某三级综合医院妇科就诊患者人乳头瘤病毒感染情况分析

Analysis of human papillomavirus infection in gynecological patients in a tertiary general hospital

目的人乳头瘤病毒持续感染与宫颈癌的发生密切相关。本研究分析青岛市第三人民医院妇科就诊女性人乳头瘤病毒(human papilloma virus,HPV)的感染情况及亚型分布,为宫颈癌早期的有效预防和疫苗的研制提供数据支持。方法选取2016-01-01-2019-06-30在青岛市第三人民医院妇科就诊的女性患者共13136例,采集宫颈口鳞状上皮细胞交界处的脱落细胞,采用实时荧光定量PCR(real-time PCR,RT-PCR)技术,对6、11、16、18、26、31、33、35、39、45、51、52、53、56、58、59、66、68、73、81和82型共21种人乳头瘤病毒亚型进行检测,计算总体HPV感染的阳性率、HPV亚型分布及感染特征;计算不同年龄段分组HPV阳性率。结果在纳入研究的13136例样本中,感染例数为2364例,总感染率18.00%。单一型别感染例数为1774例,占总感染例数的72.34%。HPV高危型感染率前5位的分别为HPV16、HPV52、HPV58、HPV53和HPV56;低危型感染率最高的为HPV81型。不同年龄段患者HPV的感染率差异有统计学意义,χ^2=157.57,P<0.001。~25岁组感染率最高,随着年龄的增长,出现下降的趋势;~55岁组感染率最低,之后感染率又开始上升。结论青岛市第三人民医院妇科就诊患者人乳头瘤病毒感染以单一高危型为主。HPV感染率随着年龄的增加,出现先下降后回升,呈现为两头高、中间低的"U"字型趋势。

OBJECTIVE Persistent human papillomavirus infection is closely related to the occurrence of cervical cancer.This paper analyzed the infection and subtype distribution of human papilloma virus(HPV)in gynecological clinics in Licang District,Qingdao City by using molecular biology technology,in order to provide strong data support for the effective prevention of early cervical cancer and the development of vaccines.METHODS A total of 13136 female patients who seek medical advice were selected in the Department of Gynecology of the Third People’s Hospital of Qingdao from January 1,2016 to June 30,2019.Exfoliated cells at the junction of cervical squamous epithelial cells were collected.Realtime fluorescence quantitative polymerase chain reaction(RT-PCR)was used to detect 21 human papilloma virus subtypes(HPV 6,11,16,18,26,31,33,35,39,45,51,52,53,56,58,59,66,68,73,81,82).The overall HPV infection positive rate,HPV subtype distribution,infection characteristics and positive rate in different groups were analyzed.RESULTS Of the13136 samples included in the study,the number of infections was 2364,with a overall infection rate of 18.00%.The number of single type infection cases was 1774,accounting for 72.34%of the total infection cases.The top five subtypes of high-risk type HPV infection were:HPV16,HPV52,HPV58,HPV53 and HPV56.The highest infection rate for lowrisk type HPV was HPV81.The difference in HPV infection rate among patients of different age groups was statistically significant,χ^2=157.57,P<0.001.The infection rate was highest in the-25 group,and it declined with age.The infection rate was the lowest in the-55 group,and then the infection rate began to rise again.CONCLUSIONS The human papilloma virus infection in gynecological patients of Qingdao Third People’s Hospital is dominated by a single high-risk type.The infection rate of HPV decreases with age,and then rises,showing a trend of"U"shape with two ends high and the middle low.