重庆市农村妇女高危型HPV感染状况分析

Analysis of high-risk HPV infection status among rural women in Chongqing City

目的分析重庆市农村妇女高危型人乳头瘤病毒(HPV)感染情况及其与宫颈病变的关系。方法 2016年1-4月选取重庆市万州区、永川区、巴南区、潼南区共20 000例农村妇女,以HPV基因分型检测对其进行宫颈癌的初筛。对HPV16、18型(+)者或其余12种HPV高危型(+)阴道镜检查异常者进行阴道镜定点活检。结果重庆市农村妇女高危型HPV感染阳性率为9.66%,不同年龄组的高危型HPV感染阳性率及不同高危型别HPV感染阳性率均有差异。高危型HPV感染阳性者中,宫颈上皮内瘤变(CIN)1发生率为2.33%,CIN2、CIN3及AIS发生率为1.35%,宫颈癌发生率为0.31%,不同年龄组各级别宫颈病变发生率差异无统计学意义。不同高危型别HPV感染者中,HPV16阳性者各级别宫颈病变发生率均最高,而其余12型HPV高危型别阳性者各级别宫颈病变发生率均最低,且差异有统计学意义。结论 HPV基因分型检测可提高宫颈癌的筛查效率,更适合在大规模人群中普查。

Objective To analyze the situation of high-risk human papillomavirus（HPV）infection and its relationship with cervical lesions among rural women in Chongqing City.Methods A total of 20000 rural women were selected from the districts of Wanzhou,Yongchuan,Banan and Tongnan of Chongqing City from January to April 2016.The cervical cancer preliminary screening was performed by detecting HPV gynotyping.The cases of HPV 16 and HPV 18 positive or other 12 high risk HPV types positive with abnormal colposcopy examination conducted the colposcopy fixed point biopsy.Results The positive rate of high-risk HPV infection was 9.66% among rural women in Chongqing City.The positive rates of high-risk HPV infection and different types of high-risk HPV infection had difference among different age groups.Among women of high-risk HPV infection positive,the occurrence rate of CIN1 was 2.33%,which of CIN2,CIN3 and AIS was 1.35%,and which of cervical cancer was 0.31%,the incidence rate of different grades of cervical lesions had no statistical difference among different age groups.Among women with different types of high-risk HPV infection,the incidence rate of different grades of cervical lesions in women of HPV 16 positive was highest,those with the other 12 types of high risk HPV positive had the lowest occurrence rate of different grades of cervical lesions,the differences were statistically significant.Conclusion HPV genotyping detection can increase the efficiency of cervical cancer screening and is more suitable for the screening of large population.