2014-2016年深圳市子宫颈癌筛查中HPV阳性者HPV高危亚型分布及相关因素

Distribution and associated factors of high-risk HPV genotypes infection among HPV-positive women who participated cervical screening test in Shenzhen,2014-2016,China

目的 分析深圳市参与子宫颈癌筛查的HPV阳性者感染高危亚型HPV状况及相关因素.方法 通过深圳市妇幼保健管理系统子宫颈癌防治信息平台选取2014—2016年参加子宫颈癌筛查且HPV检测阳性者为研究对象,共10624例,收集其基本信息和HPV基因亚型检测结果,根据致病性不同分为：高危型共15种,包括HPV 16、18、31、33、35、39、45、51、52、53、56、58、59、66和68;低危型共6种,包括HPV 6、11、42、43、44和81.采用多因素非条件logistic回归模型分析发生高危型HPV感染的相关因素.结果 本研究中HPV检测阳性者均接受HPV基因亚型检测,年龄为（38.08±9.38）岁,其中高危型感染为9979例,占93.9%;2014—2016年HPV高危型感染比例分别为91.5%（2769例）、93.8%（2785例）和95.6%（4425例）（P趋势〈0.001）.与25岁及以下者相比,26-30、31-35、36-40、41-45、≥50岁年龄组发生高危型HPV感染的OR（95%CI）值分别为1.67（1.20-2.31）、1.49（1.09-2.03）、1.71（1.23-2.37）、1.65（1.19-2.31）和1.84（1.26-2.67）;与已婚者相比,未婚者发生高危型HPV感染的OR（95% CI）值为0.71（0.50-1.00）;与2014年相比,2015和2016年感染高危型HPV的OR （95%CI）值分别为1.43（1.17-1.74）和2.03（1.68-2.46）.最常见的5种HPV感染亚型均为高危型,依次是HPV52（25.1%,2670例）、HPV16（19.2%,2041例）、HPV58（13.3%,1413例）、HPV18（9.9%, 1048例）和HPV51（9.3%,993例）.结论 年龄、婚姻状况、筛查年份是深圳市女性高危型HPV感染的相关因素.除HPV16和18型感染外,HPV52、58、51型感染也应受到重视.

Objective To analyze the distribution and associated factors of high-risk genotypes of HPV in cervical infection among women in Shenzhen. Methods The information on sociodemographic characteristics and HPV genotypes of HPV-positive women who participated cervical screening test from January 2014 to December 2016 was downloaded from Shenzhen Maternity and Child Healthcare Management Information System.According to the pathogenicity,the high-risk HPV genotypes were divided into 15 types including HPV 16,18,31,33,35,39,45,51,52,53,56,58,59,66 and 68;and there were 6 low-risk genotypes including HPV 6,11,42,43,44,and 81.Chi-square tests were applied to compare the proportions of high-risk HPV infection among women who had different sociodemographic characteristics.A non-conditional logistic regression model was used to analyze the associated factors for high-risk HPV infection. Results In total, all HIV positives received HPV genotyping, with an average age of （38.08 ± 9.38） years old. There were 9 979 （93.9%） high-risk and 645 （6.1%） low-risk HPV infections. The proportions of HPV infections for high-risk type in each year were 91.5%, 93.8%, and 95.6%, increasing with the screening years（χ2=54.79,P〈0.001）.Multivariate logistic regression analysis showed that compared with women younger than 25 years old,women in other age groups（at age 26 to 30 years,31 to 35 years,36 to 40 years,41 to 45 years,and 50 years or older）had increased risks of high-risk HPV infection,with OR （95% CI）of 1.67（1.20-2.31）,1.49（1.09-2.03）,1.71（1.23-2.37）,1.65（1.19-2.31）,and 1.84（1.26-2.67）, respectively;compared with the married,single women had a decreased risk of high-risk HPV infection（OR （95%CI）：0.71（0.50-1.00））;women received HPV testing in 2015 and 2016 showed higher risk of high-risk HPV infection than those in 2014 （OR （95% CI）： 1.43 （1.17-1.74） and 2.03 （1.68-2.46））. The 5 most common HPV genotypes were HPV52 （25.1%, 2 670 cases）, followed by HPV16 （19.2%, 2 041 cases）, HPV58 （13.3%, 1 413 cases）, HPV18 （9.9%, 1 048 cases）, and HPV51 （9.3%, 993 cases）. Conclusion Age,marital status,and screening year were associated with high-risk HPV infections.Besides HPV16 and HPV18,the prevention and control on HPV infections for HPV52,HPV58,and HPV51 should be prioritized in Shenzhen area.