湖北省五峰县宫颈癌高发区HPV16/18DNA的检测及相关危险因素的研究

HPV16/18 DNA Detection and Its Relative Risk Factors in High Incidence of Cervical Cancer Area,Wufeng County of Hubei Province

目的:探讨湖北省五峰县宫颈癌高发区人群宫颈癌发生的高危因素。方法:对1 010例健康人群及59例宫颈癌患者进行巴氏细胞学及人乳头瘤病毒(HPV)16/18DNA的检测,并采用问卷形成获取相关的个人资料,在此基础上按年龄进行病例-对照(1∶4)研究。结果:健康人群与宫颈癌患者HPV的感染率分别为23.4%、88.1%(P<0.001),健康人群中30-34岁,>50岁出现两个HPV感染峰值,HPV16、HPV18感染及第一次性行为年龄<18岁是宫颈癌发生的高危因素,相对危险度分别为OR=27.227(95%CI 12.489-59.335),OR=47.959(95%CI 6.000-383.330),OR=32.2(95%CI 7.87-131.75)。结论:HPV感染的高峰病毒的再度活化,HPV16、HPV16+HPV18的感染是该地区宫颈癌发生的关键因素,避免性行为年龄过早,定期追踪高危人群,研制高发区型别特异性疫苗是预防高发区宫颈癌的有效措施。

Objective： To find cervical cancer risk factors in Wufeng County of Hubei province.Methods： Totally,1 010 healthy control women and 59 cervical cancer patients were enrolled.A case-control study has been carried out.There were 59 women in case group and 236 age-matched women in control group.Methods were adopted includes questionnaire,physical examination,pap smears,and HPV DNA detection.Results： HPV infection rates of control and case groups are respectively 23.4% and 88.1%（P〈0.001）.Two age-peaks（30-34 years and 50 years） have been found.Risk factors for cervical cancer in multivariate analysis are HPV16,HPV16＋HPV18 DNA positivity,and age of the first sexual intercourse（OR=27.22,95%CI=12.49-59.34;OR=47.96,95%CI=6.00-383.33;OR=32.2,95%CI=7.87-131.75）.Conclusion： There are two HPV infection peaks in healthy population,and viral reactivation is perhaps the reason of the second age peak.HPV16 and HPV16＋HPV18 are the key factors of cervical cancers in the area.Avoiding too young of the first sexual intercourse,regular and close follow-ups in high risk population,and specific HPV vaccine are recommended for HPV prevention in the area.