广州地区6493例女性生殖道人乳头状瘤病毒检测结果分析

目的了解广州地区妇女生殖道人乳头状瘤病毒感染状况和基因亚型分布。方法 2006年10月至2010年2月,采用核酸分子快速导流杂交基因芯片分型技术(HybriMax)对广州地区6493例女性进行人乳头状瘤病毒检测,并对HPVDNA亚型、感染率和年龄分布进行分析。结果 6493例女性中检出HPV阳性1947例,阳性率为29.99%。阳性感染者中,单一型感染最多,为1436例,占73.75%,其中高危单一型感染者1143例,占58.71%,低危单一型感染者293例,占15.05%;混合型感染者511例,占26.25%,主要为双重感染,占19.41%。15个与宫颈癌密切相关的HPV高危亚型阳性率为25.24%,6个低危亚型HPV感染阳性率为7.98%。排在前十位的亚型分别是HPV52(25.22%)、HPV58(14.20%)、HPV16(13.56%)、HPV6(9.76%)、HPV11(8.32%)、HPV53(7.70%)、HPV33(6.73%)、CP8304(6.68)、HPV68(6.63)、HPV18(6.52%)。在各年龄组中,小于20岁女性感染率最高,为52.5%,各年龄组HPV感染差异有统计学意义...     

重庆地区29580例女性人乳头瘤病毒感染分布特点分析

目的:研究人乳头瘤病毒(HPV)感染在重庆地区的年龄分布及地理分布等特征,获得重庆地区HPV感染的型别分布特点及优势型别。方法:2010年11月至2015年9月在重庆市40个区县随机抽取有性生活的妇女29580例,进行HPV检测,对感染型别、年龄分布、单一感染及多重感染的情况进行统计。结果:129580例女性中HPV感染率为7.35%,高危型感染位居前6位的依次为HPV16、51、58、68、56、18型。2各年龄段HPV感染率及多重感染构成比呈现"U"形走势。3性伴侣个数及初次性生活年龄与HPV感染率有关(P0.01)。4城区妇女HPV感染率高于郊区(P0.01)。结论:应根据当地HPV感染分布特点,因地制宜制定防控宫颈癌的措施。     

南宁市妇女人乳头瘤病毒感染的流行病学调查

目的：了解南宁市妇女高危型人乳头瘤病毒（HR-HPV）的感染情况及其分布特点,初步探讨HR-HPV感染的相关因素。方法：2009年1月—2011年12月,采用整群抽样的方法,在南宁市抽取3 902例有性生活史的妇女进行妇科检查、宫颈HR-HPV检测,并进行问卷调查。应用SPSS13．0统计软件进行相关统计分析。结果：①南宁市18～73岁妇女HPV感染率为23.9％。②HPV感染的年龄分布特点：＜20岁年龄段感染率最高,为91.3%,25～49岁年龄段的感染率约为20％,处于较稳定的水平,不同年龄组HPV感染率差异有统计学意义（χ2=170.404 3,P =0.000）。不同职业及不同民族妇女HPV感染率差异无统计学意义（均P＞0.05）。③南宁市妇女的HPV感染以52, 16,58和18型为主,而多重感染百分率为36.3%,均为高危型多重感染或高危型合并低危型多重感染。结论：南宁市不同年龄妇女的HPV感染率存在差异,其感染的危险因素为多个性伴者、妊娠分娩数＞1,对HPV持续阳性的妇女应加强监测,以早期发现宫颈病变及宫颈癌。     

人乳头状瘤病毒与妇科其他常见病原微生物感染关系的调查

目的 探讨人乳头状瘤病毒(HPV)感染与妇科其他常见病原微生物感染的关系.方法 收集2007年6月至2008年12月在浙江省温岭市第一人民医院妇科门诊就医的857例妇女的宫颈和阴道拭子标本,采用PCR技术检查HPV DNA及其基因分型,采用链替代扩增方法检测沙眼衣原体,其他妇科病原微生物的检测按照常规方法进行,统计分析结果资料.结果 本研究收集的857例妇女中检测出HPV阳性266例,阳性率为31.0%(266/857).在266例HPV阳性妇女中,除4例为混合基因型,其余262例共检测出35种HPV的不同亚型,各亚型按所出现频率>5%排列,分另是HPVl6(14.5%,38/262)、HPV58(9.2%,24/262)、HPV53(8.0%,21/262)、HPV42(6.1%,16/262);HPV高危型和可能高危型占58.8%(154/262),HPV低危型占27.9%(73/262),HPV未知危险型占13.4%(35/262).宫颈脱落细胞检测结果显示,63.2%(168/266)的HPV阳性妇女未见异常细胞,3.8%(10/266)是高度鳞状上皮内病变(HSIL),29.7%(79/266)是低度鳞状上皮内病变(LSIL),3.0%(8/266)是未明确诊断意义的不典型鳞状上皮细胞(ASCUS).在所有研究对象中未检测出淋病奈瑟菌,人型支原体在所有研究对象中仅检测出2例.logistic回归分析显示,HPV感染与沙眼衣原体和解脲支原体[>10000颜色变化单位(CCU)/ml]感染具有显著相关性(P均<0.01),而细菌性阴道病、无乳链球菌、假丝酵母菌、阴道毛滴虫和解脲支原体(≤l0000 CCU/ml)与HPV感染无相关性(P均>0.05);但患细菌性阴道病妇女的HPV阳性率为42.6%.沙眼衣原体是HPV感染的高危因素(OR=2.82,95%CI为1.74～4.57).结论 细菌性阴道病与HPV感染虽不具有相关性,但其在HPV阳性妇女中普遍存在.HPV感染与沙眼衣原体和解脲支原体感染具有相关性;沙眼衣原体感染会增加HPV感染的机会.     

