重庆市铜梁区中老年妇女宫颈癌感染HPV的流行病学调查

Epidemiological investigation of HPV infection among middle age and elderly women with cervical cancer in Tongliang District of Chongqing City

目的了解重庆市铜梁区中老年妇女宫颈癌感染人乳头瘤病毒（HPV）的现状,并对其进行流行病学调查及分析。方法选择2014年11月至2015年11月来重庆市铜梁区人民医院妇产科门诊进行健康体检并自愿进行妇科检查的40~60岁中老年妇女820例作为研究对象。所有研究对象均进行宫颈脱落细胞收集和液基细胞学检查,采用原位杂交法进行HPV DNA检测,同时使用肉眼观察法观察宫颈,对宫颈异常者做阴道镜检查,取其病变部位进行病理活检。结果 （1）不同年龄组间HPV阳性率：总HPV感染率为13.8%（113/820）,总高危型HPV感染率为12.2%（100/820）,随着年龄的增加,总HPV感染率逐渐降低;〉50~60岁组总HPV感染率[10.5%（38/362）]及总高危型HPV感染率[9.1%（33/362）]均明显低于40~50岁组[16.4%（75/458）、14.6%（67/458）],差异有统计学意义（P〈0.05）。（2）不同年龄段宫颈病变罹患情况：宫颈上皮内瘤变（CIN）Ⅰ36例（4.4%）,CINⅡ26例（3.2%）,CINⅢ18例（2.2%）,宫颈癌2例（0.2%）;随着年龄的增加,宫颈病变的罹患率逐渐降低。（3）不同宫颈病变程度HPV的检出率：宫颈癌HPV阳性检出率最高,随着病变程度的降低,其HPV的检出率逐渐降低。结论对该地区中老年妇女宫颈癌HPV感染的流行病学调查可反映不同特征人群宫颈癌HPV感染情况。

Objective To understand the status quo of human papillomavirus（HPV） infection amiong middle-aged and elderly women with cervical cancer in Tongliang District of Chongqing City, and to conduct the epidemiological investigation and analysis. Methods A total of 820 middle-aged and elderly women aged 40-60 years old undergoing the healthy physical examination and voluntarily conducting the gynecological examination in the obstetrics and gynecology outpatient department of our hospital from November 2014 to November 2015 were selected as the research subjects. The cervical exfoliated cells were collect-ed and the liquid-based cytology examination was conducted. The HPV DNA was detected by in situ hybridization,meanwhile the cervix was observed by sing the naked eye observation, the cases of cervical abnormality was conducted the colposcopic examination for taking the pathological lesions biopsy. Results（1）The HPV positive rates among different age groups ：the total HPV infection rate was 13.8%（113/820）,the total high-risk HPV infection rate was 12.2%（100/820）,with the age increase,the total HPV infection rate was gradually decreased;the total HPV infection rate and the high risk HPV infection rate in the 50-60 years old group were 10.5%（38/362）and 9.1%（33/362）respectively,which were significantly lower than 16.4%（75/458） and 14.6%（67/458）in the 40-50 years old group,the differences were statistically significant（P〈0.05）.（2）the cervical cancer lesion situation in different age groups：CINⅠ in 36 cases（4.4%）,CINⅡ in 26 cases（3.2%）,CINⅢ in 18 cases（2.2%）,cervical cancer in 2 cases（0.2%）;with the age increase,the attack rate of cervical lesions was gradually decreased.（3）the HPV detection rate in different cervical lesions：the highest detection rate was in cervical cancer,with the reduce of lesion degree,the HPV detection rate was decreased. Conclusion The HPV infection epidemiological investigation among middle aged and elderly women in this area can reflect cervical cancer HPV infection situation among different characteristic populations.