清远市中心区域妇女人乳头瘤病毒感染现状调查与分析

THE INVESTIGATION OF PRESENT SITUATION OF HUMAN PAPILLOMAVIRUS INFECTION OF WOMEN IN PARTS OF QINGYUAN CITY GUANGDONG PROVINCE

目的：了解广东清远地区妇女人乳头瘤病毒（HPV）感染基因型的分布情况，为本地区宫颈癌的防治提供科学依据。方法采用核酸分子快速导流杂交基因芯片分型技术对23983例就诊者进行下生殖道HPV 21种基因亚型的分型检测。对其中部分HPV感染者进行宫颈液基细胞检查和（或）在阴道镜下取组织活检进行病理检查。结果23983例标本中，HPV阳性为5372例，阳性率为22．40％，21种基因亚型均有检出，感染率前五位的HPV基因亚型由高到低依次为HPV-16（6.02％）、52（4.46％）、56（2.68％）、11（2.25％）、66（1.86％）。在5372例阳性标本中，单一基因亚型感染的3966例，占73.83％；多重感染的为1406例，比例为26.17％。 HPV感染者高峰年龄段为26～45岁。随宫颈疾病及癌前病变程度的加重，高危型 HPV 感染率均显著上升， CIN Ⅱ、CIN Ⅲ和侵润癌均为100％。结论本地区宫颈炎患者的HPV感染率较高，以16、52、56亚型为主。 HPV感染高发于中青年妇女，宫颈病变程度与HPV感染密切相关，长期持续高危型HPV感染可能导致宫颈癌。进行HPV感染者长期的跟踪随访和预后判断，对降低宫颈癌的发病率等有着重要的意义。

Objective To investigate the distribution of different Human papillomavirus （ HPV） subtype infection of women in parts of Qingyuan City Guangdong Province .In order to offer some evidences for the prevention and treatment of the cervical cancer in the region.Methods Flow-through hybridization and gene chip （ HybriMax） were utilized to detect 21 different subtypes of HPV from low genitalia in 23 983 patients.And some of positive samples were checked for liquid -based pap test（LPT） and（or） biopsy by the vaginoscope.Results 5 372 positive samples were detected, occupying 22.40%in to-tal （5 372/23 983） and covering all 21 genotypes.The order of prevalence rates from high to low were HPV-16（6.02%）、52（4.46%）、56（2.68%）、11（2.25%）、66（1.86%）.In 5 372 positive samples, mono-infections account for 3 966, reaching 73.83%;the rest are multiple infections.The peak age of HPV infection ranged from 26 to 45 years old.The rate of high-risk HPV infections were increased with the higher severity of cervical dysplasia , there were all 100%for CINⅡ、CINⅢand invasive cervix carcinoma. Conclusion HPV prevalence is at a high level in woman in Qingyuan region .All 21 genotypes were found in HPV infective women, and majority infection was HPV -16、52、56.HPV infection often occurs in young and middle -age women.There is a close relation between HPV infection and cervix diseases.Cervical carcinoma would caused by HPV infec-ting.Long-time following-up visit for HPV infected patients will reduces the incidence of cervical carcinoma.