塔城地区女性人乳头瘤病毒感染情况及其与子宫颈病变的相关性

Human papillomavirus infection and its correlation with cervical lesions among women in the Tacheng area

目的筛查塔城地区女性子宫颈人乳头瘤病毒(HPV)感染情况,探讨HPV感染与子宫颈上皮内瘤变之间的相关性。方法以2018年1月至2019年5月期间在中国医科大学塔城医院进行子宫颈癌筛查的826例女性为研究对象。对受检者子宫颈脱落细胞样本采用实时荧光PCR方法进行HPV核酸分型检测和液基薄层细胞学检查(TCT),对需要阴道镜进一步明确诊断的受检者进行病理活检,比较HPV感染率在不同程度子宫颈病变组之间的差异。结果在826例受检者中,HPV阳性率为15.5%(128/826),高危型(HR)HPV和低危型(LR)HPV感染率分别为13.1%(108/826)和2.4%(20/826);在HPV感染类型中,单一型、双重型和多重型人群感染率分别为10.1%、4.0%和1.5%;检出率较高的HR-HPV亚型为52、16、58、53和45。在>50~60岁年龄段和维吾尔族人群中HPV感染率较高;初潮年龄和结婚年龄越小,怀孕、流产和生育次数越多,感染率越高。早婚和多孕是感染的独立危险因素(OR=1.802,95%CI:1.159~2.803,P<0.05;OR=2.021,95%CI:1.089~3.753,P<0.05)。子宫颈细胞学、病理学诊断未见异常组和异常组HPV感染率比较,差异有统计学意义(OR=6.098,95%CI:1.870~19.886,P=0.03;OR=5.160,95%CI:1.647~16.167,P<0.01)。结论本研究提供了塔城地区总体HPV和高危型HPV流行特点的初步信息,将有助于HPV感染者的分层管理和精准治疗,减少罹患子宫颈内瘤变和子宫颈癌的发生。

Objective To investigate cervical human papilloma virus(HPV)infection distribution and incidence in the Tacheng area and to explore its correlation with cervical intraepithelial neoplasia.Methods A total of 826 cervical exfoliated cell samples were collected from January 2018 to May 2019 in the Tacheng Hospital of China Medical University,and HPV typing was performed using realtime PCR and TCT detection.Pathological biopsies were also performed for subjects who required further colposcopy.Furthermore,this study also compared the HPV infection rate among the cervical lesion groups of different degrees.Results From the 826 samples,15.5%(128/826)were HPV positive,in which the high-risk HPV(HR-HPV)and low-risk HPV(LR-HPV)positive rates were 13.1%(108/826)and 2.4%(20/826),respectively.Single,double,and multiple gene infection rates were 10.1%,4.0%,and 1.5%respectively.The more commonly detected HR-HPV subtypes were 52,16,58,53,and 45.HR-HPV infection distribution had the following characteristics:the Uygur ethnic women and women aged 50 to 60 years old had the highest HR-HPV positive rates;the earlier the age of menarche and marriage,the higher the HPV infection rate;the HPV positive rate rose with an increased number of pregnancies,abortions,and births.Univariate logistic analysis showed that early marriage and multiple pregnancy were independent risk factors of HR-HPV infection(OR=1.802,95%CI:1.159-2.803,P<0.05;OR=2.021,95%CI:1.089-3.753,P<0.05).The HPV infection rates were significantly different between the normal and abnormal groups in cervical cytology and pathology detection(OR=6.098,95%CI:1.870-19.886,P=0.03;OR=5.160,95%CI:1.647-16.167,P<0.01).Conclusion Our study provides preliminary information on the overall HPV and HRHPV epidemic status in the Tacheng area;it can improve the stratified management and precise treatment of HPV-infected patients and reduce the occurrence of intracervical neoplasia and cervical cancer.