广州市白云区流动人口育龄妇女HPV感染及宫颈病变的流行病学调查

Epidemiological survey on HPV infection and cervical lesions of floating women with childbearing age in Baiyun District of Guangzhou City

目的了解广州市白云区流动人口育龄妇女人乳头瘤病毒(human papillomavirus,HPV)感染现状和流行病学特征,探讨HPV感染与不同宫颈病变的相关性。方法采用原位杂交法对4288名育龄妇女进行HPV-DNA检测,对宫颈肉眼观异常者作阴道镜检查并在病变处行活组织检查,行病理检查确诊。结果 4288名受检对象中,HPV感染率为7.9%,4个不同年龄组HPV感染率分别为11.3%、7.8%、5.1%、6.0%,差异有统计学意义(P<0.05)。不同性生活年限HPV病毒的感染率分别为7.6%、7.7%、8.2%、7.9%、8.3%、8.0%、7.1%,差异无统计学意义(P>0.05)。宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)级别Ⅰ、Ⅱ、Ⅲ及宫颈癌中HPV检出率分别为60.1%、87.8%、93.0%、100.0%,与正常对照相比,其近似值差异率(odd ratio,OR)分别为7.1、43.6、52.6、75.1。不同年龄组CINⅠ的患病率分别为1.7%、2.0%、2.9%、4.7%,CINⅡ的患病率分别为0.8%、1.1%、3.2%、4.7%,CINⅢ的患病率分别为0.3%、0.4%、1.5%、2.7%,宫颈癌的患病率分别为0%、0.1%、0.5%、0.6%,差异均无统计学意义(P>0.05)。结论广州市白云区流动人口育龄妇女的HPV感染主要分布在19～29岁人群,性生活年限为21～25年的感染率较高,50～59岁年龄段的人群宫颈病变的患病率最高。HPV感染与宫颈癌的发生密切相关,HPV感染是宫颈癌发生的高危因素,宫颈病变越严重,HPV检出率越高。

To study the human papillomavirus （HPV） infection status of floating women withchildbearing age and analyze the correlation of HPV infection and different cervical lesions of Baiyun District in Guangzhou City. Methods About 4 288 cases of floating women with childbearing age were detected by situ hybridization technology for HPV - DNA screening test in Baiyun District. And the positive cases were performed with colposcopy and biopsy. Then statistical analysis of correlation of HPV infection rate and the occurrence of different cervical lesions were conducted on different age and sexual history. Results The total HPV infection rate was 7.9% of 4 288 detected cases. The HPV infection rates of different age group were 11.3% ,7.8% ,5.1% ,6. 0% ,and the difference was statistically significant （ P 〈 0.05 ）. The HPV infection rates of sexual history were 7.7% , 7. 7%, 8.2% ,7.9% , 8.3% , 8.0%, 7. 1% , and the difference was not statistically significant （ P 〉 0. 05 ）. The HPV detection rates of cervical intraepithelial neoplasia （CIN） I , CIN Ⅱ , CIN Ⅲ and cervical cancer were 60. 1% , 87. 8% ,93.0% ,100% ,respectively. And the value of odd ratio（OR） comparing with the normal group were 7. 1, 43.6,52.6,75.1. The CIN I incidences of different age group were 1.7% ,2.0% ,2.9% ,4.7%. The CIN 1/ incidences of different age group were 0. 8%, 1.1% ,3.2% ,4. 7%. The CIN m incidences of different age group were 0. 3% ,0. 4% , 1.5% ,2. 7%. The cervical cancer incidences of different age group were 0% ,0. 1% ,0. 5% , 0. 6%. And the differences were not statistically significant （ P 〉 0.05 ）. Conclusion The HPV infection of floating women of childbearing age is mainly in the 19 - 29 years old women people of Baiyun District in Guangzhou City. The higher HPV infection rate of sexual history was 21 - 25 years group and the highest incidence of cervical lesions is 50 - 59 years old group. The HPV infection is high risk factor of cervical cancer factor that the higher HPV detection rate is, the more serious cervical lesions and the greater OR value does. It does play an important role in prevention and etiology research of cervical cancer for women through testing the HPV - DNA.