广州市1285例志愿者宫颈人乳头瘤病毒感染调查

Survery of Human Papilloma Virus Infection in 1285 Female Volunteers of Guangzhou City

目的调查广州地区女性人乳头瘤病毒(HPV)感染情况以及常见的21种亚型的分布情况。方法采用自愿报名方式募集20-74岁广州市市区女性居民进行的宫颈癌筛查。志愿者填写知情同意书后采集宫颈细胞学。完成宫颈细胞学检查(liquid-cytological test,LCT)后细胞残液应用导流杂交方法进行HPV基因分型。结果1305例志愿者中,有1285例符合入选条件并且同时完成LCT和HPV检测,20～34岁、35～44岁、45～54岁、55～64岁,≥65岁5组分别有358、307、246、240、134例。HPV阳性228例,总体检出率为17.7%,标准化感染率为16.5%,其中高危型HPV检出率为13.1%,低危型检出率6.2%,混合感染检出率为3.0%。不同年龄段的总HPV检出率分别为23.2%、16.0%、17.9%、15.0%和11.9%,20-34岁组与其他组检出率有统计学差异(χ2=12.26,P值<0.05);高危型HPV检出率分别为17.3%、13.4%、13.8%、8.7%和8.2%,20～54岁组与>54岁组比较有统计学统计学差异(χ2=9.75,P值<0.01);低危型HPV检出率分别为8.4%、3.9%、5.3%、7.1%和6.0%;混合感染检出率分别为5.3%、2.3%、1.6%、2.5%和2.2%,各组无统计学差异。前5位的HPV亚型是52、31、16、58和53型,其检出率分别为3.9%、2.5%、1.9%、1.9%和1.7%。结论与国内同类研究比较,本研究人群的HPV感染率处于较高水平,HPV感染率随年龄增加而下降,前5位的HPV亚型是52、31、16、58和53型,不同于其他文献报道的16/18为主要亚型。

Objective To investigate the prevalence of human papillomavirus （HPV） infection and type-distribution in the cervix of female residents in Guangzhou city.Method Female volunteers with age of 20 to 70 years were enrolled in the study. After signing informed consent, each participant had a liquid-based cytological testing（LCT） and a HPV testing. The latter identified 21 HPV genotypes by flowthrough hybridization technology. Results Of the 1305 volunteers, 1285 were eligible.There were 358 in the group at age of 20 to 34 years, 307 at age of 35 to 44 years , 246 at age of 45 to 54 years, 240 at age of 55 to 64 years and 134 at age more than 64 years respectively. The overall prevalence of HPVs infection was 17.7%（228/1285）, standard prevalence was 16.5%.Among the HPVs postive cases, prevalence of HR- HPVs , LR-HPVs and mix infection was 13.1%, 6.2% and 3.0% respectivelyoThe age-specific prevalenees of HPVs were 23.2%, 16.0%, 17.9%, 15.0% and 11.9% respectively, and the prevalence in the 20 to 34-year group was higher than that in other groups （ X^2=12-26, P〈0.05 ）; The age-specific prevalences of HR-HPVs were 17.3%, 13.4%, 13.8%, 8.7% 和 8.2% respectively, and there were statisticly different compared the age-specific prevalence of 20 to 54 years with that of 〉54 years（ X^2=9.75, P〈0.01 ）;, The age-specific prevalences of LR-HPVs were 8.4%, 3.9%, 5.3%, 7.1% and 6.0% respectively, those of mix infection were 5.3%, 2.3%, 1.6%, 2.5% and 2.2% respectively and there were no significantly difference among these age-specific groups.The leading five subtypes of HPVs were HPV-52, -31, - 16, -58 and- 53, the type-specific prevalences were 3.9%, 2.5%, 1.9%, 1.9% and 1.7% respectively. Conclusion Compared with the similar studies in China, the prevalence of HPVs was at high level and the leading five subtypes were HPV-52, -31, -16, -58 and -53, other than 16/18 which were known as the most common types in the world.