不同年龄层次宫颈癌患者高危型-HPV分型及阴道细菌感染情况分析

Analysis of high-risk HPV typing and vaginal bacterial infection in patients with cervical cancer of different ages

目的探讨不同年龄层次宫颈癌患者高危型人乳头状瘤病毒分型及阴道细菌感染情况,为临床诊治提供依据。方法回顾性分析108例宫颈癌患者的临床资料,比较不同年龄层次患者临床特征、高危型人乳头状瘤病毒感染情况及其分型分布情况,统计不同年龄层次患者阴道细菌感染情况。结果(1)临床特征:不同年龄层次患者初潮年龄、病理类型、临床分期、分化程度及有无肿瘤家族史比较差异无统计学意义(P>0.05),孕次及产次比较差异有统计学意义(P<0.01)。(2)高危型人乳头状瘤病毒感染情况:入组宫颈癌患者高危型人乳头状瘤病毒感染阳性69例(63.89%),不同年龄层次感染阳性率呈小幅度波动(58.33%vs 66.67%vs 60.61%),差异无统计学意义(P>0.05)。宫颈癌患者高危型人乳头状瘤病毒分型以16型、18型、58型居多,其中16型总感染率为52.78%,且感染率随着年龄的升高呈小幅度降低(66.67%vs 52.38%vs 48.48%),但差异无统计学意义(P>0.05);18型总感染率为9.26%,感染率在各年龄层波动不明显;HPV 31型、58型总感染率分别为4.63%、6.48%,但均未在22岁~35岁患者中发现;33型总感染率为0.93%,仅在≥50岁患者中检出;未检出其他分型。(3)阴道细菌感染情况:入组宫颈癌患者阴道检出细菌菌株64株,其中革兰氏阴性菌43株(67.19%),革兰氏阳性菌21株(32.81%),各年龄层次患者革兰氏阴性菌检出率(16.67%vs 42.86%vs 42.42%)及革兰氏阳性菌检出率(0%vs 19.05%vs 27.27%)存在小幅度波动,但差异无统计学意义(P>0.05)。结论宫颈癌患者高危型人乳头状瘤病毒及阴道细菌感染情况在不同年龄层次呈小幅波动,其关联有待扩大样本量进一步研究。

Objective To investigate the high-risk human papillomavirus(HR-HPV)typing and vaginal bacterial infection in cervical cancer patients of different ages,and to provide evidence for clinical diagnosis and treatment.Methods The clinical data of 108 patients with cervical cancer were retrospectively analyzed.The clinical characteristics,HR-HPV infection status and distribution of HR-HPV types were compared among patients of different ages,and the vaginal bacterial infection status in patients of different ages were recorded.Results(1)Clinical features:There were no statistical significances in age of menarche,pathological type,clinical stage,degree of differentiation and family history of tumor in patients of different ages(P>0.05).There were statistical significances in gravidity and parity in patients of different ages(P<0.01).(2)HR-HPV infection status:69 cases(63.89%)of the enrolled cervical cancer patients were HR-HPV positive,and the positive rate of infection in different age groups showed a small fluctuation(58.33%vs 66.67%vs 60.61%),with no statistical significance(P>0.05).Types of HR-HPV infection in cervical cancer patients were mainly 16,18 and 58,and the total infection rate of type 16 was 52.78%.The infection rate decreased slightly with increasing age(66.67%vs 52.38%vs 48.48%),with no statistical significance(P>0.05).The total infection rate of type 18 was 9.26%,and the infection rate did not fluctuate significantly among different age groups.The total infection rates of HPV 31 and 58 were 4.63%and 6.48%,respectively,but were not found in patients aged 22-35 years.The total infection rate of type 33 was 0.93%,which was detected only in patients no less than 50 years old.No other types were detected.(3)Vaginal bacterial infection status:64 strains of bacteria were detected in the vagina of cervical cancer patients,including 43(67.19%)Gram-negative bacteria and 21(32.81%)Gram-positive bacteria.There were slight fluctuations in the detection rate of Gram-negative bacteria(16.67%vs 42.86%vs 42.42%)and the detection rate of Gram-positive bacteria(0%vs 19.05%vs 27.27%)in patients of all ages(P>0.05),with no statistical significance(P>0.05).Conclusions The HR-HPV infection and vaginal bacterial infection of patients with cervical cancer fluctuate slightly among different age groups,and the correlation needs to be further demonstrated by expanding the sample size.