上海城乡结合部女性宫颈HPV感染分布及其与宫颈病变的相关性研究

The distribution of cervical HPV infection of women in Shanghai urban-rural areas and its correlation with cervical lesions

目的分析上海城乡结合部女性宫颈人乳头瘤病毒感染分型分布及其与宫颈病变的相关性。方法选取2014年11月至2017年12月在上海市松江区属公立医疗机构进行女性宫颈HPV-DNA分型检测的154509例女性为研究对象,分析HPV感染基因型在研究对象中的年龄分布、人群分布、感染型别及其与宫颈病变的相关性。结果高危亚型15种和低危亚型11种HPV均有检出,HPV感染率为16.96%(26207/154509),感染年龄呈现双高峰趋势,以<20岁、55~69岁为高。高危型HPV(hr-HPV)感染率为14.61%(22572/154509),hr-HPV感染排列前6位依次是HPV16、58、52、51、68、39。低危型HPV感染率为4.27%(4612/107975)。流动人口感染率明显高于常住人口(P<0.001),城市与乡镇人口感染无明显差异。宫颈病变hr-HPV感染率为89.78%(1089/1213),低级别、高级别、宫颈癌组hr-HPV感染排列前四位分别为hr-HPV16、52、58、33,hr-HPV16、58、52、33,hr-HPV16、33、18、39。宫颈癌中以HPV16单病毒感染的鳞癌为主。结论上海城乡结合地区女性HPV感染以高危型、单一为主,年龄、常住与流动人口分布有差异,提示需关注流动人口女性的宫颈HPV筛查。高危病毒筛查需重点关注HPV16、52、58、33、39、18,尤其是HPV16型;低危病毒关注HPV40及54。

Objective To explore the distribution of human papilloma virus(HPV)infection in women of Shanghai urban-rural areas and its correlation with cervical lesions.Methods 154509 women who underwent cervical HPV types detection of Songjiang District of Shanghai public medical institution from November 2014 to December 2017 were selected,including 15 high-risk subtypes and 11 low-risk subtypes.The age distribution,population distribution,infection type and the correlation between HPV infection genotypes and cervical lesions were analyzed.Results There were 26 kinds of HPV types were detected,and the HPV infection rate was 16.96%.The age of infection presented a double peak trend,with<20 years old and 55~69 years old as high.The infection rate of high-risk HPV was 14.61%(22572/154509),and the top 6 HPV infection types were HPV16,58,52,51,68 and 39,respectively.The infection rate of low-risk HPV was 4.27%(4612/107975).The infection rate of floating population was significantly higher than that of permanent population(P<0.001),and there was no significant difference between urban popluation and town population.The high-risk HPV infection rate of cervical lesions was 89.78%(1089/1213),and the top four hr-HPV in low grade,high grade and cervical cancer group were hr-HPV16,52,58,33,hr-HPV16,58,52,33,hr-HPV16,33,18,39,respectively.The majority of cervical carcinoma was HPV16 squamous cell carcinoma.Conclusions The female HPV infection in Shanghai urban-rural areas are mainly high-risk and Single types,and the distribution of age,permanent residence and floating population are different,which,prompts the need to pay attention to cervical HPV screening for women in floating population.High-risk HPV screening should focus on HPV16,52,58,33,39 and 18,especially HPV16;Low-risk HPV screening should pay attention to HPV40 and 54.