宫颈癌高发区妇女HPV感染及影响因素分析

HPV infection and related factors among women in high cervical cancer incidence area

目的了解宫颈癌高发区妇女高危型人乳头瘤病毒（HPV）感染及其相关影响因素,为宫颈癌筛查、疫苗研制提供基础资料。方法选取湖北省五峰县20-65岁智力正常已婚女性1 032人,进行问卷调查;采用阴道镜检查和实时荧光定量PCR法对宫颈脱落细胞样本进行HPV感染型别鉴定和DNA定量检测;应用SPSS 13.0软件对资料进行分析比较及描述性分析。结果 1 032例女性中,检出4例宫颈癌,患病率为3.88‰;宫颈脱落细胞标本1 032例中,HPV阳性123例,感染率为11.92%;20-25岁和51-55岁年龄组感染率较高,分别为16.67%（3/18）和14.46%（12/83）,〉55岁感染率较低,为8.62%（5/58）;HPV感染阳性中,HPV 16型占25.18%（34/135）,52型21.95%（27/123,）,58型21.14%（26/123,）,18/45型为8.15%（11/135）;HPV阳性与HPV阴性妇女的初次性交年龄、初婚年龄、初产年龄、孕次、产次及性伴侣数等差异均无统计学意义。结论 HPV16、52、58型在该地区感染率较高;婚育及性行为等因素与HPV感染无明显相关性;病毒DNA载量与病情轻重的关系尚需进一步研究。

Objective To investigate haman papillomavirus（HPV） infection and its related factors among women in high cervical cancer incidence area for cervical cancer screening and vaccine development.Methods Questionnaire survey and cervical cell examination were conducted among nomal women aged 20-65 years in Wufeng county,Hubei province.Colposcopy and real-time quantitative PCR were adopted for qualitative and quantitative idenification of HPV infection.SPSS 13.0 was used in analyses.Results Totally 1 032 patients were enrolled and 4 cases of cervical cancer were detected（confirmed by pathology）with an incidence rate of 3.88 ‰.For 1 032 cervical cell specimens,HPV-positive specimens were 123,with an infection rate of 11.92%.The women aged 20 to 25 years and 51 to 55 years had higher infection rates of 16.67%（3/18） and 14.46%（12/83）.The women aged more than 55 years had a low infection rate of 8.62 %（5/58）.For 135 HPV infections,the ratios of virus type were 25.18%（34）,21.95%（27）,21.14%（26）,and 8.15%（11） for type 16,52,58,and 18/45,respectively.No sigificant correlation was observed between HPV infection and the age of first sexual intercourse,age of first marriage and pregnancy,and numbers of pregnancy,children and sexual partner.Conclusion HPV16,52,58 are dominant infection type in the region.The behavioral factors are not associated with HPV infection.The relationship between viral DNA load and the severity of HPV infection requires further study.