南充地区女性高危型HPV感染及其导致的宫颈病变现状分析

Analysis of high-risk HPV infection and its cervical lesions in women in Nanchong area

目的 了解南充地区高危型人乳头瘤病毒(HPV)的感染率、主要亚型和年龄分布特征,及阳性感染者确诊为宫颈癌及癌前病变的发生率、感染亚型与年龄分布特征。方法 选取2018年1月至2020年5月在南充市中心医院门诊、健康体检和住院部就诊且自愿进行高危型HPV型别筛查的受试者为研究对象,采集其宫颈细胞,以实时荧光PCR对所采标本进行15种高危型HPV分型检测,并对阳性感染者进行为期三年的随访,收集确诊为宫颈癌及癌前病变的病例。结果 11 202例受试者中,共有2 248例为HPV阳性感染者,阳性检出率为20.1%,以≥60岁者最为高发,其次为<20岁(23.3%)和50~59岁(22.0%)。阳性感染者以单一感染为主(76.6%),其次为双重感染(18.0%);感染前五位的亚型分别是HPV 52、16、58、51和39型,主要分布于40~49岁患者中。2 248例HPV阳性感染者中,有162例(7.2%)被确诊为宫颈癌及癌前病变;确诊者以单一感染为主(74.7%),主要感染亚型为16、58和52型,主要发生于40~49岁妇女(39.5%)。结论 本研究明确了南充地区HPV感染的流行病学特征,为南充市HPV感染的防控及疫苗的接种工作提供了理论依据和科学指导。

Objective To analyze the infection rate, gene subtype and age distribution of high-risk human papillomavirus(HPV),as well as the infection rate, gene subtype and age distribution of HPV-positive infection diagnosed with cervical cancer or precancerous lesions in Nanchong area.Methods From January 2018 to May 2020,the subjects who visited the outpatient department, health examination and inpatient department of Nanchong Central Hospital and voluntarily screened for high-risk HPV types were selected as the research objects.The cervical cells were collected and tested for 15 high-risk HPV types by real-time fluorescent polymerase chain reaction(PCR).The HPV-positive infection was followed up for three years, and the cases diagnosed with cervical cancer and precancerous lesions were collected.Results Among the 11,202 subjects, a total of 2,248 were HPV-positive infection, with a positive detection rate of 20.1%.The highest incidence was in those aged≥60 years old, followed by those aged<20 years old(23.3%) and 50-59 years old(22.0%).The positive infection was mainly single infection(76.6%),followed by dual infection(18.0%).The top five subtypes of HPV were 52,16,58,51 and 39,which are mainly distributed in patients aged 40-49 years.Among the 2248 cases of HPV-positive infection, 162 cases(7.2%) were diagnosed with cervical cancer and precancerous lesions.The diagnosed cases were mainly single infection(74.7%) and occurred in women aged 40-49 years(39.5%),and the main subtypes of HPV were 16,58 and 52.Conclusion The study clarified the epidemiological characteristics of HPV infection in Nanchong, and provided theoretical basis and scientific guidance for the prevention and control of HPV infection and vaccination in Nanchong.