上海浦东地区宫颈HPV感染状况的流行病学调查分析

Epidemiological investigation and analysis of cervical HPV infection status in Pudong area of Shanghai

目的调查最近5年上海市浦东地区女性宫颈HPV感染情况及各年龄段分布特点。方法收集2014年1月~2018年12月在我院妇科门诊就诊女性的宫颈脱落细胞样本30 953例,采用PCR-反向点杂交法进行HPV DNA分型检测,并对数据进行统计学分析。结果 30 953例中7253例感染HPV,感染率为23.46%(7253/30 953),高危型HPV总感染率为19.33%(5983/30 953),包括17种高危型别(HPV16、HPV18、HPV31、HPV33、HPV35、HPV39、HPV45、HPV51、HPV52、HPV53、HPV56、HPV58、HPV59、HPV66、HPV68、HPV73、HPV82)和6种低危型别(HPV6、HPV11、HPV42、HPV43、HPV81、HPV83),23种型别均有检出,以高危型感染为主,占82.49%(5983/7253),感染率排前5位的高危型HPV分别为HPV52(4.33%)、HPV16(3.07%)、HPV58(2.09%)、HPV53(2.02%)和HPV51 (1.69%)。不同年龄段中,60~69岁女性HPV感染率最高,达41.53%,高危型检出率也居于首位,占35.47%;其次为<20岁的女性,其HPV感染率达38.28%,高危型检出率占32.42%。7253例阳性标本中,单一感染占75.44%(5472/7253),多重感染(两种亚型及以上)占24.56%(1781/7253)。其中双重感染占19.01%(1379/7253),三重感染占3.52%(255/7253),四重及以上感染占2.03%(147/7253)。结论上海市浦东地区女性宫颈HPV感染的亚型及年龄分布具有明显地域特征,提示宫颈癌筛查及HPV疫苗接种要考虑年龄及HPV感染亚型分布的地域性差异。

Objective To investigate the infection status of human papilloma virus in female in Pudong area of Shanghai in recent 5 years and its characteristics of age distribution.Methods A total of 30953 samples of cervical abscission cells from females who were treated in our Hospital from January 2014 to December 2018 were collected.DNA typing of HPV was conducted by PCR-reverse dot blot,and the data were statistically analyzed.Results A total of7253 cases of HPV infection were detected in the 30953 samples,and the infection rate was 23.46%(7253/30953).The total infection rate of high-risk HPV was 19.33%(5983/30953).Twenty three HPV types were detected,including17 high-risk types(HPV16,HPV18,HPV31,HPV33,HPV35,HPV39,HPV45,HPV51,HPV52,HPV53,HPV56,HPV58,HPV59,HPV66,HPV68,HPV73,HPV82)and 6 low-risk types(HPV6,HPV11,HPV42,HPV43,HPV81,HPV83),82.49%(5983/7253)of which were high-risk types.The top 5 high-risk HPV types were HPV52(4.33%),HPV16(3.07%),HPV58(2.09%),HPV53(2.02%)and HPV51(1.69%).In different age groups,the HPV infection rate of women aged 60-69 was the highest,up to 41.53%,and its detection rate of high-risk types was also the highest,accounting for 35.47%.The HPV infection rate of women aged below 20 years old was the second highest,accounting for38.28%,in which the high-risk type detection rate accounted for 32.42%.Among 7253 positive specimens,single infection accounted for 75.44%(5472/7253),multiple infection(two subtypes and above)accounted for 24.56%(1781/7253),double infection accounted for 19.01%(1379/7253),triple infection accounted for 3.52%(255/7253),and quadruple infection accounted for 2.03%(147/7253).Conclusion The subtype and age distribution of cervical HPV infection in women in Pudong area of Shanghai have obvious regional characteristics,suggesting that the regional differences in the age and subtype distribution of HPV infection should be taken into account during cervical cancer screening and HPV vaccination.