1955例武汉市农村妇女HPV感染状况与危险因素分析

Analysis of HPV Infection Status and Risk Factors Among 1955 Rural Women in Wuhan

目的:探讨武汉市农村妇女HPV在宫颈炎、宫颈上皮内瘤变(CIN)、宫颈癌中的感染分布情况及HPV感染危险因素。方法:在2011年武汉市20万农村妇女宫颈癌初筛阳性患者中随机抽取1955例,采用飞行时间质谱检测法对宫颈刷片进行HPV分型测定,分析HPV在宫颈炎、CIN、宫颈癌中的感染情况。结果:1955例宫颈刷片标本中发现HPV感染1115例,感染率为57.03%。HPV在不同宫颈疾病中的感染率不同,HPV在宫颈炎中的感染率为40.72%,CIN中为89.64%,宫颈癌中为92.86%,差异有统计学意义(P<0.01);HPV感染患者中,单纯高危型及单纯低危型HPV感染所占比例分别为92.74%、3.23%,差异有统计学意义(P<0.01)。1955例患者中HPV 16型感染率最高(18.16%),其次是HPV 58型(13.35%)、HPV52型(11.00%)、HPV 33型(5.68%)。1955例患者中单一亚型感染率为41.43%,双重及多重感染率为15.60%。不同初婚年龄、临床症状、宫颈癌家族史及是否熬夜等患者HPV感染率比较,差异有统计学意义(P<0.05)。结论:武汉市农村妇女高危型HPV感染是宫颈癌及CIN发生的必要因素。初婚年龄较早、有宫颈癌家族史、经常熬夜等为HPV感染的危险因素。

Objective ：To explore the status among cervicitis, cervical intraepithelial neoplasia and cervical cancer,and investigate the risk factors of HPV infections. Methods：Questionnaire survey and the flight time mass spectrometry method were conducted among a random sample of 200000 rural women,whose cervical cancer screening were positive, in wuhan 2011. Analysis the status among cervicitis, cervical intraepithelial neoplasia and cervical cancer,and investigate the risk factors of HPV infections. Results：Totally 1955 cases of cervical brush specimens were enrolled and 1115 cases of HPV infection were detected with an infection rate of 57.03%, compared with the control group,the difference is statistically significant （ P 〈 0.05）. The in- fection rates of HPV were different in cervical lesions of different, the infection rate of HPV in cervicitis was 40.72%, and in cervical intraepithelial neoplasia was 89. 64%, while in cervical cancer was 92. 86%, three groups have statistically significant difference （ P 〈 0.01 ）. Among patients with HPV infection, the positive rates of pure high-risk HPV and pure low-risk HPV was 92.74% and 3. 23%, two groups have significant difference（ P 〈 0. 01 ）. HPV16 has highest detection rate in HPV infections （ 18. 16%）, next is HPV58 （13.35%） ,HPV52（11.00%） ,HPV33（5.68%）. For 1955 cases the relevance ration of single subtypes in- fection was 41.43%, multiple HPV infection rate was 15.60%. Statistically significant correlation was ob- served between HPV infection and the age of first marriage, clinical symptoms, cervical cancer family history and stay up all night（ P 〈0.05）. Conclusions： Infection with high-risk HPV is the necessary factor for the development of cervical intraepithelial neoplasia and cervical cancer, young age at first marriage, cervical cancer family history and stay up all night are risk factors of HPV infections.