人乳头瘤病毒感染的民族分布特点与宫颈病变的分析研究

Analytic study on distribution the distribution characteristics of nationality and cervical lesion about human papilloma virus (HPV) infection and cervical lesions

目的:分析云南玉溪地区主要少数民族妇女人乳头瘤病毒(HPV)宫颈感染现状、基因型分布特点及宫颈上皮内瘤变(CIN)与HPV多重感染的关系。方法:收集云南玉溪地区彝族、哈尼族和傣族1155例妇女宫颈脱落细胞标本(1155份),应用微阵列基因芯片法分型检测,对受检者感染结果进行统计分析。结果:(1)在1155份宫颈脱落细胞标本中HPV阳性病例832例,感染率72.0%,其中彝族HPV主要型别依次为HPV-33型、51型、52型、56型、58型、59型、66型和68型;哈尼族HPV主要型别依次为HPV-51型、52型、56型、68型和33型;傣族HPV的主要型别依次为HPV-58型、52型、16型和39型,均以单一感染为主;(2)不同年龄段的HPV亚型分布有差异,≤20岁阳性检出率占5.4%,21~30岁阳性检出率占32.4%,31~40岁阳性检出率占26.6%,41~50岁阳性检出率占22.7%,>51岁感染阳性检出率占11.0%。21~30岁和31~40岁为HPV感染的主要群体,各年龄段阳性检出率比较差异有统计学意义(x^2=11.716,P<0.01);(3)3个少数民族的妇女CINⅡ级以上二重感染率比较,差异有统计学意义(x^2=27.0,P<0.05),经相关性分析CIN等级与HPV多重感染有显著相关性(x^2=12.0,P<0.05);结论:玉溪地区3个少数民族的妇女宫颈HPV的感染以单一感染为主,具有年龄差异。3个少数民族的妇女CIN等级与HPV多重感染有显著相关性,HPV感染与宫颈病变严重程度相关。

Objective： To analyze the current status of cervical infection of human papilloma virus（HPV） and distribution characteristic of HPV genotype, and the relationship between cervical intraepithelial neoplasias（CIN） and HPV multiple infection of main minority women in Yuxi area of Yunnan province. Methods： 1155 samples of cervical exfoliated cell of Yi nationality, Hani nationality and Dai nationality of Yuxi area were collected, and the genotyping test of gene chip of microarray was applied, and the infection results of samples were analyzed as statistic method. Results：（1）In 1155 samples of cervical exfoliated cells, 832 samples were positive of HPV, and the infection rate was 72%. And the main types of the Yi nationality successively were HPV-33, 51, 52, 56, 58, 59, 66 and 68, and the main types of Hani nationality successively were HPV-51, 52, 56, 68 and 33, and the main types of Dai nationality successively were HPV-58, 52, 16 and 39, and all of them mainly were single infection.（2）The distribution of HPV subtypes of various age groups were different. And the positive rate was 5.4% when their ages were equal or less than 20 years old, and it was 32.4% when their ages were 21-30 years old, and it was 26.6% when their ages were 31-40 years old, and it was 22.7% when their ages were 41-50 years old, and it was 11.0% when their ages were more than 51 years old. Therefore, the main age groups of HPV infection were 21-30 years old and 31-40 years old, and the differences of positive rate among various age groups were significant（x^2=11.716, P〈0.01）.（3）For CIN, the difference of double infection rates of Ⅱ grade and higher than Ⅱ grade among three nationalities were significant（x^2=27.0, P〈0.05）. And the results of correlation analysis indicated that there was a significant correlation between CIN grade and multiple infection of HPV（x^2=12.0, P〈0.05）. Conclusion： In Yuxi area, the mainly cervical HPV infection is single infection in three minority nationalities, and there is age difference in them. And there is significant correlation between CIN grade of three minority nationalities and multiple infection of HPV, and the HPV infection is related to the severe degree of cervical lesion.