西安交通大学第一附属医院8581名妇女生殖道人乳头瘤病毒感染筛查

Screening of the Genital Human Papillomavirus Infection among 8581 Women in the First Affiliated Hospital of Xi'an Jiaotong University

目的调查陕西地区妇女生殖道人乳头瘤病毒(HPV)感染情况,了解本地区妇女生殖道HPV感染特征。方法采用PCR+导流杂交技术检测2009年2月至2012年12月在西安交通大学第一附属医院妇科就诊的8581名陕西地区妇女生殖道HPV-DNA,必要时进行宫颈细胞学或组织学检查。结果 8581名陕西地区妇女中,生殖道HPV感染率为33.06%,高危型HPV(HR-HPV)感染率为30.08%,复合型别感染者占27.18%;最常见感染型别依次为HPV-16、HPV-52、HPV-58、HPV-6和HPV-18。HPV感染存在年龄差异,感染高峰年龄为25岁以下和51岁以上。HR-HPV感染者中宫颈组织学正常、轻度上皮内瘤变(CINⅠ)、中度上皮内瘤变(CINⅡ)、重度上皮内瘤变(CINⅢ)和宫颈癌(CC)组中,感染率分别为88.72%、97.48%、97.35%、95.88%和99.23%;常见致癌型别依次为HPV-16、HPV-18、HPV-58、HPV-52和HPV-33。HPV-16、18和58共同引起94.62%的宫颈癌。结论陕西地区妇女生殖道HPV感染比较普遍,最常见的感染型别是HPV-16、HPV-52、HPV-58、HPV-6和HPV-18,常见致癌型别依次为HPV-16、HPV-18、HPV-58、HPV-52和HPV-33。HPV-16、18和58引起94.62%的宫颈癌。高危型HPV感染和宫颈病变显著相关,HR-HPV复合感染不是宫颈病变的危险因素。

Objective To investigate the prevalence of genital human papillomavirus （HPV） infection among women in Shaan＇ xi Province of China,and to detect the characteristics of genital HPV infection among these women.Methods Totally 8581 women in the Department of Gynaecology of the First Affiliated Hospital of Xi＇ an Jiaotong University were enrolled to detect HPV-DNA in their genital tracts by PCR ＋ flowthrough hybridization.Some subjects were also screened by cytology or histology.Results Among these subjects,the prevalence of female genital tract HPV infection was 33.06％,among which high rsik （HR）-HPV infection accounted for 30.08％ and multiple HR-HPV infection 27.18％.The genotypes HPV-16,-52,-58,-6,and HPV-18 were the most prevalent strains.The distribution of HPV infection differed among different age groups：the first infection peak occured less than 25 years and the second peak was above 51years.Among the HR-HPV DNA positive women,the rates of HR-HPV infection with normal histology,cervical intraepithelial neoplasias Ⅰ （CIN Ⅰ）,CIN Ⅱ,CIN Ⅲ,and cervical cancer （CC） were 88.72％,97.48％,97.35％,95.88％,and 99.23％,respectively.For women with CC,HPV-16 was the most common genotype,followed by HPV-18,HPV-58,HPV-52,and HPV-33.HPV-16,-18,and 58 were responsible for 94.62％ of CC cases in this region.Conclusions The most common genotypes of HPV infection among women in Shaan＇ xi province are HPV-16,HPV-52,HPV-58,HPV-6,and HPV-18.HPV-16,HPV-18,HPV-58,HPV-52,and HPV-33 are the most frequently genotypes found in cervical carcinoma,in particular HPV-16,HPV-18,and HPV-58.HR-HPV infection aggravates the cervical lesions.The multiple HPV infections increase the risk of cervical lesions.