甘肃省3995例门诊女性宫颈HPV 基因分型及感染特征分析

Infection and genotyping of cervical HPV among 3 995 outpatients in Gansu province

目的 分析及探讨甘肃省肿瘤医院妇瘤科门诊就诊女性人乳头瘤病毒(human papilloma virus, HPV)感染亚型及分布特征,为本地区有效防治宫颈癌提供病毒学及流行病学依据。方法 对2018年1月—2021年1月在甘肃省肿瘤医院妇瘤科门诊就诊的3 995例女性患者的宫颈脱落细胞样本进行荧光聚合酶链式反应(polymerase chainreaction, PCR)法23型HPV核酸分型检测,分析不同年龄组女性HPV感染率及感染模式、分型分布特征。结果 3 995例样本中23种HPV基因型均被检测到,HPV DNA总检出率为29.86%(1 193/3 995)。虽然各年龄组中40~<50岁组受检人数最多,占比43.80%,但不同年龄组之间患者HPV检出率差异无统计学意义(χ^(2)=2.74,P=0.602);在1 193例HPV感染患者中单一HPV感染占比最多,为68.99%(823/1 193);其次为双重感染,占比21.71%(259/1 193);多重感染最多检出六重感染;按多重感染分别计数排序,高危型HPV感染率由高到低排序前五位依次为:HPV16、52、58、53、18型;低危型HPV感染率由高到低排序前三位依次为:HPV42、81、6。不同年龄组按感染亚型排序前五位:20~<30岁组排序为HPV16、58、39、52、33型;30~<40岁组为16、58、52、53、42型;40~<50岁组为16、52、58、53、68型;50~<60岁组为16、52、58、51、53型;≥60岁组为16、52、58、53、42型;以高危型HPV感染为主。结论 本研究中HPV感染总检出率为29.86%,常见HPV感染亚型前五位排序为16、52、58、53、42型,以单一高危型感染为主,尤其是HPV16型在各年龄组感染率最高,且随着年龄的增加感染率逐渐增高,了解本地区HPV感染亚型及分布特征有利于当地宫颈癌的有效防治,为策略的制定及疫苗接种的选择提供理论依据。

Objective To understand the infection and genotyping of human papilloma virus(HPV) in female outpatients in gynecomatology department of Gansu Cancer Hospital, and to provide virologic and epidemiological evidence for effective prevention and treatment of cervical cancer in women. Methods A total of 3 995 samples of cervical exfoliated cells were collected from female outpatients in the gynecomatology department of Gansu Cancer Hospital from January 2018 to January 2021, and the genotypes of HPV were determined using fluorescence PCR method.The infection rates, infection patterns and genotype distribution of HPV were compared among different age groups. Results All 23 HPV genotypes were detected in 3,995 samples, the overall positive rate of HPV DNA was 29.86%(1 193/3 995).There were no significant differences in HPV detection rates among women in different age groups(χ^(2)~2=2.74, P=0.602).Single HPV infection accounted fo r 68.99%(823/1 193), 21.71%(259/1 193) were double infection.Some cases wereinfecte d with 6 typesof HPV.Based on the ranking number of HPV genotype of patients with multiple infe ctions,the top five high-risk HPV infectionrates from high to low were HPV16, 52, 58, 53, 18, while theto p three low-risk HPV infec tion rates from high to low were HPV42, 81, 6.The top five sub types of HPVwere HPV16, 58, 39, 52,33 in the age group of 20-<30 years old, HPV 16, 58, 52, 53 and42 in 30-<40 ag e group, HPV16, 52, 58, 53 and 68 in 40-<50 age group, HPV16, 52, 58, 51 and 53 in 5-<60 age group,HPV 16, 5 2, 58, 53 and 42i n women of ≥60 years old.High-risk HPVi nfection was predominant. Conclusions Theoverall prevalence of HPVi nfectioni n female outpatientsi s as high as 29.86%, with the top five subtypes of HPV 16, 52, 58, 53 and HPV 42.Single high-risk HPV infection is common, especially HPV16, which is fo und to be thetop one in all age groups, and the infection rate gradually increased with age.Understandingthe subtypes and distribution characteristics of HPVi nfection may helpi n the effective prevention and treatment of cervical cancer, and provide theoretical basis for the formulation of strategies and selectionof vaccination.