深圳市某肿瘤医院女性HPV感染亚型分布及宫颈病变特征分析  

Analysis of human papillomavirus subtype distribution and cervical lesion characteristics in a cancer hospital in Shenzhen City

作　　者：张丽 肖敏 何希川 林勇平 Zhang Li;Xiao Min;He Xichuan;Lin Yongping(National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital and Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Shenzhen 518116,China)

机构地区：[1]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院深圳医院检验科,深圳518116

出　　处：《中华预防医学杂志》2025年第4期490-494,共5页Chinese Journal of Preventive Medicine

基　　金：深圳市“医疗卫生三名工程”项目资助(SZSM202311002)。

摘　　要：本研究旨在分析女性就诊者感染人乳头瘤病毒(HPV)亚型的分布情况及宫颈病变特征。采用回顾性观察研究方法,通过方便抽样法,选择2020年9月至2023年12月在中国医学科学院肿瘤医院深圳医院就诊女性为研究对象,采用核酸分子快速杂交分型技术对6402名女性的宫颈脱落细胞进行HPV基因分型检测。同时对845例HPV阳性标本进行宫颈液基细胞学(TCT)检测。对于高级别鳞状上皮内病变(HSIL)则进一步通过宫颈活检或锥形切除术后的组织病理学检查来进行宫颈上皮内瘤变(CIN2/3)分类。采用χ^(2)检验和双侧检验进行数据统计分析。结果显示,HPV分型检测共发现1205例阳性患者,总阳性率为18.8%(1205/6402)。其中高危型HPV的阳性率为14.34%(918/6402),低危型HPV为3.58%(229/6402),其他型别HPV为0.91%(58/6402)。在高危型HPV中,HPV16/52/39/58/53型阳性率分别为3.16%(202/6402)、2.92%(187/6402)、1.34%(86/6402)、1.30%(83/6402)、1.05%(67/6402)。在宫颈恶性肿瘤组、CIN3组和CIN2/3组中,HPV16型的感染率最高,分别达53.18%(92/173)、47.37%(27/57)和34.78%(8/23);在非典型鳞状细胞(ASC)组、低级别鳞状上皮内病变(LSIL)组和CIN2组中,HPV52型的感染率最高,分别达29.68%(19/64)、23.50%(43/183)和37.93%(11/29)。在845例HPV检测阳性的女性就诊者中,病理学诊断为鳞状细胞癌,占22.13%(187/845),腺癌,占1.42%(12/845)。HPV感染率随年龄增加而逐渐上升,在≤30岁组、31~40岁组、41~50岁组、51~60岁组、>60岁组,阳性率分别为16.39%(97/592)、14.46%(301/2082)、17.26%(318/1842)、23.98%(300/1251)、29.76%(189/635)。综上,本研究的医院女性就诊人群中HPV16型感染与宫颈癌及高等级宫颈病变相关,HPV52型感染与低至中度宫颈病变相关,需加强成年女性的HPV筛查以预防宫颈癌及相关病变。This study aims to retrospectively analyze the distribution of human papillomavirus(HPV)subtypes and cervical lesion characteristics in female patients at Shenzhen Cancer Hospital.Adopting a retrospective observation research method.Using convenience sampling,the study subjects were selected from women who visited the Shenzhen Hospital of the Chinese Academy of Medical Sciences Cancer Hospital from September 2020 to December 2023.HPV genotyping was performed on cervical exfoliated cells from 6402 women using rapid nucleic acid hybridization.Additionally,thinprep cytologic test(TCT)was conducted on 845 HPV-positive samples.High-grade squamous intraepithelial lesions(HSIL)were further classified as cervical intraepithelial neoplasia grades 2 or 3(CIN2/3)through histopathological examination via cervical biopsy or conization.Data were statistically analyzed usingχ^(2) test and two-sided test.The results showed that HPV testing identified 1205 HPV-positive cases,with an overall positivity rate of 18.8%(1205/6402).Among these,the positivity rate for high-risk(HR)HPV was 14.34%(918/6402),low-risk(LR)HPV was 3.58%(229/6402),and other HPV types accounted for 0.91%(58/6402).The most prevalent high-risk HPV subtypes were HPV16,HPV52,HPV39,HPV58,and HPV53,with positivity rates of 3.16%(202/6402),2.92%(187/6402),1.34%(86/6402),1.30%(83/6402),and 1.05%(67/6402),respectively.HPV16 had the highest infection rate in cervical malignancies,CIN3,and CIN2/3 groups,with rates of 53.18%(92/173),47.37%(27/57),and 34.78%(8/23),respectively.Conversely,HPV52 showed the highest infection rate in the atypical squamous cells(ASC),Low-grade squamous intraepithelial lesion(LSIL),and CIN2 groups,at 29.68%(19/64),23.50%(43/183),and 37.93%(11/29),respectively.Among 845 HPV positive female patients,the pathological diagnosis was squamous cell carcinoma,accounting for 22.13%(187/845),and adenocarcinoma accounting for 1.42%(12/845).HPV infection rates increased with age:16.39%(97/592)in the≤30 age group,14.46%(301/2082)in the 31-40 group,17.26%(3

关 键 词：人乳头瘤病毒16 人乳头瘤病毒52 宫颈癌 HPV基因分型检测 肿瘤医院 

分 类 号：R737.33[医药卫生—肿瘤]