宫颈癌筛查妇女高危型人乳头瘤病毒感染现状及影响因素研究:基于成都市45万人群  

Study on the Infection and Related Factors of High-risk HPV in Cervical Cancer Screening Women:Based on 450000 Participants in Chengdu

作　　者：舒婷 兰志鹏 巫霞 罗映娟 杨柳 SHU Ting;LAN Zhipeng;WU Xia;LUO Yingjuan;YANG Liu(Health Care Department,the Affiliated Women's and Children's Hospital,School of Medicine,University of Electronic Science and Technology of China/Chengdu Women's and Children's Central Hospital,Chengdu 611731,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院保健部,四川省成都市611731

出　　处：《中国全科医学》2025年第2期213-219,共7页Chinese General Practice

基　　金：成都市科技局成果转化示范项目(2024-YF09-00020-SN);成都市医学科研课题(2023557)。

摘　　要：背景宫颈癌是女性常见恶性肿瘤之一,其病因明确,通过规范筛查可以有效降低宫颈癌发病率。人乳头瘤病毒(HPV)检测是WHO推荐的首选宫颈癌筛查方法,了解成都市高危型人乳头瘤病毒(hrHPV)感染状况,对优化成都市宫颈癌筛查方案具有重要意义。目的分析成都市35~64岁参加宫颈癌筛查人群的hrHPV感染现状和宫颈病变患者的hrHPV亚型感染分布情况,探讨hrHPV阳性检出率的相关影响因素。方法从“成都市育龄妇女生殖健康数据库”收集2023年参加成都市免费宫颈癌筛查的459433例个案数据,分析不同hrHPV基因型感染总体分布情况以及宫颈病变患者的hrHPV亚型感染分布情况,比较不同特征人群hrHPV感染情况,并构建多水平Logistic回归模型分析hrHPV检出阳性情况的相关因素。结果459433例中,hrHPV阳性检出率为11.65%(53509/459433),hrHPV感染随年龄的增长呈上升趋势(χ_(趋势)^(2)=1501.082,P<0.001)。82.39%(131/159)的宫颈癌患者感染HPV 16或18亚型,以单纯感染HPV 16亚型为主(52.20%,83/159)。多水平Logistic回归分析结果显示,年龄、文化程度、婚姻状况、绝经状态、避孕方式、妊娠次数、分娩次数为hrHPV阳性检出情况的影响因素(P<0.05)。结论成都市女性hrHPV阳性检出率略低于全国平均水平。在筛查过程中,要重视健康教育与随访工作,特别是对HPV 16或18亚型阳性者的后续随访工作。开展宫颈癌筛查宣传工作时应特别关注年长者、文化程度较低者、未婚或离异/丧偶者、已绝经者、未避孕或采用避孕套外的其他避孕方式者、妊娠或分娩2次以上者等重点人群,加强宫颈癌防治核心知识、生殖健康知识等的宣传,提高妇女健康素养。Background Cervical cancer,a prevalent malignancy in women,has a well-established etiology and can be effectively prevented through standardized screening.The WHO recommends HPV testing as the primary method for cervical cancer screening.Understanding the status of high-risk human papillomavirus(hrHPV)infection in Chengdu is crucial for optimizing primary hrHPV screening.Objective To investigate the hrHPV infection status among cervical cancer screening participants aged 35-64 years in Chengdu,and explore the related factors affecting the positive detection rate of hrHPV.Methods We retrospectively analyzed data from 459433 women who received free cervical cancer screening in Chengdu in 2023,sourced from the"Chengdu Reproductive Health Database of Women of Childbearing Age".We analyzed the overall distribution of different hrHPV genotypes and the distribution of hrHPV subtypes in patients with cervical lesions,and compared the hrHPV infection in different populations.Multivariate Logistic regression models identified factors affecting the positive detection rate of hrHPV.Results The hrHPV prevalence among participants was 11.65%(53509/459433),with an increase observed with age(χ^(2)=1501.082,P<0.001).Among cervical cancer patients,82.39%(131/159)were infected with HPV 16 or 18,predominantly with simple HPV 16 infection(52.20%,83/159).Multivariate Logistic regression analysis revealed that age,education level,marital status,menopausal status,contraceptive method,gravidity,and parity were significant factors influencing the positive detection rate of hrHPV(P<0.05).Conclusion The hrHPV infection prevalence in Chengdu is slightly lower than the national average.The findings suggest a need for targeted health education and follow-up,particularly for patients positive for HPV 16 or 18.Emphasis should be placed on carrying out related publicity to groups such as the elderly,less educated,unmarried or divorced/widowed,postmenopausal women,those not using contraception or using methods other than condoms,and women with gr

关 键 词：宫颈癌 乳头状瘤病毒感染 高危型人乳头瘤病毒 筛查 影响因素分析 

分 类 号：R737.33[医药卫生—肿瘤]