惠州市14175例妇女HPV分型分布特征及高危型致癌风险分析

Analysis of the distribution characteristics of HPV genotypes and the carcinogenic risk of high-risk types in 14 175 women in Huizhou

目的探讨不同年龄组人乳头瘤病毒(HPV)分型分布特征及不同高危型的致癌风险,为宫颈癌的防治提供科学依据。方法应用聚合酶链反应(PCR)联合寡核苷酸探针导流杂交法,对惠州市第一妇幼保健院14175例宫颈脱落细胞样本行21种HPV分型检测和液基薄层细胞检测(TCT)检查。针对阳性患者进一步行阴道镜病理学检查,并对结果进行分析比较。结果检出2135例HPV阳性样本(15.06%),其中单一型阳性率为12.24%,多重阳性率为2.82%。高危型HPV共1821例,占85.29%(1821/2135),最常见的高危型HPV为HPV52(27.45%),其次为HPV58(15.08%)。不同年龄组的阳性率差异有统计学意义(P<0.05),HPV阳性率最高的是≤20岁组,而宫颈癌病变最高的是>50~60岁组。在宫颈高级别病变中HPV16和HPV18的致癌风险性最高,而HPV52和HPV58与非癌症组的归因率较高。结论惠州市妇女HPV感染具有地区特异性,主要为单一型HPV52和HPV58,致癌风险最高的是HPV16和HPV18。做好宫颈癌筛查,做到早发现早干预,加强不同年龄人群不同高危型HPV的监测。

Objective To explore the distribution characteristics of human papillomavirus(HPV)genotypes in different age groups and the carcinogenic risks of different high-risk types,and provide scientific basis for the prevention and treatment of cervical cancer.Methods A total of 14175 cases of cervical exfoliated cell samples were detected by polymerase chain reaction(PCR)combined with oligonucleotide probe guided hybridization technology for 21 of HPV genotypes and thinprep cytologic test(TCT).The positive patients were further examined by colposcopy pathological examination and the results were analyzed and compared.Results There were 2135 HPV positive samples(15.06%)detected;of which,the single positive rate was 12.24%and the multiple positive rate was 2.82%.There were 1821 positive samples of high-risk HPV,accounted for85.29%(1821/2135).The most common high-risk HPV was HPV52(27.45%),followed by HPV58(15.08%).There was significant difference in the positive rate among different age groups(P<0.05).The highest HPV positive rate was≤20 years old,while the highest cervical cancer was>50-60 years old.Among high-grade cervical lesions,HPV16 and HPV18 had the highest carcinogenic risk,while HPV52 and HPV58 have higher attribution rates to non-cancer groups.Conclusions The HPV positive of women was region-specific in Huizhou.The main genotypes were HPV52 and HPV58,while HPV16 and HPV18 had the highest carcinogenic risk.Cervical cancer screening and monitoring of different high-risk HPV in people of different age groups should be strenghtened to achieve early detection and intervention.