2018—2020年宁夏地区女性人乳头瘤病毒感染者病毒分型与宫颈病变的分析

Analysis of virus typing and cervical lesions of human papillomavirus infected female patients in Ningxia from 2018 to 2020

目的了解宁夏地区妇女人乳头瘤病毒(human papillomavirus,HPV)感染分布特征及与宫颈病变的关系。方法选取2018—2020年接受宁夏宫颈癌筛查的140498例妇女,采用荧光PCR法检测女性宫颈脱落细胞,分析HPV感染特征以及与宫颈病变的关系。结果140498例筛查女性,高危型HPV总阳性数为13969人,阳性率为9.94%。2018—2020年HPV阳性检出率分别为9.84%、11.20%和9.61%。19个区县中HPV阳性率较高的地区是固原县(15.06%)和彭阳县(13.32%),HPV阳性率较低的地区是沙头坡区和利通区,阳性率分别为7.63%、7.54%。高危型HPV的阳性率随年龄呈"V"型分布,其中40~49岁年龄组的HPV阳性率最低(9.5%),各年龄组HPV阳性检出率差异具有统计学意义(χ^(2)=53.01,P<0.001)。各年龄组单一感染以HPV16为主,HPV16阳性率在4个年龄组分别为1.3%、1.3%、1.1%和1.0%。HPV多重感染中,≥60岁年龄组的阳性率最高(10.0%)。在宫颈高级别病变和宫颈癌中,以HPV16型别的感染为主(46.0%,63.6%),而低级别病变中,以其他16种高危HPV型别感染占比最高(60.8%)。不同宫颈病变中HPV感染类型的阳性检出率的差异具有统计意义学(χ^(2)=99.01,P<0.001)。结论宁夏回族地区女性人群的高危HPV阳性率属于中等水平;主要以高危型别的混合感染为主,单一感染中优势型别为HPV16;18种高危型别HPV感染最低的年龄组是40~49岁,HPV感染最高的年龄是大于等于60岁女性;在宫颈高级别病变和宫颈癌中,以HPV16单一感染为主。

Objective To investigate the distribution characteristics of human papillomavirus(HPV)different types infection in women in Ningxia and its relationship with cervical lesions.Methods A total of 140498 women who received cervical cancer screening in Ningxia from 2018 to 2020 were selected.Cervical exfoliated cells were detected by fluorescence PCR.The characteristics of HPV infection and its relationship with cervical lesions were analyzed.Results The total positive rate of high-risk HPV was 9.94%in 140498 screened women.The annual HPV positive detection rates from 2018 to 2020 were 9.84%,11.20%and 9.61%respectively.Among the 19 districts or counties,the areas with higher HPV positive rates were Guyuan County(15.06%)and Pengyang County(13.32%),and the areas with lower HPV positive rates were Shatoupo District and Litong District,with positive rates of 7.63%and 7.54%,respectively.The positive rate of HPV showed a"V"type distribution with age,with the lowest HPV positive rate in the age group of 40~49 years(9.5%),and there was a statistically significant difference in the HPV positive detection rate among the age groups(χ^(2)=53.01,P<0.001).HPV16 was the main single infection in all age groups,and the positive rates of HPV16 were 1.3%,1.3%,1.1%and 1.0%,respectively.Among multiple HPV infections,the age group≥60 years had the highest positive rate(10.0%).Among high-grade cervical lesions and cervical cancer,HPV16 infection was predominant(46.0%,63.6%),while among low-grade lesions,the other 16 HPV types accounted for the highest proportion(60.8%).The comparison of the positive detection rates of HPV infection types in different cervical lesions was significantly different(χ^(2)=99.01,P<0.001).Conclusions The high-risk HPV positive rate of female population in Ningxia Hui Autonomous Region is at a moderate level,and the dominant type of single infection was HPV16;the lowest age group of 18 high-risk HPV infections was 40-49 years,and the highest age of HPV infection was women aged 60 years;among high-grade cervical lesions and cervical cancer,HPV16 single infection was predominant.