大理地区HPV感染与宫颈病变及相关危险因素关系初探

Relashionship between HPV Infection and Cervical Lesions and Associated Risk Factors in Dali

目的：探讨大理地区妇女宫颈人乳头瘤病毒（HPV）感染亚型与宫颈病变及其流行病学特征的关系。方法：收集2011年7月至2014年9月在大理大学附属医院妇产科门诊病例,共2 053例,平均年龄为39.46岁,应用基因扩增及导流杂交技术进行基因亚型检测。TCT及病理检查方法对其进行病变类型检测。收集整理HPV阳性患者的年龄、民族、职业。结果：2 053例病例中阳性例数为308例,阳性率为15.00%。共检测出14种高危型：HPV16（28.90%）、HPV52（21.75%）、HPV58（12.99%）、HPV18（10.39%）、HPV68（4.22%）、HPV31（2.27%）、HPV66（3.25%）、HPV33（5.19%）、HPV39（5.52%）、HPV53（4.55%）、HPV59（1.62%）、HPV56（0.65%）、HPV35（1.62%）、HPV51（2.60%）;5种低危型：HPV45、HPV42、HPV6、HPV11、81（cp8304）。HPV单一感染宫颈病变阳性率为21.95%（TBS）、50%（病理）,多重感染宫颈病变阳性率为4.88%（TBS）、9.38%（病理）。阳性病例中有122例记录了民族,其中白族81例（66.39%）,汉族27例,彝族6例,傈僳族4例,藏族2例,回族1例,纳西族1例。白族妇女中共检出8种基因亚型。职业主要分为务农人员（52.70%）,非务农人员（职员、公务员及自由职业者等）（47.30%）。结论：大理地区HPV感染高危型以16型、52型、58型、18型最常见,多重感染并不增加宫颈癌的发生。HPV病例构成比较高的年龄段为30-52岁,阳性率较高的年龄段为≥62岁。白族妇女中较常见的HPV基因亚型为HPV52型、16型、58型、18型。HPV感染亚型分布具有一定的地域、年龄及民族特点。

Objective： To explore the relationship between Dali women with cervical human papillomavirus（HPV）infection anddisease subtypes and epidemiological characteristics of the cervix. Methods： Samples of the obstetrics and gynecology outpatients fromJuly 2011 to September 2014 at the Affiliated Hospital of Dali University were collected. 2 053 cases with an average age of 39.46 years were undertaken the detection of subgenotypes diversion by gene amplification and hybridization techniques. TCT andpathological examination method was used to the type of lesion detection. HPV-positive patients were collected according to the age,nationality and profession. Results： Positive cases were 308 and the positive rate was 15.00%. 14 kinds of high-risk were detected：HPV16（28.90%）, HPV52（21.75%）, HPV58（12.99%）, HPV18（10.39%）, HPV68（4.22%）, HPV31（2.27%）, HPV66（3.25%）,HPV33（5.19%）, HPV39（5.52%）, HPV53（4.55%）, HPV59（1.62%）, HPV56（0.65%）, HPV35（1.62%）, HPV51（2.60%）. 5kinds of low-risk types were： HPV45, HPV42, HPV6, HPV11,81（cp8304）. HPV infection in cervical lesions single positive rate were21.95%（TBS）, 50%（pathology）, and multiple infections cervical lesions positive rate 4.88%（TBS）, 9.38%（pathology）. 122 positive cases were recorded nationalities, including 81 Bai cases（66.39%）, 27 Han, 6 Yi, 4 Lisu, 2 Tibetan, 1 Muslim and 1 Naxi.Bai women were detected eight kinds of subgenotypes. The occupations were farmers（52.70%）and non-farmers（employees, civilservants and freelancers, etc.）（47.30%）. Conclusion： Most common types of HPV infection in Dali were 16, 52, 58, 18. And multipleinfection did not increase the incidence of cancer. HPV cases constituted a relatively high age group of 30 to 52 years old, and a highpositive rate is ≥62 years of age. The common genetic subtypes in Bai women were HPV type of 52, 16, 58, 18. HPV infection withcertain subtypes were characterized by geography, age, and ethnic characteristics.