新疆喀什伽师县维吾尔族妇女HPV的分布研究

Research on distribution of HPV subtypes among Uyghur women in Payziwat County Kaxkar

目的探讨新疆喀什地区伽师县克孜勒博依乡维吾尔族妇女人群HPV(Human papilloma virus,人乳头瘤病毒)感染情况及HPV感染与不同程度宫颈病变的关系,为制定新疆农村妇女宫颈癌防治对策和措施提供科学依据。方法于2011年6月15日-7月15日在伽师县克孜勒博依乡选择30～60岁的1 300例维吾尔族妇女为主要研究对象。所有研究对象接受问卷调查、妇检、HPV-DNA检测(HC-Ⅱ)、液基细胞学检查,对于HPV-DNA检测(HC-Ⅱ)与液基细胞学检查任意一项阳性者行阴道镜下宫颈活组织检查。结果 (1)喀什地区伽师县克孜勒博依乡妇女HPV总阳性率为10.31%。宫颈液基细胞异常率为2.77%。(2)不同宫颈病变脱落细胞中HPV DNA负荷量中位数最高为宫颈癌,最低为慢性宫颈炎,慢性宫颈炎组与CIN组及宫颈癌组比较,差异有统计学意义(P<0.05);CIN各组和宫颈癌组之间比较差异无统计学意义(P>0.05)。(3)HPV感染组中,细胞学阳性率分别为:ASCUS 42.11%、ASC-H 50%、LSIL 66.7%、HSIL 66.7%、浸润癌100%,与HPV非感染组阳性率比较差异有统计学意义(P<0.05);随着宫颈病变程度的加重,HPV阳性率也逐渐升高,且在各种宫颈细胞学病例中HPV感染的阳性率差异有统计学意义(P<0.05)。结论 HPV感染率与宫颈病变严重程度有关;宫颈细胞学异常与HPV感染有关;高病毒负荷量可能比患宫颈癌及宫颈上皮内瘤变的风险更大,但是不能用来预测宫颈病变的严重程度。

Objective By investigating the infection of human papillomavirus （HPV ） and distribution of HPV subtypes in population ,and the relation between HPV infections with squamous intraepithelial lesion in the Kizilbuy village in Kashgar Xinjiang ,provides a scientific basis for the development of cervical canc-er prevention strategies and measures .Methods A population based cervical cancer screening was done from June15 to July 15 ,2011 ,among 1 ,300 women in Kizilbuy township of Payzawat ,Kashgar ,Xinjiang ranging in age from 30 to 60 .And all of the objectives were carried through questionnaire performing , HPV-DNA testing ,liquid-based Cytology the patient who had positive for the HPV-DNA testing and liq-uid-based cytology was put up colposcopic biopsy .Results （1） 134（10 .31% ） women in all were HPV positive ,diagnosis ≥ASCUS by liquid-based cytology was 2 .77% （36/1 ,300） .（2） In different cervical le-sions ,the highest median load shedding of HPV is cervical cancer ,and the lowest is chronic cervicitis . When Chronic cervicitis group compared with the CIN group ,the difference was statistically significant （P〈0 .05）;Comparison between the CIN group and cervical cancer group was not statistically significant （P〉0 .05） .（3） In HPV infected group ,positive ratio of cytologic test was 42 .11% in ASCUS ,50% in ASC-H ,66 .7% in LSIL ,66 .7% in HSIL and 100% in Invasive carcinoma .There was a statistically sig-nificance in this group .Conclusion The positive rate of HPV related to the severity of cervical disease , the positive rate of cytology related to HPV positivity ;High viral load is likely to suffer a greater risk of cervical cancer and cervical intraepithelial neoplasia ,but can not be used to predict the severity of cervical lesions .