山东省三地区34258例HPV感染率及基因型别分布情况

HPV infection rate and genotype distribution of 34258 cases in three cities in Shandong province

目的了解山东泰安、济南、东营三地区女性人乳头瘤病毒(HPV)各基因型别的感染和分布情况,为山东三地区HPV分子流行病学研究提供依据。方法回顾性分析2014年1月-2016年6月在山东省三地区就诊、筛查和体检的34 258例宫颈脱落细胞标本,采用PCR体外扩增和DNA反向点杂交相结合的DNA芯片技术,对宫颈脱落细胞标本进行HPV基因分型检测。结果不同地区人群HPV阳性率及高危、低危、多重感染率差异有统计学意义(P<0.01),三地区检出阳性标本:泰安地区检出阳性标本701例,占18.17%(701/3 857),其中高危型HPV 339例,占8.78%(339/3 857,包含多重感染);低危型HPV 151例,占3.91%(151/3 857,包含多重感染),多重感染297例,占7.70%(297/3 857);济南地区检出阳性标本1 825例,占17.86%(1 825/10 216),其中高危型HPV 1 486例,占14.54%(1 486/10 216,包含多重感染);低危型HPV 338例,占3.30%(338/10 216,包含多重感染),多重感染626例,占6.13%(626/10 216);东营地区检出阳性标本5 607例,占27.78%(5 607/20 185),其中高危型HPV 4 431例,占21.95%(4 431/20 185,包含多重感染);低危型HPV 1 176例,占5.83%(1 176/20 185,包含多重感染),多重感染2 167例,占10.74%(2 167/20 185)。23种型别均被检出,三地区HPV亚型前5位有所区别,各类型HPV感染顺位分别是泰安为HPV16、HPV52、HPV58、HPV53、HPV81;济南为HPV16、HPV52、HPV58、HPV6、HPV81;东营为HPV16、HPV52、HPV58、HPV18、HPV51,不同地区之间HPV感染率及各型别感染率差异有统计学意义(P<0.01)。结论各地区之间女性人群的HPV感染率及HPV型别感染率存在显著差异,因此早期筛查对控制HPV的感染是预防或降低宫颈病变的有效途径。

Objective To investigate infection and distribution of different human papillomavirus （HPV） genotypes among the women in Taian city, Ji＇nan city, and Dongying city of Shandong province, provide a basis for molecular epidemiological study of HPV in the three cities in Shandong province. Methods The cervical exfoliated cell samples of 34 258 cases who were treated, screened, and examined in three cities in Shandong province from January 2014 to June 2016 were analyzed retrospectively, HPV genotyping was performed using PCR in vitro amplification combined with DNA reverse blot hybridization. Results There were statistically significant differences in HPV positive rate, high-risk HPV infection rate, low-risk HPV infection rate, multiple HPV infection rate among the women in different cities （P〈 0. 01）. In Taian city, HPV positive rate was 18. 17% （701/3 857） ; high-risk HPV infection rate was 8. 78% （339/3 857）, including multiple HPV infection; low-risk HPV infection rate was 3.91% （151/3 857）, including multiple HPV infection; multiple HPV infection rate was 7.70% （297/3 857） . In Ji＇nan city, HPV positive rate was 17.86% （1 825/10 216）; high-risk HPV infection rate was 14. 54% （1 486/10 216）, including multiple HPV infection; low-risk HPV infection rate was 3.30% （338/10 216 ）, including multiple HPV infection; multiple HPV infection rate was 6. 13% （626/10 216） . In Dongying city, HPV positive rate was 27.78% （5 607/ 20 185 ） ; high-risk HPV infection rate was 21.95% （4 431/20 185 ） , including multiple HPV infection; low-risk HPV infection rate was 5.83% （1 176/20 185 ）, including multiple HPV infection; multiple HPV infection rate was 10. 74% （2 167/20 185 ） . A total of 23 kinds of HPV genotypes were screened out, the top five HPV genotypes in the three cities were different. The top five HPV genotypes in Taian city were HPV16, HPV52, HPV58, HPV53, and HPVS1, respectively; the top five HPV genotypes in Ji＇nan city were HPV16, HPV52, HPV58, HPV6, and HPV81, respectively; the top five HPV genotypes in Dongying city were HPV16, HPV52, HPV58, HPV18, and HPV51, respectively. There were statistically significant differences in HPV infection rate and infection rates of different HPV genotypes among the three cities （ P〈0. 01 ） .Condusion HPV infection rate and infection rates of different HPV genotypes are significantly different among the women in the three cities. Therefore, early screening for HPV infection is an effective way to prevent or reduce cervical lesions.