2015-2017年重庆地区感染HPV各基因型及分布特点

Genotypes and distribution characteristics of HPV infection in Chongqing from 2015 to 2017

目的研究重庆地感染人乳头瘤病毒(HPV)各基因型及分布特点。方法选取2015年1月至2017年12月重庆市三大片区各级医院送检女性样本,用PCR-斑点杂交法作HPV-DNA分型检测,分别统计各基因型阳性率、2个年龄段及地区分布和多重感染情况,选取部分HPV阳性病例同时用第二代捕获杂交法(HCⅡ法)作比对检测及基因测序和液基薄层细胞(TCT)检查。结果 143 083例样本,HPV阳性检出率为25.38%,在阳性中占比达10%的基因型依次为52、16、58、81、53;高危型HPV(hrHPV)检出率为21.58%;18～45岁感染阳性率为24.74%,45岁以上为27.39%,2个年龄段(18～45岁、45岁以上)阳性率差异有统计学意义(P<0.05);渝西及主城阳性检出率为24.44%,渝东北为31.81%,渝东南为24.70%,渝东北阳性检出率明显高于另外两个片区,差异有统计学意义(P<0.05);各年龄段及各片区均以感染单一基因型为主;两种方法比对检测结果符合率为96.2%;各型测序结果分别与NCBI相对应基因的序列比对,一致性均在99%以上;同时作TCT检查的7 168例中,属hrHPV 5 835例,结果为CINⅡ5.50%,低危型HPV(lrHPV)有1 333例,结果为CINⅡ0.53%。HPV感染导致宫颈细胞CIN改变的检出率均低于10%,hrHPV的CINⅡ明显高于lrHPV,差异有统计学意义(P<0.05)。结论通过对重庆市超14万例次女性感染HPV各基因型的检查研究,为该地区宫颈癌诊断和防治体系的建立提供有力科学依据,为该病原疫苗的研发和应用提供高价值流行病学资料。

Objective To investigate the genotypes of HPV infection and their distribution characteristics in Chongqing.Methods Samples of women from hospitals in three major districts of Chongqing from January 2015 to December 2017 were detected by PCR dot-blot hybridization.The genotypes,positive rates,age groups,location distributions and multiple infections were counted and analyzed.Selected patients were compared by HCⅡ,gene sequencing and TCT simultaneously.Results Among the 143 083 samples,total infection rate of HPV was 25.38%,among which the genotypes of 52,16,58,81,and 53 were higher than 10%.The infection rate of high-risk HPV was 21.58%.The infection rate of 18-45 years old was 24.74%and 27.39%for those over 45 years old.The infection rate was significantly different among the two age groups(P<0.05).The infection rate were 24.44%,31.81%and 24.70%in west and main cities of Chongqing,northeastern and southeastern respectively.The infection rate in the northeast was significantly higher than that in the other two regions(P<0.05).The single genotypes of infection were dominant in all age groups and regions.Compared with PCR dot-blot hybridization and HCⅡmethods,the agreement rate was 96.2%.Compared with various sequencing of the genotypes and the gene sequence correspondingly in the NCBI,the consistency of sequence was above 99%.7 168 cases were examined by TCT at the same time,and there were 5835 cases with high-risk HPV,of which the rate of,CINⅡwas 5.50%;and there were 1 333 cases with low-risk HPV,of which the rate of CINⅡwas 0.53%.The detection rate of CIN changes in cervical cells caused by HPV infection was less than 10%,and CINⅡof the high-risk infection was significantly higher than the low-risk infection(P<0.05).Conclusion Through the study of HPV genotypes that from more than 140 000 women who were checked for HPV DNA types in Chongqing.The scientific basis are provided for the establishment of cervical cancer diagnosis and prevention system in this region.Furthermore high-value epidemiological data are provided for the development and application of HPV vaccine.