新疆生产建设兵团地区人乳头瘤病毒亚型与子宫颈癌关系及影响因素  

Relationship between HPV subtypes and cervical cancer and its influencing factors in Xinjiang Production and Construction Corps

作　　者：李秉政 张慧[2] 杨振 祖丽胡玛尔·艾尼瓦尔 李凡卡[2] LI Bingzheng;ZHANG Hui;YANG Zhen;Zulihumaer AINIWAER;LI Fanka(School of Public Health,Xinjiang Medical University,Xinjiang Uygur Autonomous Region 830011,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆维吾尔自治区乌鲁木齐830011 [2]新疆生产建设兵团疾病预防控制中心

出　　处：《中国预防医学杂志》2023年第8期781-787,共7页Chinese Preventive Medicine

基　　金：新疆生产建设兵团疾病预防控制中心研究课题立项项目(BTCDCKY202207)。

摘　　要：目的了解新疆生产建设兵团地区人乳头瘤病毒(human papilloma virus,HPV)基因型分布与子宫颈癌分布情况,为子宫颈癌筛查工作提供科学参考。方法2019—2020年对新疆生产建设兵团7个师常驻人口(≥6个月)的35~64岁女性开展子宫颈癌筛查。结合HPV亚型感染与混合感染情况,分析与不同程度癌变的关系。结果本研究最终纳入100525人,HPV检测阳性9533例,阳性率9.48%,子宫颈癌397例,患病率0.39%。HPV阳性率在地区、民族、年龄和文化水平差异有统计学意义(P<0.05),子宫颈癌患病率在地区、民族、文化水平差异有统计学意义(P<0.05)。HPV感染以HPV16(1.50%)、HPV52(1.60%)、HPV58(1.30%)、HPV53(0.90%)、低危型(1.60%)为主,子宫颈癌(≥CINⅠ)的主要HPV亚型有HPV16(0.25%)、HPV18(0.04%)、HPV52(0.04%)、HPV58(0.04%)、低危型(0.04%)、HPV53(0.02%)为主。高危型HPV可导致不同程度子宫颈癌前病变,HPV感染层数之间差异有统计学意义(P<0.05),含高危型HPV双重或多重感染具有很高的致癌率。主要致癌的有HPV16、HPV18、HPV52,HPV58在CINⅡ/CINⅢ阳性率(1.34%)高于HPV18(0.74%)、HPV52(0.89%),HPV53在各级子宫颈癌中阳性率最低。多因素回归分析发现,高危型HPV单一(OR=4.71,P<0.05))、双重(OR=6.67,P<0.05))、多重感染(OR=8.31,P<0.05))增加了致癌风险,HPV16、HPV18是导致子宫颈癌的主要亚型,北疆子宫颈癌患病率高于南疆,地域是导致子宫颈癌的危险因素(OR=4.03,P<0.05),文化水平不是患子宫颈癌的危险因素(P>0.05)。结论高危型HPV16、HPV18是导致子宫颈癌的主要基因型,可导致不同程度的癌前病变,还需重点关注HPV52、HPV53、HPV58型。Objective To understand the distribution of HPV genotypes and cervical cancer in the Xinjiang Production and Construction Corps(XPCC),and to explore their relationship,so as to provide scientific evidence for cervical cancer screening.Methods From 2019 to 2020,cervical cancer screening was carried out for women aged 35-64 in the resident population(living for≥6 months in the study area)in 7 divisions of XPCC.The relationship of HPV subtype infection and mixed infection with different degrees of carciongenesis was analyzed.Results 100525 women were included in this study,of whom 9533 were tested HPV-positive,with a total positive rate of 9.48%,and 397 cases of cervical cancer were identified,resulting in a prevalence rate of 0.39%.There were statistically significant differences in HPV positive rate by region,ethnicity,age and educational level(P<0.05),and in cervical cancer prevalence across different regions,ethnic groups and educational levels(P<0.05).HPV infection was mainly due to HPV16(1.50%),52(1.60%),58(1.30%),53(0.90%),and low-risk subtype(1.60%),and the main HPV subtypes causing cervical cancer(≥CINⅠ)were HPV16(0.25%),18(0.04%),52(0.04%),58(0.04%),low-risk subtype(0.04%),and 53(0.02%).High-risk HPV subtypes led to different degrees of cervical precancerous lesions,and statistically significant difference in the number of layers infected(P<0.05),and double or multiple infection involving high-risk HPV sybtypes showed a high carcinogenic rate.The main carcinogenic subtypes were HPV16,18 and 52.In CINⅡ/CINⅢcases,HPV53 positive rate(1.34%)was higher than that of HPV18(0.74%)and HPV52(0.89%).HPV53 had the lowest positive rate across all levels of cervical cancer.Multivariable regression analysis showed that single(OR=4.71,P<0.05)),double(OR=6.67,P<0.05),multiple infection involving high-risk HPV subtypes(OR=8.31,P<0.05))increased the risk of cancer,HPV16 and 18 were still the main subtypes causing cervical cancer.The north part of Xinjiang had higher risk of cervical cancer compared with south Xinji

关 键 词：人乳头瘤病毒 子宫颈癌 高危型HPV HPV多型感染 

分 类 号：R173[医药卫生—妇幼卫生保健]