深圳某社区非户籍女性HPV感染与宫颈鳞状上皮内病变的相关性研究

Correlation between HPV infection and cervical squamous intraepithelial lesions in non-native women in communities of Shenzhen

目的了解深圳市宝安区非户籍妇女人类乳头状瘤病毒(HPV)感染与宫颈鳞状上皮内病变(SIL)之间的相关性。方法多阶段分层抽样对2015年6月至2016年6月深圳市宝安区12个社区5 391名妇女进行宫颈HPV基因型检测,初筛阳性1 445例再进行液基细胞学技术(TCT)检测。运用单因素Logistic回归分析宫颈病变与HPV亚型的相关性。结果 HPV阳性中最常见的5种基因型为HPV16(9.56%)、HPV58(8.52%)、HPV52(6.92%)、HPV18(6.31%)、HPV6(5.65%)。未见上皮内病变/恶性细胞(NILM)组和高度鳞状上皮内病变(HSIL)组中高危型HPV比例分别为26.99%、96.88%。单因素Logistic回归分析结果显示,NILM与HPV6、HPV11、HPV43有相关性,LSIL病变与HPV35、HPV51、HPV56相关,ASC-US病变与HPV31、HPV39相关。HSIL+组HPV16、HPV33和HPV58感染的风险较非HSIL+组明显升高。结论特定高危型HPV基因型与宫颈高度鳞状上皮内病变有相关性,尤其HPV16、HPV33、HPV58感染,可为宫颈癌防治提供参考依据。

Objective To investigate the association between human papilloma virus（HPV） infection and cervical squamous intraepithelial lesions（SILs） for non-native women in Baoan District of Shenzhen. Methods A total of5 391 women were recruited by multi-stage stratified sampling method for cervical cancer screening in 12 communities in Baoan District of Shenzhen from June 2015 to June 2016. Exfoliated cervical cells were collected to detect the HPV genotype. A total of 1 445 HPV-infected samples were tested by liquid thin-layer cytology technology（TCT）. Logistic regression analysis was used to analyze the correlation between HPV genotypes and cervical squamous intraepithelial lesions. Results The five most common HPV genotypes were HPV16（9.56%）, followed by HPV58（8.52%）, HPV52（6.92%）, HPV18（6.31%）, HPV6（5.65%）. The ratio of high risk（HR）-HPV genotypes in Negative for Intraepithelial Lesions or Malignancy（NILM） and high-grade SIL（HSIL） or worse（HSIL ＋） were 26.99% and 96.88%, respectively.HPV6, HPV11 and HPV43 were related to NILM, while HPV35, HPV51, HPV56 were related to LSIL. HPV31, HPV39 were related to atypical squamous cells of undetermined significance（ASC-US）. HPV16, HPV33, HPV58 infection may lead to HSIL＋. Conclusion There are correlations between high-grade SILs and high risk HPV genotypes, especially HPV16, HPV33, HPV58 infection, which provide evidences for prevention and intervention of cervical cancer.