新疆汉族、维吾尔族、哈萨克族妇女生殖道人乳头瘤病毒感染状况分析

The investigation of reproductive tract human papillomavirus infection genotypes and distribution in Hans

目的探讨新疆汉族、维吾尔族、哈萨克族妇女生殖道不同型别人乳头瘤病毒(HPV)的感染状况以及在人群中的分布。方法自2009年1月至2010年6月对新疆18～64岁的女性开展以人群为基础的宫颈癌筛查,对合格对象进行流行病学问卷调查。采集受试者宫颈脱落细胞,进行液基细胞学(LCT)检测、HPV分型基因芯片检测。LCT异常者进行阴道镜及宫颈组织病理活检。以病理结果作为诊断宫颈上皮内瘤变(CIN)的金标准。结果 (1)维吾尔族妇女HPV感染率最高(27.97%,299/1069),与汉族(13.42%,161/1200)、哈萨克族(14.00%,35/250)比较差异有统计学意义(均P<0.01)。(2)汉族高危型HPV阳性人群中以16、58、52、18和31型HPV阳性者最多,维吾尔族高危型HPV阳性人群中以16、58、31、52和68、39型HPV阳性者最多,哈萨克族高危型HPV阳性人群中以16、18、58、33型HPV阳性者最多。(3)3个民族妇女HPV感染率随着宫颈病变的加重呈趋势性增加;3个民族CINⅡ及CINⅢ发生率比较,差异有统计学意义(P<0.01),其中维吾尔族发生率最高,与其他两组比较,差异均有统计学意义。结论维吾尔族妇女HPV感染率最高;新疆汉族、维吾尔族、哈萨克族高危型HPV感染型别不同,3个民族HPV感染率随着宫颈病变的加重呈趋势性增加。

Objective To investigate the human papillomavirus infection genotypes and distribution in Hans, Uygurs and Hazakhs of XinJiang. Methods Between January 2009 and June 2010 ,a questionnaire survey was conducted among the women aged 18-64 years in XinJiang based on crowd. All of patients received liquid-based cytology test（LCT） and HPV types. The patients who had abnormal cytological diagnosis were put up digital colposcopic exam. We Used pathologic diagnosis as a gold standard to diagnose CIN. Results （ 1 ） The positive rate of HPV of Uygurs （ 27.97% ,299/1069 ） was highest, the comparison with Hans （ 13.42 %, 161 / 1200 ）, Hazakhs （ 14. 00%, 35/250 ） had statistical significance. （ 2 ） The most prevalent genotypes of high-risk human papillomavirus （HR-HPV） of Hans were HPV16, 58, 52, 18,31. Uygnrs＇ were HPV16,58,31,52,68,39. Hazakhs＇ were HPV16, 18,58, 33. （3）The risk of cervical lesion significantly increased in women showing positive in cytology and HPV test. The comparison of incidence of CIN Ⅱ and CIN Ⅲ of three nations had statistical significance. Uygurs ＇ were the highest. Conclusion The positive rate of HPV of Uygurs was highest. The genotypes of high-risk human papillomavirus （HR-HPV） of three nations were different. The risk of cervical lesion significantly increased in women showing positive in cytology and HPV test in three nations.