青岛市部分地区女性HPV感染现状分析

CURRENT STATUS OF HUMAN PAPILLOMAVIRUS INFECTION AMONG WOMEN IN SEVERAL AREAS OF QINGDAO,CHINA

目的调查青岛市部分地区女性人乳头瘤病毒(HPV)感染的情况及其与宫颈病变的相关性分析。方法收集2019年6月—2020年5月在青岛大学附属医院进行HPV基因型检测的37267例女性的临床资料,研究对象按照年龄分为≤25岁组、26~35岁组、36~45岁组、46~55岁组和>55组。其中2651例进行宫颈活检及病理学检查,按照病理学分级分为慢性宫颈炎组、低级别鳞状上皮内病变(LISL)组、高级别鳞状上皮内病变(HISL)组和宫颈癌组。分析受检者HPV感染情况,并比较各年龄组、不同病理学分级组HPV感染情况,分析HPV多重感染与宫颈病变的相关性。结果37267例女性中HPV和高危型HPV(HR-HPV)阳性率分别为24.1%和20.5%;其中≤25岁组HPV阳性率最高,其次是>55岁组。LISL组、HSIL组和宫颈癌组中HR-HPV阳性率显著高于慢性宫颈炎组(q=4.27~11.67,P<0.05)。活检患者中HPV多重感染率随宫颈病变病理学分级升高呈线性下降的趋势(χ_(趋势)^(2)=4.35,P<0.05)。所有研究对象中阳性率居前3位的HR-HPV基因型分别为HPV52、HPV16以及HPV53。结论青岛部分地区女性HPV易感年龄呈低龄和高龄双峰分布,以HPV52、HPV16和HPV53为最常见HR-HPV基因型;HR-HPV感染与宫颈病变密切相关,但HPV多重感染可能无促进宫颈病变进展的作用。

Objective To investigate the current status of human papillomavirus(HPV)infection and its association with cervical lesions among women in several areas of Qingdao,China.Methods Clinical data were collected from 37267 women who underwent HPV genotyping in The Affiliated Hospital of Qingdao University from June 2019 to May 2020,and according to age,they were divided into≤25 years group,26-35 years group,36-45 years group,46-55 years group,and>55 years group.Among these women,2651 underwent cervical biopsy and pathological examination,and according to pathological grade,they were divided into chronic cervicitis group,low-grade squamous intraepithelial lesion(LSIL)group,high-grade squamous intraepithelial lesion(HSIL)group,and cervical cancer group.The prevalence of HPV infection was analyzed for all women,and HPV infection was compared between different age groups and pathological grade groups to analyze the association between HPV multiple infection and cervical lesions.Results For the 37267 women,the positive rates of HPV and high-risk HPV(HR-HPV)were 24.1%and 20.5%,respectively,and the≤25 years group had the highest positive rate of HPV,followed by the>55 years group.The LSIL group,the HSIL group,and the cervical cancer group had a significantly higher positive rate of HR-HPV than the chronic cervicitis group(q=4.27-11.67,P<0.05).For the women who underwent biopsy,the HPV multiple infection rate showed a trend of linear reduction with the increase in the pathological grade of cervical lesions(χ_(trend)^(2)=4.35,P<0.05).The top three HR-HPV genotypes in terms of positive rate were HPV52,HPV16,and HPV53 in all women.ConclusionThe susceptible age of HPV among women in Qingdao shows a bimodal distribution of young age and old age,and HPV52,HPV16,and HPV53 are the most common genotypes.HR-HPV infection is closely associated with cervical lesions,while HPV multiple infection may not promote the progression of cervical lesions.