高危型HPV感染分布及其在宫颈细胞学病变中的作用

Distribution of high risk types of infected HPV and its role in cervical cytological lesions

目的研究妇科门诊妇女高危型人类乳头瘤病毒(hrHPV)感染的亚型分布状况,并探讨其与宫颈薄层液基细胞学检测(TCT)结果之间的相关性。方法选择2017年1月-2018年9月在本院妇科就诊并检测hrHPV患者1984例作为研究对象,分析其高危亚型分布状况。选择其中同时进行TCT检测的患者1081例,研究hrHPV与TCT结果之间的相关性,并探讨hrHPV亚型在TCT阳性患者中分布状况。结果 1984例患者中hrHPV基因阳性有478例(24.09%),且此478例hrHPV阳性患者的亚型分布占前五位的一次为16、52、58、39、56型,占比分别为21.01%(120/478)、19.44%(111/478)、19.26%(110/478)、10.04%(48/478)和9.00%(43/478)。hrHPV阳性组和阴性组TCT的阳性率分别为30.08%(74/246)和7.90%(66/835);TCT阳性组和阴性组hrHPV阳性率分别为52.86%(74/140)和18.28%(172/941),两组分别比较,差异有统计学意义(χ^2=82.90,P<0.05)。140例TCT阳性患者hrHPV亚型阳性率排前五位是16、58、52、39和56型,阳性率分别为14.28%(20/140)、13.57%(19/140)、12.14%(17/140)、5.00%(7/140)和5.00%(7/140)。结论高危型人类乳头瘤病毒亚型分布存在地区差异;高危型人类乳头瘤病毒感染是导致宫颈薄层液基细胞学病理学改变的因素之一,且其亚型分布与就诊患者的亚型分布基本一致。

Objective To study the distribution of sub-types of hrHPV(high risk human papillomavirus) infection in women in Tongling area, and to explore its correlation with the results of TCT(Thinprep cytology test).Methods FromJanuary 2017 to September 2018, 1984 cases of patients those visited the department of gynecologyTongling people’s hospital and revived the detection of hrHPV were enrolled in the study, and the distribution of high-risk sub-types was analyzed. One thousand and eighty-one patients who underwent TCT test were selected to study the correlation between hrHPV and TCT results, and to explore the distribution of HR-HPV sub-types in TCTpositive patients.Results 478 out of the 1984 cases of patients were positive in hrHPV gene test, the positive rate reached 24.09%. Among the 478 cases of hrHPV positive patients the top fivesub-types of the hrHPV were 16, 52, 58, 39, 56 type, contribute to 21.01%(120/478), 19.44%(111/478), 19.26%(110/478), 10.04%(48/478) and 9.00%(43/478), respectively. Positive rate of TCT in hrHPV positive and negative groups were 30.08%(74/246) and 7.90%(66/835), hrHPV positive rate in TCT positive and negative groups were 52.86%(74/140) and 18.28%(172/941), the two groups were compared and the difference was statistically significant(χ^2=82.90,P<0.05). The top five sub-typesof hrHPVin the 140 TCTpositive patients were types 16, 58, 52, 39 and 56, contribute to 14.28%(20/140), 13.57%(19/140), 12.14%(17/140), 5.00%(7/140) and 5.00%(7/140), respectively.Conclusions There are regional differences in the distribution of hrHPV sub-types. High-risk human papillomavirus infection is one of the factors leading to the pathological changes of cervical thinprep cytology, and its sub-type distribution is basically consistent with the sub-type distribution of the patients in the clinic.