粤东地区妇女人乳头瘤病毒感染情况和亚型分布及其与宫颈癌的关系

Prevalence of human papillomavirus genotypes and associated risk of cervical carcinoma in Chaoshan population

目的:检测粤东地区妇女人乳头瘤病毒(HPV)感染情况及亚型分布,探讨其与宫颈癌的关系。方法:选取2015年10月—2016年9月粤东地区7家三级医院30 000例行宫颈筛查的妇女作为研究对象。收集所有对象宫颈脱落细胞,采用Hybri Max方法对HPV感染情况进行检测。对8 739例宫颈病变患者进行宫颈组织活检与HPV分型。比较分析不同病变类型以及年龄段HPV感染率与亚型分布。结果:脱落细胞检查个体中,HPV阳性者9 000例,感染率为30.00%。在8 739例行宫颈活检的宫颈病变患者中,HPV感染率为58.29%(5 094/8 739),慢性宫颈炎中HPV感染率为40.00%(1 088/2 720),CINⅠ中为53.59%(1 396/2 605),CINⅡ/Ⅲ中为71.61%(1 647/2 300),宫颈癌中为86.45%(963/1 114)。在各种宫颈病变中,HPV 16、18、33、58、52是最常见的高危亚型,感染率依次是14.02%、6.28%、5.23%、4.46%、3.71%。在宫颈癌患者中,最常见的亚型是HPV 16;≥60岁的人群中HPV感染率最高,达到49.92%。结论:粤东地区HPV感染最常见的亚型为16、18、33、58、52型,宫颈病变程度越重,HPV的感染率越高。在宫颈癌患者中,HPV 16是最为常见的亚型,中老年患者的HPV感染率高于年轻人,单一感染可能更易导致宫颈癌的发生。

OBJECTIVE:To determine genotype-specific distribution of human papillomavirus(HPV)in women and to identify its relationship with cervical carcinoma in Chaoshan population.METHODS:Data from30000women who were subjected to cervical HPV DNA testing were retrospectively evaluated in a hospital-based study.A total of8739women,who had both HPV typing and pathological examination,were investigated.RESULTS:Overall,30.00%(9000/30000)of women were HPV positive,the frequency of HPV infection was58.29%(5094/8739)in women with cervical cytological abnormalities,and the infection rate for patients with chronic cervicitis was40.00%(1088/2720),patients with CIN I was53.59%(1396/2605),patients with CIN was II/III71.61%(1647/2300)and patients with cervical carcinoma was86.45%(963/1114).HPV16(14.02%)was the most common type for all cervical cytological abnormalities,followed by18type6.28%(549),33type5.23%(457),58type4.46%(390)and52type3.71%(324),while the more common HPV16type in cervical carcinoma with the highest infection(49.92%)was in women aged over60.CONCLUSION:Our data indicate a relatively high prevalence of HPV16,52,33,58and18in women,their positive association with cervical cytological abnormalities.Specifically,the HPV16was the most common subtype among senior women with cervical carcinoma.