三峡库区人乳头瘤病毒的基因型分布及其与宫颈病变程度的相关性分析

The distribution of human papillomavirus in different age groups and its correlation with the degree of cervical lesions

目的：探讨人乳头瘤病毒在三峡库区人群中的基因型分布及其与宫颈病变程度的相关性。方法选择2012年5月至2015年5月重庆三峡中心医院妇科门诊行人乳头瘤病毒（HPV）筛查的2031例患者为研究对象。采集患者宫颈管内鳞柱状上皮交界处细胞进行 HPV DNA 分型检测，对 HPV 阳性患者采用宫颈超薄液基细胞学检查（TCT），对 TCT 检查异常的患者进行电子阴道镜下病理活检，以病理活检结果为诊断标准，分析 HPV 在不同年龄人群和不同宫颈病变程度中的分布。结果在不同年龄组中，≤20岁组患者的高危型 HPV 阳性率为19．7％，显著高于＞20～30岁、＞30～40岁和＞40～50岁组的14．4％、13．9％、15.0％（χ2＝4．259、5．724、3．988，均 P ＜0．05），但与＞50岁组的17．1％差异无统计学意义（χ2＝1.724，P ＞0．05）。高危 HPV 混合感染组和低危 HPV 感染组在≤20岁、＞20～30岁、＞30～40岁、＞40～50岁和＞50岁组患者HPV 阳性率差异无统计学意义（χ2＝0．679、1．021、0．968、0．736和0．668，P ＞0.05）。HPV 高危型组中，HPV类型单一感染在≤20岁、＞20～30岁、＞30～40岁、＞40～50岁和＞50岁组的概率远大于多重感染（χ2＝4.213、3．894、4．256、5．330、5.666，均 P ＜0．05）。各年龄组患者感染的 HPV 高危型以 HPV16、HPV52、HPV58型为主，而低危型则以 HPV43型为主。＞30～40岁组感染高危型 HPV 患者的宫颈病变类型以宫颈炎为主，40岁以上组感染高危型 HPV 患者的浸润性宫颈癌的发病率显著升高。结论对不同年龄段女性进行 HPV分型检测对宫颈病变程度的诊断具有重要意义。

Objective To investigate the distribution of human papillomavirus（HPV）in different age groups and its correlation with the degree of cervical lesions.Methods 2 031 patients with HPV screening specimens in our hospital from May 2012 to May 2015 were chosen as study subjects.To acquire patient cervical squamous columnar epithelial cells at the junction to detect HPV DNA types.HPV -positive patients used ultra -thin liquid -based cervical cytology technology （TCT）to detect.Patients with abnormal TCT detection were performed with electronic biopsy,and the diagnosis was made by pathology biopsy,and analyzed the distribution of HPV in different age groups and different degree of cervical lesions.Results In different age groups,≤20 years of age groups of patients with high -risk HPV positive rate was 19.7%,which was significantly higher than that of 〉20 -30 years,〉30 -40 years and 〉40 -50 years three groups （14.4%,13.9%,15.0%）（χ2 =4.259,5.724,3.988,all P 〈0.05）.There was no significant difference with the 50 years old group （17.1% ）（χ2 =1.724,P 〉0.05）.There was no significant difference in HPV positive rate among the ≤20 years,〉20 -30 years,〉30 -40 years,〉40 -50 years,〉50 years ages patients with high risk HPV infection group and low risk HPV infection group（χ2 =0.679,1.021,0.968,0.736, 0.668,all P 〉0.05）.In the high -risk HPV infected group,the risk of single type infection in 〉20 -30 years,〉30 -40 years,〉40 -50 years,〉50 years ages patients were significant higher than the mixed types infection（χ2 =4.213,3.894,4.256,5.330,5.666,all P 〈0.05）.Infected patients of all ages with high -risk HPV were HPV16, HPV52,HPV58 type -based,low -risk type HPV43 type places mainly.More than 31 to 40 years age group of patients infected with high -risk HPV types in cervical lesions mainly cervicitis and 40 years and older group of patients with high -risk HPV infection incidence of invasive cervical cancer were significantly higher.Conclusion Different age groups of women for HPV genotyping is important for diagnosis of cervical lesions.