高级别鳞状上皮内病变的危险因素及不同级别宫颈病变中的HPV感染亚型分布

Risk factors for high-grade squamous intraepithelial lesion and the distribution of HPV subtypes in different grades of cervical lesions

目的探讨高级别鳞状上皮内病变(HSIL)的危险因素,以及不同级别宫颈病变中的HPV亚型分布情况。方法前瞻性选取首都医科大学附属北京友谊医院阴道镜室于2018年12月至2019年8月进行宫颈活检后病理组织确诊为宫颈上皮内瘤变(CIN)的患者,共计300例,收集患者的年龄、吸烟史、有无宫颈糜烂及阴道炎、初次性生活的年龄及孕产史的情况,采用单因素χ^2检验和多因素Logistic回归分析HSIL的危险因素。结果 HPV16亚型感染以及宫颈糜烂是HSIL的显著高危因素(P<0.05),OR值分别为3.143、2.138。在300例患者中,HPV总感染率前5位的亚型依次为HPV16(24.7%)、52(9.3%)、58(5.7%)、18(4.0%)、51(2.7%)。具体到不同CIN级别中,HPV的感染率又有所差别,在CIN I中,HPV感染率排名前5位的亚型依次为HPV16、52、58、18、56。在CIN II中,HPV感染率排名前5位的亚型依次为HPV16、58、52、51、18;在CIN III中HPV感染率排名前5位的亚型依次为HPV 16、52、58、18、51。HSIL与HPV感染种类无关(P>0.05)。结论宫颈上皮内瘤变的患者中,感染HPV亚型前5位分别为HPV 16、52、58、18、51。HPV16亚型感染以及宫颈糜烂是HSIL的独立危险因素。HSIL与HPV感染种类无关。

Objective To investigate the risk factors of high-grade squamous intraepithelial lesion(HSIL)and the HPV subtype distribution in different grades of cervical lesions.Methods Data of 300 cases diagnosed with cervical intraepithelial neoplasia(CIN)by cervical biopsy in the department of colposcopy of Beijing friendship hospital,Capital medical university from December 2018 to August 2019 were prospectively analyzed,including age,smoking history,cervical erosion and vaginitis history,age of first sexual life and pregnancy history.Univariate Chi-square test and multivariate Logistic regression were used to analyze the risk factors of HSIL.Results HPV16 subtype infection and cervical erosion were significant risk factors for HSIL(P<0.05),and OR values was 3.143 and 2.138,respectively.Among the 300 cases,the top five HPV infection rates were HPV16(24.7%),52(9.3%),58(5.7%),18(4.0%),and 51(2.7%).The infection rate of HPV subtype was different in different CIN grades.In CIN I,the top 5 HPV infection rates were HPV16,52,58,18 and 56.In CIN II,the top five HPV infection rates were HPV16,58,52,51 and 18.In CIN II,the top five HPV infection rates were HPV 16,52,58,18 and 51.HSIL was not related to the type of HPV infection(P>0.05).Conclusion In patients with cervical intraepithelial neoplasia,the top five infected HPV subtypes were HPV16,52,58,18 and 51.HPV16 infection and cervical erosion are independent risk factors for HSIL.HSIL is not related to the type of HPV infection.