甘肃省徽县妇女人乳头瘤病毒感染与宫颈癌关系的研究

Association between Human Papillomavirus Infection and Cervical Cancer in Hui County

目的了解我国宫颈癌高发地区妇女生殖道人乳头瘤病毒(HPV)感染现状,研究HPV感染与宫颈癌的关系。方法随机选择1000名宫颈癌高发地区已婚妇女,进行宫颈液基细胞标本采集及细胞学诊断、阴道镜检查并取活体组织做组织病理学诊断。病理学检查发现散在或成群出现的凹空细胞即诊断为HPV感染,所有检查均双盲进行。结果1000例组织活检标本中发现宫颈鳞状上皮癌(SCC)2例,宫颈上皮内瘤变Ⅲ级(CINⅢ)4例,宫颈上皮内瘤变Ⅱ级(CINⅡ)16例,宫颈上皮内瘤变Ⅰ级(CINⅠ)111例,正常867例。HPV感染603例,总阳性率60.30%(603/1000)。SCC和CINⅢ病例中HPV阳性率为100%(6/6)。SCC和宫颈上皮内瘤变(≥CINⅠ)病例中HPV阳性率为81.95%(109/133),正常者HPV阳性率为56.98%(494/867),后两者之间具有显著性差异(x2=29.02,P<0.001)。结论该地区妇女HPV感染率明显增高并且宫颈癌及宫颈上皮内瘤变Ⅲ级病例中全部感染HPV,证明HPV感染是该地区宫颈癌高发的主要危险因素。

Objective ： To investigate human papillomavirus （HPV） prevalence in the high incidence areas of cervical cancer and to study the association between HPV infection and cervical cancer. Methods： 1 000 married women from Hurl county of Gansu province were selected. Cervical samples and subsequent eolpescopie biopsies were done. Human papillomavirus infection was diagnosed by biopsies. All tests were carried out independently and blindly. Results： Of 1000 cereal biopsies there were,2 cases squamous cell carcinoma （SCC）, 4 eases of cervical intraepithelial neoplasia Ⅲ（ CIN Ⅲ）, 16 of cervical intraepithelial neoplasiaH （CINH）, 111 of cervical intraepithelial neoplasia Ⅰ（CINⅠ） and 867 of normal cases. The overall rates of HPV infection were 60.3% （630/1 000） , 100% ,81.95% and 56.98% in the SCC and CIN Ⅲ groups, SCC and CIN （≥CINI）groups, normal groups, respectively （P 〈0. 001 ）. Conclusions： There is high- risk HPV infection in female genital tract in Hui county, High - risk HPV infection was the major risk factor of cervical cancer .