成都市9142例女性HPV感染状况、亚型分布及与宫颈病变的关系分析

Relation of Cervical Lesions to HPV Incidence and Genotypes:A Study of 9,142 Females in Chengdu

目的:分析成都市9142例女性人乳头瘤病毒(human papillomavirus,HPV)感染状况、基因亚型分布特征及与宫颈病变的关系,为预防HPV感染及宫颈病变和宫颈癌的防治提供参考。方法:收集2015年1月至2019年12月我院妇科9142例女性就诊者的宫颈分泌物,采用PCR荧光探针法进行HPV基因分型检测,分析HPV感染率、基因亚型分布及年龄分布特征,并比较不同HPV基因亚型与宫颈鳞状上皮内病变的关系。结果:HPV感染率为20.91%,单一HPV感染有1502例(78.23%);多重感染占21.77%。23种HPV基因亚型均有检出,检出率最高的前5位HPV亚型依次为HPV52、16、53、58、51,均为高危亚型。各年龄组感染率呈“V”形分布,HPV感染率的年龄分布之间,差异有统计学意义(χ^2=86.038,P<0.001)。在单一感染患者中,≥55岁组感染率最高(24.00%),其次为25~29岁组(17.51%);在多重感染患者中,<25岁组感染率最高(14.71%),其次为≥55岁组(10.50%)。高危亚型的HPV感染者发生宫颈鳞状上皮内病变的比例明显高于低危亚型HPV感染者[45.92%(759/1653)vs 26.25%(68/259);χ^2=35.267,P<0.001]。结论:成都市女性HPV感染率较高,年龄分布以<25岁组和≥55岁组感染率最高,感染率排在前5位的基因亚型依次为HPV52、16、53、58、51,均为高危亚型,高危亚型HPV感染患者发生宫颈鳞状上皮内病变的风险较低危亚型更高。

Objective:To investigate the relation of cervical lesions to human papillomavirus(HPV)incidence and genotypes based on data of 9,142 female patients in Chengdu,and provide reference for the prevention and treatment of HPV infection,cervical lesions and cervical cancer.Methods:Cervical secretion of 9142 women treated in Chengdu Tianfu New Area People’s Hospital from January 2015 to December 2019 were collected,and HPV genotypes were identified by fluorescent probes.Incidence of HPV infection,distribution of genotype and age were analyzed,and the relationship between different HPV genotypes and cervical squamous intraepithelial lesions was compared.Results:The incidence of HPV was 20.91%,including 78.23%(1,502 cases)of single HPV infection and 21.77%of multiple HPV infection.All of the 23 HPV genotypes were detected.The top five HPV genotypes were HPV-52,HPV-16,HPV-53,HPV-58 and HPV-51,all of which were high risk.There was a significant difference in the age distribution of HPV infection rates(χ^2=86.038,P<0.001).Among patients with single infection,the infection rate of the age group≥55 was the highest(24.00%),followed by that of the age group 25-29(17.51%).Among patients with multiple infection,the infection rate of the age group<25 was the highest(14.71%),followed by that of the age group≥55(10.50%).The incidence of cervical squamous intraepithelial lesions in high-risk subtypes was significantly higher than that in low-risk subtypes[45.92%(759/1653)vs 26.25%(68/259);χ^2=35.267,P<0.001].Conclusion:The infection rate of HPV in women in Chengdu is relatively high.The highest infection rate is in the age group<25 and the age group≥55.The top five subtypes of HPV infection are HPV-52,HPV-16,HPV-53,HPV-58 and HPV-51,all of which are high-risk subtypes.The risk of cervical squamous intraepithelial lesions in high-risk HPV types is higher than that in low-risk subtypes.