育龄期妇女宫颈HPV感染自然转归的随访分析

Follow-up analysis of natural outcomes of cervical HPV infection in child-bearing women

目的研究育龄期妇女宫颈人乳头瘤病毒(HPV)感染的自然转归。方法选择20~40岁育龄期妇女宫颈HPV感染者596例进行定期(6、12、24个月)随访,失访4例,入组592例,入组者根据HPV类型分为低危组89例,高危组503例;两组TCT(-)、(+)分别21例、68例和131例、372例;两组DNA载量<500p/mL、500~1 000pg/mL、>1 000pg/mL者分别为52例、21例、16例和296例、129例、78例;观察两组.HPV感染的自然转归情况,并进行统计分析。结果低危组随访6、12、24个月HPV感染自然转阴率均显著高于高危组(x^2值分别为12.720、11.578、17.843,均P<0.05)。低危组和高危组HPV感染随访6、12、24个月TCT(-)者自然转阴率均显著高于TCT(+)者(x^2值分别为4.307、17.168、25.740、7.906、44.。740、68.204,均P<0.05),低危组HPV感染随访6、12、24个月,TCT(-)者自然转阴率均显著高于高危组HPV感染TCT(-)者(X^2值分别为6.355、8.605、12.663,均P<0.05),低危组HPV感染随访6、12、24个月,TCT(+)者自然转阴率均显著高于高危组HPV感染TCT(+)者(x^2值分别为5.452、6.838、12.981,均P<0.05)。低危组DNA载量中<500pg/mL者随访6、12、24个月自然转阴率均显著高于高危组DNA载量中<50(0pg/mL者(x^2值分别为12.999、12.191、21.204,均P<0.05)。结论育龄期妇女宫颈HPV感染者低危型自然转阴率高于高危型,TCT阴性者自然转阴率高于TCT阳性,DNA栽量<500pg/mL HR-HPV感染者自然转阴率高于LR-HPV感染,DNA载量>500pg/mL的HR-HPV、LR-HPV感染者很少出现转阴现象。

Objective To study the natural outcomes of cervical HPV infection in child-bearing women.Methods Totally 596 cervical HPV-infected childbearing women aged 20-40 years old were followed up regularly （6, 12, 24 months）.Among them, 4 were lost to follow up, and 592 were enrolled.Enrolled patients were classified into two groups, including 89 in low-risk group and 503 in high-risk group.In two groups there were 21 cases, 68 cases, 131 cases and 372 cases of TCT （ -） and TCT （ ＋） .There were 52 cases, 21 cases, 16 cases, 296 cases, 129 cases and 78 cases with DNA loading〈500pg/mL, DNA loading ranged 500-1 000pg/mL and DNA loading 〉1 000pg/mL in two groups.The natural outcomes of HPV infection in two groups were observed and analyzed.Results After follow-up for 6, 12 and 24 months, the negative rate of HPV infection was significantly higher in low-risk group than in high-risk group （χ^2 value was 12.720, 11.578 and 17.843, respectively, all P〈0.05） .The negative rate of patients with TCT（-） was significantly higher than those with TCT（＋） in two groups after follow-up for 6, 12 and 24 months （χ^2 value was 4.307, 17.168, 25.740, 7.906, 44.740 and 68.204, respectively, all P〈0.05）.In low-risk group the negative rate of patients with TCT（ -） was remarkably higher than in high-risk group （χ^2 value was 6.355, 8.605 and 12.663, respectively, all P〈0.05）, and the negative rate of patients with TCT（ ＋） was obviously higher in low-risk group （χ^2 value was 5.452, 6.838 and 12.981, respectively, all P〈0.05）.Compared with the patients in high-risk group with DNA loading〈500pg/mL, the negative rate of patients in low-risk group with DNA loading〈500pg/mL was significantly higher （χ^2 value was 12.999, 12.191 and 21.204, respectively, all P 〈0.05）.Conclusion Natural negative rate in child-bearing women infected with low-risk HPV type is higher than that with high-risk HPV type, and natural negative rate in TCT negative women is higher than that in TCT positive women.Natural negative rate in high-risk HPV infected women with DNA loading〈500 pg/mL is higher than that in Low-risk HPV infected women, and negative conversion is rarely observed in high-risk HPV and low-risk HPV infected women with DNA loading 〉500pg/mL.