已婚育龄妇女人乳头状瘤病毒感染的调查研究

Investigation of Human Papillomavirus Infection in Married Women of Childbearing Age

目的:探讨已婚育龄妇女人乳头状瘤病毒(HPV)感染情况及感染的相关因素。方法:选取本院体检中心2016年1月-2018年12月妇科体检已婚育龄妇女46463例,均采用美国Digene公司HPV第二代杂交捕获实验法检测HPV感染情况,风险人群采用阴道镜宫颈取材病理活检,分析已婚育龄妇女HPV感染、HPV分型及HPV感染与年龄、孕产次及阴道分泌物清洁度的关联。结果:本组46463例已婚育龄妇女HPV阳性1554例,其中低危型320例,高危型1482例,其中同时感染低危型及高危型248例,本组育龄妇女HPV阳性率为3.34%。子宫颈正常、子宫颈炎、CINⅠ级、CINⅡ级、CINⅢ级及子宫颈癌的HPV阳性率分别为0.26%、21.59%、35.46%、85.55%、93.04%、95.71%。子宫颈炎、CINⅠ级、CINⅡ级、CINⅢ级及子宫颈癌HPV阳性率均显著高于子宫颈正常组(P<0.001);子宫颈癌、CINⅡ级、CINⅢ级的HPV阳性率均显著高于子宫颈炎及CINⅠ级(P<0.05),子宫颈癌的HPV阳性率显著高于CINⅡ级(P<0.05)。不同年龄、孕次、阴道分泌物清洁度的HPV阳性发生率比较,差异均有统计学意义(P<0.001);20~25岁与31~35岁、36~40岁HPV阳性率比较,差异均有统计学意义(P<0.05);26~30岁与36~40岁HPV阳性率比较,差异有统计学意义(P<0.05)。孕0~2次的HPV阳性率显著低于孕3~4次、孕5~6次(P<0.05);孕3~4次HPV阳性率显著低于孕5~6次(P<0.05)。产0~2次的HPV阳性率显著低于产3~4次(P<0.05)。Ⅲ度、Ⅳ度HPV阳性率均显著高于Ⅰ度及Ⅱ度(P<0.05);Ⅳ度HPV阳性率显著高于Ⅲ度(P<0.05)。结论:HPV感染是子宫颈癌及癌前病变的重要条件,本地区已婚育龄妇女HPV感染以高危型HPV为主,HPV感染与年龄、孕产次及阴道分泌物清洁度密切相关。

Objective:To investigate the human papillomavirus(HPV)infection status and related factors of married women of childbearing age.Method:A total of 46463 married women of childbearing age were selected from the physical examination center of our hospital from January 2016 to December 2018.All HPV infections were detected by the HPV second-generation hybrid capture test method of the US Digene company.The risk groups were used colposcopy to obtain cervical materials Pathological biopsy.HPV infection,HPV typing and the relationship between HPV infection and age,times of pregnancy and delivery,and cleanliness of vaginal secretion in married women of childbearing age were analyzed.Result:Among 46463 married women of childbearing age,1554 cases were HPV positive,including 320 cases of low-risk type and 1482 cases of high-risk type,among which 248 cases were infected with both low-risk type and high-risk type.The positive rate of HPV among women of childbearing age was 3.34%.Normal cervix,cervicitis,CINⅠ,CINⅡ,CINⅢgrade and cervical cancer HPV positive rate were 0.26%,21.59%,35.46%,85.55%,93.04%,95.71%.The positive rates of HPV in cervicitis,CINⅠ,CINⅡ,CINⅢand cervical cancer were significantly higher than those in normal cervix group(P<0.001).The positive rates of HPV in cervical cancer,CINⅡand CINⅢwere significantly higher than those in cervicitis and CINⅠ(P<0.05).The positive rate of HPV in cervical cancer was significantly higher than that in CINⅡ(P<0.05).There were statistically significant differences in HPV positive rate among different age,pregnancy times and vaginal secretion cleanliness(P<0.001).The difference of HPV positive rate between 20 to 25 years old and 31 to 35 years old,36 to 40 years old was statistically significant(P<0.05).The difference of HPV positive rate between 26 to 30 years old and 36 to 40 years old was statistically significant(P<0.05).The positive rate of HPV in 0 to 2 pregnancies was significantly lower than that in 3 to 4 pregnancies and 5 to 6 pregnancies(P<0.05).The positive rate of HPV in 3 to 4 pregnancies was significantly lower than that in 5 to 6 pregnancies(P<0.05).The positive rate of HPV in 0 to 2 times was significantly lower than that in 3 to 4 times(P<0.05).The positive rates of HPV in gradeⅢandⅣwere significantly higher than those in gradeⅠandⅡ(P<0.05).The positive rate of HPV in gradeⅣwas significantly higher than that in gradeⅢ(P<0.05).Conclusion:HPV infection is an important condition for cervical cancer and precancerous lesions.HPV infections in married women of childbearing age in this area are mainly high-risk HPV infections.HPV infection was closely related to age,times of pregnancy and delivery and cleanliness of vaginal secretions.