绝经期宫颈高级别上皮内病变或宫颈癌患者HPV感染及临床特点分析  

Analysis of human papillomavirus infection types and clinical characteristics in menopausal patients with high-grade cervical intraepithelial lesions or cervical cancer

作　　者：张书敏 付艺璇 戚亚兰 Zhang Shumin;Fu Yixuan;Qi Yalan(Department of Obstetrics and Gynecology,Nanjing Drum Tower Hospital Group Suqian Hospital,The Affiliated Suqian Hospital of Xuzhou Medical University,Suqian223800,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属宿迁医院南京鼓楼医院集团宿迁医院妇产科,宿迁223800

出　　处：《中国基层医药》2024年第12期1773-1777,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：江苏省宿迁市指导性科技计划(Z202396)。

摘　　要：目的分析绝经期宫颈高级别上皮内病变(HSIL)或宫颈癌患者人乳头瘤病毒(HPV)感染类型及临床特点。方法回顾性分析2021年9月至2022年9月在徐州医科大学附属宿迁医院(南京鼓楼医院集团宿迁医院)经电子阴道镜下活检病理确诊的HSIL或宫颈癌患者475例的临床资料。按照是否自然绝经分为绝经组和非绝经组,比较两组患者临床资料及感染的高危HPV分型情况。结果475例患者中,绝经组142例,年龄(57.63±6.23)岁;未绝经组333例,年龄(36.79±6.85)岁。既往无宫颈癌筛查史和因有临床症状而就诊患者比例,绝经组高于未绝经组[23.2%(33/142)比5.4%(18/333),χ^(2)=33.03,P<0.05]。475例患者中,347例进行了HPV分型检测,前五位的HPV分型依次为16、52、58、33、18型。绝经组的HPV 16阳性率低于未绝经组[43.8%(32/73)比61.3%(168/274),χ^(2)=7.53,P<0.05],HPV 52阳性率高于未绝经组[28.8%(21/73)比13.5%(37/274),χ^(2)=9.64,P<0.05],多重感染比例高于未绝经组[47.9%(35/73)比31.8%(87/274),χ^(2)=6.63,P<0.05]。绝经组3型转化区比例[63.4%(90/142)比23.4%(78/333),χ^(2)=69.52,P<0.05]、宫颈管搔刮的比例[59.9%(85/142)比33.6%(112/333),χ^(2)=28.20,P<0.05]均高于未绝经组。绝经组宫颈癌的比例高于未绝经组[35.2%(50/142)比8.7%(29/333),χ^(2)=50.42,P<0.05],绝经组中宫颈癌≥IB期比例90%(45/50)。结论HSIL或宫颈癌患者中,HPV 16是最常见的类型;绝经组中,HPV 52阳性比例高,多重感染率高,宫颈筛查率低,患癌比率高且多属晚期。ObjectiveTo analyze human papillomavirus(HPV)infection types and clinical characteristics in postmenopausal patients with high-grade squamous intraepithelial lesion or cervical cancer.MethodsThe clinical data of 475 patients diagnosed with high-grade squamous intraepithelial lesions or cervical cancer,pathologically confirmed by colposcopic biopsy,were retrospectively analyzed.These patients received treatment at The Affiliated Suqian Hospital of Xuzhou Medical University(Nanjing Drum Tower Hospital Group Suqian Hospital)between September 2021 and September 2022.The patients were divided into two groups based on their menopausal status:the menopausal group and the non-menopausal group.The clinical data and the types of high-risk HPV infections were compared between the two groups.ResultsAmong the 475 patients,there were 142 in the menopausal group,with an average age of(57.63±6.23)years,and 333 in the non-menopausal group,with an average age of(36.79±6.85)years.The proportion of patients with no prior history of cervical cancer screening and those who sought medical attention due to clinical symptoms was higher in the menopausal group than in the non-menopausal group[23.2%(33/142)vs.5.4%(18/333),χ^(2)=33.03,P<0.05].Among the 475 patients,347 underwent HPV typing tests,with the top five HPV types identified as 16,52,58,33,and 18.The positive rate of HPV 16 was lower in the menopausal group compared with the non-menopausal group[43.8%(32/73)vs.61.3%(168/274),χ^(2)=7.53,P<0.05],while the positive rate of HPV 52 was higher in the menopausal group[28.8%(21/73)vs.13.5%(37/274),χ^(2)=9.64,P<0.05].The proportion of multiple infections was also higher in the menopausal group compared with the non-menopausal group[47.9%(35/73)vs.31.8%(87/274),χ^(2)=6.63,P<0.05].The proportion of patients with type 3 transformation zone in the menopausal group was higher[63.4%(90/142)vs.23.4%(78/333),χ^(2)=69.52,P<0.05],as was the proportion of cervical canal curettage[59.9%(85/142)vs.33.6%(112/333),χ^(2)=28.20,P<0.05]compared with

关 键 词：宫颈鳞状上皮内病变 人乳头瘤病毒16 宫颈肿瘤 绝经期 阴道镜检查 

分 类 号：R737.33[医药卫生—肿瘤]