安徽地区17160例健康体检女性人乳头瘤病毒感染状况及基因分型

Genotypes distribution of human papillomavirus in infected cervical tissue from 17160 women for physical examination in Anhui area

目的探讨安徽地区健康体检女性感染人乳头瘤病毒(HPV)发生率及病毒亚型分布,为宫颈癌的防治提供依据。方法采用聚合酶链反应(PCR)反向点杂交技术对2018年4月至2018年12月合肥金域医学检验实验室有限公司接收的不同年龄段的健康体检女性宫颈脱落细胞样本进行HPV基因分型检测,根据基因型检测结果分析HPV及其亚型在女性人群中的潜在感染率、各基因型检出率和不同年龄段分布。结果17160例健康女性体检样本中,HPV基因检测阳性者共2990例,总阳性率为17.42%(2990/17160)。17种高危型和6种低危型HPV均被检出。其中单一基因型检出者占73.71%(2204/2990),二重基因型检出者占19.03%(569/2990),三重基因型检出者占5.55%(166/2990),四重(43例)、五重(7例)和六重(1例)基因型检出共占1.71%(51/2990)。2204例单一基因型感染样本中,高危型感染者1829例(82.99%)。常见的高危HPV亚型依次为HPV52(20.07%、367/1829)、HPV16(16.84%、308/1829)、HPV53(9.84%、180/1829)、HPV18(8.26%、151/1829),此4种高危型HPV检出率占总高危型的55.00%(1006/1829);其他13种高危型HPV分布于其他823例患者。低危型HPV共检出375例,以HPV81亚型最常见(40.00%、150/375),其次为HPV42亚型(22.13%、83/375)和HPV43亚型(17.33%、65/375)。其他3种低危型分布于其余23例患者。二重HPV感染者中,均为高危亚型感染者390例(68.54%),均为低危亚型感染者10例(1.76%),高低危亚型混合感染者169例(29.70%)。三重感染中,高危亚型感染者73例(43.98%),低危亚型感染者2例(1.20%),高低危亚型混合感染者91例(54.82%)。四重及以上HPV感染中,高危亚型感染22例(43.14%),低危亚型感染0例(0.00%),高低危混合感染29例(56.86%)。无论单一HPV感染还是多重HPV感染,均以高危型HPV感染为主。21~25岁、26~30岁、31~35岁、36~40岁、41~45岁、46~50岁、51~55岁、56~60岁、≥61岁年龄组体检者HPV阳性检出率差异有统计学意义(χ^2=28.701、P<0.001)。结论安徽地区健康体检女性HPV感染以单一感染和高危感染为主,高危型HPV感染率从高至低依次为HPV52、HPV16、HPV53和HPV18;不同年龄分层HPV感染率存在差异。

Objective To investigate the incidence of human papillomavirus(HPV)infection and the distribution of HPV subtypes in women for physical examination in Anhui area,and to provide evidence for the prevention and treatment of cervical cancer.Methods The sample of female cervical exfoliated cells specimen were collected by Hefei KingMed Diagnostics laboratory and HPV genotypes were detected by polymerase chain reaction reverse dot blot hybridization(PCR-RDB)method.According to the genotype results,the potential infection rate and HPV subtypes,the detection rate of each genotype and the distribution of different age groups were analyzed,respectively.Results Among the 17160 samples from healthy women for physical examination,a total of 2990 cases were HPV positive,with the positive rate 17.42%(2990/17160).Seventeen high-risk genotypes and 6 low-risk genotypes of HPV were all detected.Cases with single genotype HPV infection accounted for 73.71%(2204/2990),double HPV genotypes infection were 19.03%(569/2990),triple HPV genotypes were 5.55%(166/2990);while quadruple HPV genotypes(43 cases),five genotypes(7 cases)and six genotypes(1 case)infection accounted for 1.71%(51/2990)in total.Among the 2204 cases with single genotype HPV infection,1829(82.99%)cases were with high-risk genotypes HPV infection.The common high-risk subtypes were HPV52(20.07%,367/1829),HPV16(16.84%,308/1829),HPV53(9.84%,180/1829)and HPV18(8.26%,151/1829).The detection rate of the above four high-risk genotypes of HPV accounted for 55.00%,relative to the total high-risk genotype of HPV infection(1006/1829).The remaining 823 patients were distributed in the other 13 high-risk genotypes of HPV.There were 375 cases with low-risk genotype of HPV infection,the most common of which was HPV81(40.00%,150/375),followed by HPV42(22.13%,83/375)and HPV43(17.33%,65/375).The other 23 patients were distributed in the other 3 middle and low risk genotypes.Among the cases with double HPV infection,390 cases(68.54%)were with only high-risk HPV subtypes infection,10 cases(1.76%)with only low-risk HPV subtypes infection and 169 cases(29.70%)with high-risk and low-risk HPV subtypes mixed infection.Among the triple HPV genotypes infection,73 cases(43.98%)were with only high-risk HPV subtypes infection,2 cases(1.20%)were with only low-risk HPV subtypes infection and 91 cases(54.82%)with highrisk and low-risk HPV subtypes mixed infection.Among quadruple and above HPV genotypes infection,22 cases(43.14%)were with only high-risk subtypes HPV infection,no case was with only low-risk HPV subtype infection and 29 cases(56.86%)with high-risk and low-risk HPV subtypes mixed infection.Highrisk HPV subtype infection was the main infection,whether in single HPV subtype infection or in multiple HPV subtypes infection.The positive rates of HPV in groups aged 21-25,26-30,31-35,36-40,41-45,46-50,51-55,56-60 and≥61 years old were significantly different(χ^2=28.701,P<0.001).Conclusions HPV infection in healthy women in Anhui was maily single subtype infection and high-risk subtypes infection,and the high-risk infection rate ranks HPV52,HPV16,HPV53 and HPV18,and the infection rate of different age groups were significantly different.