(6.59%,415/6 302)、HPV43(4.13%,260/6 302)、HPV61(4.00%,252/6 302)和HPV81(3.48%,219/6 302);不同宫颈病变组最常见的感染亚型主要为HPV16(20.31%,213/1 049)、HPV58(9.15%,96/1 049)、HPV52(7.05%,74/1 049)、HPV56(5.15%,54/1 049)和HPV51(4.77%,50/1 049)。各宫颈病变组均以单一高危型感染为主,低级别鳞状上皮内病变(low-grade squamous intraepithelial lesions,LSIL)、高级别鳞状上皮内病变(high-grade squamous intraepithelial lesions,HSIL)和宫颈癌组占比最高的感染亚型均为HPV16。结论 HPV感染与宫颈癌密切相关,除了HPV16和HPV18型感染外,还应重点加强对HPV58、HPV52、HPV56和HPV51等型别感染女性的健康管理。OBJECTIVE Human papilloma virus(HPV)has many subtypes,and its infection rate and subtype distribution also have significant regional differences.The purpose of this study was to investigate the prevalence of HPV infection of female patients who naturally visited to Linyi People’s Hospital,and to provide theoretical references for cervical cancer prevention and control and prophylactic HPV vaccination in the region.METHODS HPV testing results of 9227 cases of female patients for gynecological symptoms,who had undergone 27 HPV genotyping tested by universal primermultiplex-PCR amplification and flexible multi-analyte profiling technology,including 615 cases with pathological biopsy results among 3712 cases of HPV-positive patients,were selected from August 4,2015 to August 28,2019 in Linyi People’s Hospital.The HPV infection status of patients with different age groups and cervical lesions was retrospectively analyzed.RESULTS The overall HPV infection rate was 40.23%(3712/9227).The HPV infection rate among different age groups was statistically different(χ2=108.475,P<0.001),and the age distribution exhibited a U-shaped curve,with the first major peak at the≥56 years group(54.82%,108/197)and a second minor peak at the≤25 years group(48.44%,885/1827).The five most prevalent high-risk and low-risk HPV subtypes were HPV16(10.39%,655/6302),52(7.38%,465/6302),58(6.59%,415/6302),51(4.92%,310/6302),53(4.76%,300/6302)and HPV6(9.66%,609/6302),11(6.59%,415/6302),43(4.13%,260/6302),61(4.00%,252/6302),81(3.48%,219/6302),respectively.In different cervical lesion groups,HPV16(20.31%,213/1049),58(9.15%,96/1049),52(7.05%,74/1049),56(5.15%,54/1049),51(4.77%,50/1049)were the 5 most common HPV genotypes.Single high-risk HPV infection was the main patterns in different cervical lesion groups,and HPV16 was the most common genotype in LSIL,HSIL and cervical cancer groups.CONCLUSIONS HPV infection is closely associated with cervical cancer.In addition to HPV16 and HPV 18 infections,emphasis should be placed on strengthening the h

关 键 词：人乳头状瘤病毒 感染 亚型 宫颈癌 HPV疫苗 

分 类 号：R737.3[医药卫生—肿瘤]