沈阳地区人乳头瘤病毒感染分布及与宫颈病变的相关性分析

Distribution of HPV infection among women and its relevance with cervical lesions in Shenyang

目的：探讨沈阳地区不同年龄组妇女宫颈人乳头瘤病毒（HPV）感染的分布及与宫颈病变的相关性。方法对7311例18～85岁女性进行 HPV 和超薄液基细胞学检查技术（TCT）检测，并对部分患者进行了电子阴道镜下病理活检，以病理诊断为宫颈病变诊断的金标准。对实验数据应用 SPSS18．0统计软件包进行统计学分析。结果＜30岁年龄组感染率显著高于30～＜40岁组、40～＜50岁组和≥50岁组（P ＜0．05）。沈阳地区最常见高危型 HPV 亚型为：16、52、58、53、33、31和18；低危型HPV 亚型为81、11和6；前4种高危亚型占高危型总数的67．3％。这4种亚型中，≥40岁组感染率与小于40岁组比较，差异有统计学意义（χ2＝20．29，P ＝0．00）。排前2位的低危亚型感染占低危总数的74．8％。在宫颈病变中，子宫颈浸润癌（ICC）组患者的平均年龄与宫颈炎症组、宫颈上皮内瘤变（CIN）Ⅰ～Ⅲ组平均年龄比较差异有统计学意义（P ＜0．05）。40～＜50岁年龄段是宫颈病变好发年龄，占37．1％，比其他年龄段患病率高（P ＜0．01）。HPV16感染率随着宫颈病变程度加重而增加。结论 HPV DNA 分型检测是筛查宫颈癌及癌前病变的必要手段，是对细胞学漏诊的有效补充，是对 CIN 患者的治疗及术后随诊不可或缺的检查。

Objective To investigate the Human papillomavirus（HPV）infection in different age groups of women in Shenyang, and explore its correlation with cervical biopsy diagnosis.Methods 7 311 women aged 13-85 did HPV test and thin-cytologic test （TCT）in the hospital.Some of them had biopsy detection under electronic colposcopy,and the pathological diagnosis was the golden standard for the diagnosis of cervical lesions.SPSS18.0 statistical software was used for all statistical analysis.Results The infection rate of 〈30 years old women was significantly higher than that of 30 - 〈40,40 - 〈50,≥50 years old women （P 〈0.05）.The most prevalent high-risk HPV genotype in Shenyang were subtype 16,52,58,53,33,31 and 18,and the most prevalent low-risk HPV subtypes were 81,11 and 6.The former 4 subtypes of high-risk HPV infection accounted for 67.3% of all high-risk infection.As to the 4 subtypes with higher infection rate,the infection rate of ≥40 years old women was higher than that of 〈40 years old（χ2 =20.29,P =0.00）.The top two low-risk HPV subtypes accounted for 74.8% of the infections.The mean age of the ICC patients were 48.3,which was statistically different from the other groups（P 〈0.05）.Cervical lesions occured mostly in 40-49 years old,which accounted for 37.1% and was higher than the other agees（P 〈0.01）.HPV16 infection rate increased with the severity of cervical lesions.Conclusion HPV DNA genotyping is a necessary methord for cervical cancer screen,an effective com-plement for precancerous lesions diagnosis which was missed in cytology test,and also an indispensable test for CIN treatment and follow-up after operation.