1359例男性患者外生殖器HPV感染亚型分布及男女分型差异分析

Subtypes analysis of human papilloma virus infection in 1359 male patients and analysis of differences in male and female infection

背景男性人乳头瘤病毒(human papilloma virus,HPV)感染是男性生殖疾病的危险因素之一,应引起临床工作者的高度重视。目的探讨男性外生殖器HPV感染基因型分布情况,同时对不同性别流行状况进行差异分析。方法收集2017年1月-2019年9月北京大学第三医院皮肤科门诊送检的1359例男性外生殖器赘生物组织刮擦样本,对其进行15种高危HPV和低危型HPV6/11检测,检测结果分别与同期送检的858例女性外阴和5869例宫颈分泌物样本检测结果进行比较。男性患者年龄18~70岁,女性患者年龄18~68岁。结果1359例男性外生殖器样本中低危HPV6/11检出率最高(38.5%),男性外生殖器组与女性外生殖器组仅HPV6/11、52、45、33型检出率差异有统计学意义(P<0.05),男性外生殖器组HPV6/11、45型检出率高于女性,而HPV33、52型低于女性。男性外生殖器组与女性宫颈组除HPV33、52型差异无统计学意义,其余亚型均为男性检出率更高(P<0.05)。男性、女性高危HPV检出前4位均为16、51、52、58型。外生殖器多重高危感染中,仅二重感染率男性低于女性(P<0.05),其余多重感染构成差异无统计学意义;男性外生殖器组HPV单纯低危感染、低危高危混合感染检出率均高于女性宫颈组(P<0.05)。男性各年龄段HPV检出率中,仅≥51岁年龄段HPV阳性检出率高于31~40岁年龄段(P<0.05)。结论男性外生殖器高危HPV检出情况与女性外生殖器相似,但高于女性宫颈检出率。需重视男性外生殖器高危HPV筛查和预防。

Background Male human papillomavirus(HPV)infection is one of the risk factors of male reproductive disease,which has drawn attention from clinical workers for male HPV infection.Objective To investigate the subtypes analysis of human papilloma virus infection in 1359 males,and analyze the prevalence of different genders.Methods From January 2017 to September 2019,1359 scrape samples of male external genitalia were collected from dermatology outpatient department of Peking University Third Hospital.Totally 15 high-risk HPV subtypes and 1 low-risk HPV subtype were analyzed.The HPV distribution of male patients were further compared with HPV distribution of 858 female external genitalia and 5869 cervical secretions respectively.The male patients’age ranged from 18 to 70 years and the female patients were from 18 to 68 years.Results The positive rate of HPV6/11 was 38.5%in 1359 males,which was the highest in all the HPV subtypes.The infection rate was distinct between male external genitalia group and female external genitalia group for HPV subtype of HPV6/11,52,45 and 33(P<0.05).The detection rate of HPV6/11 and 45 in male external genitalia group was higher than those in female,while HPV33 and 52 were lower than those in female.The infection rate of the subtypes was significantly higher among male(P<0.05),except HPV33 and 52.The top four subtypes were HPV 16,51,52 and 58,both in male and female group.Among the multiple high-risk HPV infections of external genitalia groups,only the dual subtype infection rate was lower in men than that in women(P<0.05),and the remaining multiple infections constituted no statistical difference.However,compared with the female cervical group,the infection rate of low-risk infection and multiple risk mixed infection HPV in male external genitalia group was higher than those of female cervical group(P<0.05).The HPV positive rate was higher in age≥51 years group of male patients than that in cases with age 31-40 years(P<0.05).Conclusion The positive rate of high-risk HPV in male external genitalia is similar to that of female external genitalia,but higher than that of female cervical.Therefore,it is necessary to screen high-risk HPV in males.