台州市宫颈癌筛查中高危型HPV的基因型别分析

Genotype analysis of high-risk HPV in cervical cancer screening in Taizhou City

目的了解分析台州市中心医院近5年体检妇女高危型人类乳头瘤病毒(HPV)的基因型别分布情况。方法选取2013年1月至2018年12月期间于台州市中心医院行宫颈癌体检筛查的1 556名40~59岁妇女为研究对象,行宫颈组织的HPV检测及病理活检,分析比较不同年龄和病理级别组高危型HPV基因型别分布情况。结果本研究1 556例受试者共检出高危型HPV273例,检出率为17.54%,其中HPV16的检出率最高(2.89%),其次为HPV52(2.25%);病理结果异常率为5.46%,其中宫颈上皮内瘤变(CIN)Ⅰ级44例(2.83%)、CINⅡ级及以上41例(2.63%);40~49岁年龄组中HPV16的检出率最高(3.90%),50~59岁组中HPV52检出率最高(2.39%),HPV16和HPV51的检出率在不同年龄组有统计学差异(χ^2=4.82,P=0.03;χ^2=5.57,P=0.02);50~59岁组(2.74%)患者多重感染检出率高于40~49岁组(1.25%),差异有统计学意义(χ^2=4.27,P=0.04);CINⅠ级组(18.18%)和CINⅡ级及以上组(29.27%)中HPV16的检出率最高,正常组HPV16、31、33、35、39、45、52、56、58、59、66、73、83的检出率明显低于CINⅠ级组和CINⅡ级及以上,差异均有统计学意义(P<0.05);正常组多重感染的检出率(1.50%)低于CINⅠ级组(11.36%)和CINⅡ级及以上组(12.20%),差异有统计学意义(χ^2=42.14,P=0.04)。结论高危型HPV的基因型别分布与年龄、宫颈组织病理级别有关,其中HPV16的变化最为显著,CIN患者HPV16的感染率较病理正常者明显升高。

Objective To analyze and understand the distribution of high-risk human papillomavirus(HPV) genotypes among women in Taizhou Central Hospital from 2013 to 2018.Methods 1 556 women aged 40-59 years and underwent cervical cancer physical examination and screening in Taizhou Central Hospital from January 2013 to December 2018 were selected as the subjects of study.The HPV detection and pathological biopsy were carried out in cervical tissues of all subjects to analyze and compare the distribution of high-risk HPV genotypes in different age and pathological grade groups.Results The 273 cases of high-risk HPV were detected in 1 556 subjects,with a detection rate of 17.54%,of which HPV16 was the highest(2.89%),followed by HPV52(2.25%).The abnormal rate of pathological results was 5.46%,including 44 cases of cervical intraepithelial neoplasia(CIN) grade Ⅰ(2.83%),41 cases of CIN grade Ⅱ and above(2.63%).The detection rate of HPV16 was the highest in the 40~49 age group(3.90%) and the detection rate of HPV52 was the highest in the 50~59 age group(2.39%).The detection rates of HPV16 and HPV51 in different age groups were statistically different(χ^2=4.82,P=0.03;χ^2=5.57,P=0.02).The detection rate of multiple infections in the 50~59 years group(2.74%) was higher than that in the 40~49 years group(1.25%),the difference was statistically significant(χ^2=4.27,P=0.04).The detection rate of HPV16 was the highest in CIN grade Ⅰ group(18.18%) and CIN grade Ⅱ and above group(29.27%),and the rate of HPV16,31,33,35,39,45,52,56,58,59,66,73,83 in the normal group was lower than that in the CIN grade Ⅰ group and the CIN grade Ⅱ and above group,and the difference was statistically significant(all P<0.05).The detection rate of multiple infections in the normal group(1.50%) was lower than that in CIN grade Ⅰ group(11.36%) and CIN grade Ⅱ and above group(12.20%),the difference was statistically significant(χ^2=42.14,P=0.04).Conclusion The genotype distribution of high-risk HPV was related to cervical tissue pathological grade and age.Among them,the change of HPV16 was the most significant,and the infection rate of HPV16 in CIN patients was significantly higher than that of patients with normal pathology.