咸宁地区女性人乳头瘤病毒感染与子宫颈病变相关性分析  

The relationship between human papilloma virus infection and cervical lesions in women in Xianning

作　　者：章登政 王亚 姜琼[1] 饶志威[1] 曾智[1] 张聪子[1] ZHANG Dengzheng;WANG Ya;JIANG Qiong;RAO Zhiwei;ZENG Zhi;ZHANG Congzi(Xianning Central Hospital,The First Affiliated Hospital of Hubei University of Science and Technology,Xianning,Hubei437000,China)

机构地区：[1]咸宁市中心医院湖北科技学院附属第一医院,湖北咸宁437000

出　　处：《中国预防医学杂志》2023年第8期775-780,共6页Chinese Preventive Medicine

基　　金：湖北省科技计划项目(2020CFB868);咸宁市中心医院同济咸宁医院各级科研立项项目(2016XYB004);咸宁市中心医院同济咸宁医院各级科研立项项目(2020XYA007)。

摘　　要：目的分析咸宁地区女性感染人乳头瘤病毒(human papilloma virus,HPV)基因型分布与年龄、子宫颈病变程度相关性,了解该地区女性HPV感染特征。方法2019年1月—2021年12月,本研究采用荧光聚合酶链式反应(polymerase chain reaction,PCR)方法及液基薄层细胞学检测(thinprep cytologic test,TCT)对咸宁市中心医院行宫颈癌筛查的12868例女性患者进行检测,对其中高危HPV感染或TCT异常患者行阴道镜检查及宫颈组织活检。结果12868例样本中,HPV阳性2496例(19.40%),低危HPV阳性275例(2.14%),高危HPV阳性2221例(17.26%)。对于不同年龄人群组,HPV阳性率及高危型阳性率分布在0~<20岁、65~<70岁,均呈现明显双峰现象;HPV阳性率(χ^(2)=80.135,P<0.01)、单一感染-多重感染率(χ^(2)=23.278,P<0.01)、低危型感染-高危型感染率(χ^(2)=17.386,P<0.01)在不同年龄段分布差异有统计学意义。宫颈组织活检提示宫颈病变712例,高危HPV感染率91.57%,高危HPV阳性率(χ^(2)=78.835,P<0.01)、单一感染-多重感染率(χ^(2)=8.705,P=0.033)在不同级别宫颈上皮内病变组中分布差异有统计学意义,同时不同高危型别HPV(16、52、18、33、53、51、66、39、56、82)在不同级别宫颈病变组中分布差异有统计学意义(P<0.05)。结论咸宁地区不同年龄人群的HPV感染率差异较大,子宫颈病变与高危型HPV感染相关,且高级别子宫颈上皮内病变与HPV16/18型感染密切相关,子宫颈癌筛查可以为本地宫颈癌防控提供参考。Objective To analyze the correlation of genotype distribution of human papillomavirus(HPV)infection with age and cervical lesions in women in Xianning,so as to understand the characteristics of HPV infection in women in this area.Methods Cervical tissue samples taken from 12868 women who underwent cervical cancer screening in Xianning Central Hospital from January 2019 to December 2021 were tested using fluorescent polymerase chain reaction(PCR)and thinprep cytology test(TCT).For those high-risk HPV infection or abnormal TCT results,colposcopy and cervical biopsy were performed.Results Among the 12868samples,2496 were HPV positive(19.40%),in which 275 were low-risk HPV(2.14%)and 2221 were highrisk HPV(17.26%).For women of different ages,the HPV positive rate and high-risk HPV positive rate both showed bimodal distribution,peaking at 0-<20 years and 65-<70 years.The distribution of HPV positive rate(χ^(2)=80.135, P<0.01),proportion of single infection/multiple infection(χ^(2)=23.278, P<0.01),and the proportion of low-risk/high-risk infection(χ^(2)=17.386, P<0.01)were statistically significantly different across different age groups.The results of cervical biopsy showed that there were 712 cases of cervical lesions,and the high-risk HPV infection rate was 91.57%.There were statistically significant differences in high-risk HPV positive rate(χ^(2)=78.835, P<0.01)and the proportion of single infection/multiple infection(χ^(2)=8.705,P=0.033)across the groups of different degrees of cervical intraepithelial lesions.There were also statistically significant differences in the distribution of high-risk genotypes of HPV(16,52,18,33,53,51,66,39,56,82)across different degrees of cervical lesions( P<0.05).Conclusions There are significant differences in HPV infection across different age groups in Xianning.Cervical lesions are associated with high-risk HPV infection,and high-grade squamous intraepithelial lesions at the cervix are closely associated with HPV16/18 infection.Cervical cancer screening can provide reference

关 键 词：人乳头瘤病毒 子宫颈癌 子宫颈病变 基因型 

分 类 号：R186[医药卫生—流行病学] R737.33[医药卫生—公共卫生与预防医学]