陕西省西安地区2387例HPV感染及亚型分布特征分析

Investigation of infection status HPV and its subtype distribution in 2387 women of child-bearing age in Xi'an region

目的:对西安市育龄妇女人乳头状瘤病毒(human papillomavirus,HPV)感染及亚型分布特征进行研究,为预防HPV感染和宫颈癌防治提供参考依据。方法:采用聚合酶链反应(PCR)体外扩增和脱氧核糖核酸(DNA)反向点杂交相结合的DNA芯片技术,对2387例宫颈脱落细胞标本进行HPV基因分型检测。结果:2387例育龄妇女中共检出HPV阳性者930例,总感染阳性率为38.96%。其中高危型感染阳性率为76.88%(715/930包括多重高危感染),低危型感染阳性率为14.73%(137/930包括多重低危感染),高低危混合感染阳性率为8.39%(78/930)。在被检测的18个高危HPV-DNA亚型中,常见类型依次为16(31.17%,3 6 6/1 1 7 4)、5 8(1 1.0 7%,1 3 0/1 1 7 4)、18(6.13%,72/1174)、66(5.62%,66/1174)、33(5.03%,59/1174)和56(4.43%,52/1174)型,未检测出8 2型;在被检测的5个低危HPV-DNA亚型中依次为4 3(11.07%,130/1174)、42(3.24%,38/1174)、6(2.56%,30/1174)和11(1.87%,22/1174)型,未检测出44型。HPV阳性者中单一基因型感染率为78.49%(730/930),单一高危型感染率为63.98%(595/930);多重感染率为21.50%(200/930),以二重感染最为常见(17.20%,160/930),其中以二重高危感染为最多达106例(11.40%)。不同年龄段人群HPV阳性率有明显差异,其中41-50岁年龄段人群HPV阳性率和高危感染阳性率均最高(39.03%,33.23%),与其他组别相比差异非常显著(P<0.05)。结论:西安地区育龄妇女宫颈HPV感染率较高,以16、58、18、66、33和56型感染比较常见;HPV感染高发年龄段为41-50岁女性;HPV基因分型检测技术对宫颈癌预防有积极作用。

Objective：To investigate infection status and distribution of different types of cervical human papillo- mavirus（HPV） of 2387 cases of women of childbearing age in Xi＇an. Methods：All 2387 cases of cervical cell speci- mens and 23 HPV genotypes were analyzed by PCR and reverse dot blot gene chip technology. Results：930 patients with HPV infection were found in 2387 women of childbearing age. The total infection positive rate, infection rate of high - risk HPV,infection rate of low -risk HPV and infection rate of mixed high and low risk were 38.96 % , 76.88 % （ 715/930, including muhiple high - risk of HPV infection） , 14.73 % （ 137/930, including multiple low - risk of HPV infection） and 8.39% （78/930） respectively. The most common subtype was HPV - 16 （ 31.17%, 366/1174） and followed by HPV - 58 （ 11.07 %, 130/1174 ）, HPV - 18 （ 6.13 %, 72/1174 ）, HPV - 66 （ 5.62 %, 66/1174 ）, HPV - 33 （5.03% ,59/1174） and HPV - 56 （4.43%, 52/1174 ） respectively in tested 18 high - risk HPV subtypes, and there was no HPV- 82. The most common subtype was HPV -43 （11.07% , 130/1174） and followed by HPV -42 （3.24% ,38/1174） ,HPV -6（2.56% ,30/1174） and HPV - 11 （ 1.87% ,22/1174） respectively in tested 5 low - risk HPV subtypes, there was no HPV -44. The infection rate of single subtype of HPV, infection rate of single high - risk subtype of HPV and infection rate of multiple subtype of HPV were 78.49% （730/930）, 63.98% （595/930） and 21.50% （200/930） respectively in all cases with HPV infection. The double infections（ 17.20% ,160/930） and double high- risk infections（ 11.40%, 106/930） of HPV were most. The different ages of HPV positive rate had ob- vious difference and HPV infection positive rate and high -risk HPV infection positive rate were the highest（39.03 % and 33.23% respectively） in cases of 41 - 50 years old and higher than that in other groups （ P 〈 0.05 ）. Conclu- sion：The HPV infection rate of women of childbearing age in Xi＇an region is higher especially in 41 - 50 years of age and the more common HPV subtype is HPV - 16, HPV -58, HPV - 18, HPV -66, HPV -33 and HPV -56. HPV genotyping detection technology has positive effect to prevent cervical cancer.