677例基层医院就诊女性HPV感染情况分析

Analysis of HPV infection among 677 women in primary hospital

目的了解于本院就诊的女性人乳头状瘤病毒(HPV)感染状况,为预防和控制HPV感染,提高女性健康水平。方法选取2019年1月至2020年4月于本院体检的276名无临床症状女性作为健康对照组,94例阴道炎患者作为阴道炎组,202例慢性宫颈炎患者作为慢性宫颈炎组,70例宫颈癌前病变患者作为宫颈癌前病变组,35例宫颈癌患者作为宫颈癌组。将所有样本分为<20岁年龄组,20~<30岁年龄组,30~<40岁年龄组,40~<50岁年龄组,50~<60岁年龄组,≥60岁年龄组。宫颈癌前病变组根据病理检查结果分为宫颈上皮内瘤样变Ⅰ级(CINⅠ)、宫颈上皮内瘤样变Ⅱ级(CINⅡ)、宫颈上皮内瘤样变Ⅲ级(CINⅢ),分别为25、22、23例,经过严格操作取样后采用聚合酶链式反应(PCR)、核酸分子快速杂交方法(HCⅡ)检测HPV。比较各组及不同分型、不同年龄组的HPV感染情况。结果677例样本中HPV感染率为44.9%。阴道炎组HPV阳性感染率为36.2%,慢性宫颈炎组HPV阳性感染率为44.1%,宫颈癌前病变组HPV阳性感染率为74.3%,宫颈癌组HPV阳性感染率为65.7%,健康对照组HPV阳性感染率为38.4%,宫颈癌前病变组及宫颈癌组的HPV阳性感染率明显高于其余组HPV阳性感染率,差异有统计学意义(P<0.05);各组单一型HPV感染率分别为22.3%、25.7%、48.6%、45.7%、26.4%,多重型HPV感染率分别为13.8%、18.3%、25.7%、20.0%、12.0%,各组单一型HPV感染率和多重型HPV感染率比较,差异均有统计学意义(P<0.05)。各年龄组间HPV阳性率比较差异无统计学意义。CINⅠ、CINⅡ、CINⅢ3组HPV阳性感染率分别为60.0%、72.7%、91.3%,3组HPV阳性感染率比较,差异有统计学意义(P<0.05)。感染的HPV亚型分型中前5位分别为HPV16、HPV6、HPV52、HPV33、HPV81,例数分别为91、55、53、42、36例。结论HPV在本地区女性中的感染情况不容乐观;HPV感染与女性宫颈疾病,尤其是宫颈癌的发生、发展密切相关;加强HPV感染早期筛查对于宫颈炎性疾病和宫颈癌的预防和治疗具有重要的临床意义。

Objective To investigate the status of human papilloma virus(HPV)infection in women attending our hospital,so as to prevent and control HPV infection and improve women's health.Methods A total of 276 women without clinical symptoms who were examined in our hospital from January 2019 to April 2020 were selected as the healthy control group,94 patients with vaginitis as the vaginitis group,202 patients with chronic cervicitis as the chronic cervicitis group,70 patients with cervical precancerous lesions as the cervical precancer group,and 35 patients with cervical cancer as the cervical cancer group.All samples were divided into<20 years old age group,20-<30 years old age group,30-<40 year old age group,40-<50 years old age group,50-<60 year old age group,≥60 years old age group.According to the pathological examination results,the cervical precancerous lesion group was divided into cervical intraepithelial neoplasia gradeⅠ(CINⅠ),cervical intraepithelial neoplasia gradeⅡ(CINⅡ),cervical intraepithelial neoplasia gradeⅢ(CINⅢ),respectively,25 cases,22 cases and 23 cases,after strict operation and sampling,polymerase chain reaction(PCR)and nucleic acid molecular rapid hybridization method(HC)were used to detect HPV.The HPV infection of different groups,different types and age groups was compared.Results The HPV infection rate in 677 samples was 44.9%.The HPV-positive infection rate of the vaginitis group was 36.2%,the HPV-positive infection rate of the chronic cervicitis group was 44.1%,the HPV-positive infection rate of the cervical precancer group was 74.3%,the HPV-positive infection rate of the cervical cancer group was 65.7%,the HPV-positive infection rate of the healthy control group was 38.4%,and the HPV-positive infection rate of the cervical precancer group and the cervical cancer group was significantly higher than that of the other groups.The differences were statistically significant(P<0.05),the single-type HPV infection rates in each group were 22.3%,25.7%,48.6%,45.7%,and 26.4%,and the multi-severe HPV infection rates were 13.8%,18.3%,25.7%,20.0%,and 12.0%,respectively,and the single-type HPV infection rates and multi-severe HPV infection rates in each group were statistically significant(P<0.05).There was no significant difference in HPV positivity between the age groups.The HPV-positive infection rates of CINⅠ,CINⅡand CINⅢwere 60.0%,72.7%and 91.3%,respectively,and the differences in the positive infection rates of hpv in the three groups were statistically significant(P<0.05).The top 5 HPV subtypes were HPV16,HPV6,HPV52,HPV 33 and HPV 81,with 91,55,53,42 and 36 cases,respectively.Conclusion The infection situation of HPV in women in this region is not optimistic.HPV infection is closely related to the occurrence and development of cervical diseases in women,especially cervical cancer.Strengthening early screening for HPV infection is of great clinical significance for the prevention and treatment of cervical inflammatory diseases and cervical cancer.