河北省12352例农村妇女人乳头瘤病毒高危亚型筛查结果分析

Results of human papillomavirus high risk subtypes screening of 12352 rural women in Hebei Province

目的了解河北省农村妇女人乳头瘤病毒高危亚型（HPV-HR）感染及其基因分布情况,为预防子宫颈癌前病变及子宫颈癌提供参考依据。方法以2014年8月至2015年8月在河北省妇幼保健中心进行人乳头瘤病毒高危亚型筛查的12 352例农村妇女作为研究对象,按年龄分成4组：31~40岁组、41~50岁组、51~60岁组、60~70岁组。采用荧光定量PCR技术进行人乳头瘤病毒高危亚型筛查。结果在12 352例受检者中HPV-HR感染率占10.29%（1271/12 352）,其中31~40岁组HPV-HR感染率占11.36%（364/3 205）、41~50岁组HPV-HR感染率占10.15%（560/5 515）、51~60岁组占9.86%（293/2 972）、60~70岁组HPV-HR感染率占8.18%（54/660）,31~40岁组与61~岁组HPV-HR总感染率差异具有统计学意义（χ2=5.72,P〈0.05）,其他各组之间HPV-HR总感染率差异无统计学意义（均P〉0.05）。在1 271例HPV-HR感染病例中,HPV-16、HPV-18感染和HPV-16、HPV-18合并其他12种HPV高危亚型（HPV-HR12）感染占26.67%（339/1 271）,HPV-HR12（包括：HPV-31、33、35、39、45、51、52、56、58、59、66、68）感染者932例,占所有感染病例的73.33%（932/1 271）。结论河北省农村妇女人乳头瘤病毒高危亚型（HPV-HR）感染处于中等水平,并且HPV-16型具有较高的感染率;31~40岁的年轻女性HPV-HR感染率达最高,随着年龄的增高,感染比例逐步缓慢减少。该结果对农村妇女宫颈癌防治和农村妇女HPV-HR筛查策略的实施具有指导意义。

Objective To understand the epidemic situation of human papillomavirus high risk （HPV-HR） infection and its gene distribution among rural women in Hebei Province, so as to provide reference for prevention of cervical precancerous lesions and cervical cancer. Methods Totally 12 352 rural women taking HPV-HR examination in Hebei Provincial Maternity and Child Healthcare Center from August 2014 to August 2015 were selected and divided into four age groups： 31-40 years-old group, 41 -50 years-old group, 51 -60 years-old group and 61 - 70 years-old group. The multi-color real time fluorescence quantitative PCR technique was used for HPV-HR screening. Results The infection rate of HPV-HR among 12 352 rural women was 10.29% （ 1 271/12 352）. The infection rate of HPV- HR in 31 - 40 years-old group was 11.36% （364/3 205 ）, in 41 - 50 years-old group was 10.15 % （560/5 515 ）, in 51 - 60 years-old group was 9.86% （293/2 972）, and in 61 -70 years-old group was 8.18 （54/660）. The difference in HPV-HR infection rate was statistically significant between 31 - 40 years-old group and 61 - 70 years-old group （X2 = 5.72, P 〈 0.05 ） , but it was not significant among other groups （ all P 〉 0.05）. The infection rate of HPV-16, HPV-18 and HPV-16/HPV-18 combined with other 12 HPV high-risk subtypes （HPV-HR12） accounted for 26.67% （339/1 271 ）. There were 932 cases infected with HPV-HR12 （ including HPV-31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68）, which accounted for 73.33% （932/1 271 ） of HPV-HR infection cases. Conclusion The infection rate of HPV-HR among rural women is medium level in Hebei Province, and the infection rate of HPV-16 is higher. The infection rate of HPV-HR reached peak among young women aged 31 - 40 years old, and it declines gradually with age increasing. The data are helpful for cervical cancer prevention and implement of HPV-HR screening strategy for rural women.