新疆地区宫颈鳞状上皮内病变及宫颈癌患者中人乳头瘤病毒流行情况及基因型分布调查

Prevalence and genotype distribution of human papillomavirus in patients with cervical squamous epithelial lesions and cervical cancer in Xinjiang

目的了解新疆不同级别宫颈病变中人乳头瘤病毒(HPV)流行及基因型分布特点,为HPV亚型特异性筛查试验和新型多价HPV疫苗在中国人群中的开发提供依据。方法回顾性分析2015年1月至2019年6月新疆医科大学第一附属医院收治的1261例宫颈病变患者的临床资料。所有患者均采用HPV-DNA检测(PCR杂交基因芯片检测)及液基细胞学(LBC)进行宫颈癌筛查,发现异常,行阴道镜下宫颈活检确诊为宫颈病变。结果1261患者中包括154例浸润性宫颈癌(ICC),均为鳞状细胞癌(SCC),1107例宫颈鳞状上皮内瘤变(其中CIN1431例,CIN2322例,CIN3354例)。共833例患者HPV阳性,阳性率为66.06%。CIN1、CIN2、CIN3、ICC组HPV患病率分别为51.74%、68.63%、78.53%、72.08%。HPV16/58/52是所有CIN1~CIN3的主要贡献者,HPV16的患病率随着疾病严重程度的增加而增加。HPV16/58/18/52是ICC的主要贡献者。HPV16是主要的高危HPV(HR-HPV)基因型,占CIN1的31.39%,CIN2的42.99%,CIN3的75.18%,ICC的71.17%。结论新疆地区与宫颈病变相关的HR-HPV基因型是16、52、58、33、31、53和18,为开发适合中国的新型HPV预防性疫苗提供数据支持。

Objective To explore the prevalence and genotype distribution characteristics of human papillomavirus(HPV)in different grades of cervical lesions in Xinjiang,so as to provide basis for the development of HPV subtype specific screening test and new polyvalent HPV vaccine in the Chinese population.Methods The clinical data of 1,261 patients with cervical lesions admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2015 to June 2019 were retrospectively analyzed.All patients were screened for cervical cancer by HPV-DNA test(PCR hybridization gene chip test)and liquid-based cytology(LBC).If abnormalities were found,cervical lesions were confirmed by colposcopy cervical biopsy.Results The 1,261 patients included 154 cases of invasive cervical cancer(ICC),all of which were squamous cell carcinoma(SCC),and 1,107 cases of cervical squamous intraepithelial neoplasia(CIN1431 cases,CIN2322 cases,CIN3354 cases).A total of 833 patients were HPV positive,with a positive rate of 66.06%.The prevalence of HPV in the CIN1,CIN2,CIN3 and ICC groups was 51.74%,68.63%,78.53%and 72.08%,respectively.HPV16/58/52 is a major contributor to all CIN1~CIN3,and the prevalence of HPV16 increases with the increase of disease severity.HPV16/58/18/52 is a major contributor to the ICC.HPV16 is the main high-risk HPV(HR-HPV)genotype,accounting for 31.39%of CIN1,42.99%of CIN2,75.18%of CIN3 and 71.17%of ICC.Conclusions The HR-HPV genotypes associated with cervical lesions in Xinjiang are 16,52,58,33,31,53 and 18,providing data support for the development of new HPV prophylactic vaccines suitable for China.