广州女性群体人乳头瘤病毒流行现状及其与宫颈病变的关系

Epidemiological analysis of the prevalence of HPV and its correlation with cervical lesions in women of Guangzhou

目的分析广州地区女性人群生殖道人乳头瘤病毒(HPV)感染现状及其与宫颈病变的关系,为预防HPV的感染及宫颈癌的防治提供依据。方法以2013年12月至2017年10月于广州医科大学附属第一医院就诊的9 621名女性为研究对象,采用PCR-膜杂交法对其宫颈脱落细胞进行HPV分型检测。结果 HPV总感染率为22.95%(2 208/9 621)。其中高危型、低危型HPV检出率分别为25.56%(2 459/9 621)和4.24%(408/9 621)。高危型中检出率最高的前3位依次为HPV52、HPV16、HPV58,低危型则以HPV81为主要亚型。77.81%(1 718/2 208)的HPV感染者为单亚型感染。以19～25岁组和≥55岁组HPV感染率最高。宫颈癌组以HPV16、18最为常见,且HPV总感染率随宫颈病变程度升高而上升,9价HPV疫苗能够覆盖宫颈癌组中84.35%的HPV感染型别。结论广州地区女性群体HPV感染率较高,且随年龄增长呈先降低后增高的趋势,HPV的防治应综合考虑不同人群感染型别的分布特征。

Objective To analyze the prevalence of human papillomavirus (HPV)infection and its correlation with cervical lesions in women of Guangzhou,and provide the theoretical basis for preventing HPV and treating cervical cancer. Methods 9621 cases of cervical cell specimens in the First Affiliated Hospital of Guangzhou Medical University from December 2013 to October 2017 and 21 HPV genotypes were analyzed by PCR-reverse dot blot hybridization technology. Results The total positive rate of HPV in 9621 samples was 22.95%(2208/9621).The infection rate of high-risk HPV was 25.56%(2459/9621),with the top three subtypes of HPV52,HPV16 and HPV58.The infection rate of low-risk subtypes of HPV was 4.24%(408/9621),and HPV81 was the most common type.The infection rates of single subtype of HPV was 77.81%(1718/2208).The distribution of HPV infection was different among different age groups,with a peak at the 19-25 age group and the second one at ≥55age group.The most common subtypes were HPV16 and 18in the group of cervical cancer.HPV detection rate increased with the malignancy in cervical lesions (P<0.05).The 9-valent HPV vaccine can protect against 84.35% of HPV infection in the group of cervical cancer.Conclusion The HPV infection rate of female population in Guangzhou was high,and it tended to decrease first and then increase with age.The prevention and treatment of HPV should consider the distribution characteristics of different subtypes among different age groups.