云南省德宏州各民族子宫颈人乳头瘤病毒感染相关因素分析

目的 探讨人乳头瘤病毒（HPV）感染现状及相关影响因素，为制定云南省德宏州相应预防HPV感染策略提供证据支持。方法 选取2021年11月至12月德宏州芒市及梁河地区765例女性（包括阿昌族、傣族、德昂族、汉族、景颇族、傈僳族）进行子宫颈HPV检测，分析HPV感染相关因素，包含年龄、民族、吸烟史、性伴侣数、初次性生活年龄、流产次数、分娩次数、居住地、子宫颈柱状上皮外移情况；对有意义的因素进行多因素logistic回归分析。结果 765例女性HPV总体人群感染率为10.8%（83/765），其中阿昌族感染率为8.7%（8/92），傣族感染率为11.6%（16/138），德昂族感染率为13.9%（20/144），汉族感染率为11.7%（17/145），景颇族感染率为8.7%（15/172），傈僳族感染率为9.5%（7/74）。影响HPV感染的相关因素包括性伴侣数（χ2=5.848,P<0.05）和子宫颈柱状上皮外移（χ2=5.646,P<0.05）；进一步行多因素logistic回归分析提示：性伴侣数（OR=1.943）及子宫颈柱状上皮外移情况（OR=1.723）均为HPV感染的...     

2006-2008年北京地区25～54岁育龄妇女HPV亚型感染状况的调查

目的 调查北京地区25～54岁育龄妇女生殖道HPV亚型的感染状况.方法 从2006年9月-2008年12月,对在北京城市和乡镇居住的5552例妇女以每5岁为一个年龄段进行了 以人群为基础的横断面抽样调查,主要进行流行病学问卷调查、宫颈脱落细胞涂片液基薄层细胞学检查(TCT)和基因芯片HPV亚型检测.结果 HPV总感染率为6.68%(371/5552),高危型HPV感染率为5.76%(320/5552),低危型HPV感染率为2.00%(111/5552).常见的HPV亚型为16型(2.61%,145/5552)、58型(0.97%,54/5552)、33型(0.85%,47/5552)、43型(0.74%,41/5552)和56型(0.70%,39/5552).人群感染高峰年龄段为30～34岁(8.21%,82/999)和40～44岁(7.48%,86/1150).结论 北京地区妇女常见HPV亚型为高危型16、58、33型及低危型43型,并且存在两个年龄段感染高峰.

Abstract：

Objective To investigate subtype of HPV infection among women at age of 25 to 54 years in Beijing. Methods From Sept. 2006 to Dec. 2008, 5552 reproductive women at age of 25 to 54 years classified into each 5-year as group were screened. Each participant completed a questionnaire and a sample of exfoliated cervical cells for liquid-based cytology and HPV subtype gene testing was performed.Results The overall prevalence of HPV was 6.68% (371/5552). High-risk HPV and Low-risk HPV prevalence were 5.76% (320/5552) and 2.00% (111/5552), respectively. The most common HPV types were HPV16 (2.61%, 145/5552), HPV58 (0. 97%, 54/5552), HPV33 (0.85%, 47/5552), HPV43 (0.74% ,41/5552) and HPV56(0.70% ,39/5552). There were two peaks of HPV prevalence: groups of 30 -34 years and 40 -44 years. Conclusion The most common HPV subtypes in Beijing were HPV 16,58, 33 and 43 and HPV prevalence showed a bi-medal age-specific curve.     

2285例女性下生殖道人乳头状瘤病毒感染筛查结果分析

目的探讨门诊就诊的高危人群人乳头状瘤病毒(HPV)感染的型别分布和年龄特征.方法 2004-10-2005-11采用核酸分子快速杂交分型技术,对2285例于北京大学第一医院妇产科门诊就诊妇女进行生殖道21种HPV亚型感染筛查.结果 HPV总感染率57.1%(1305/2285),21种型别均被检出,感染率最高的型别是HPV16,其他常见型别依次为58、52、53、33、6、CP8304、11、31和18型,高危型感染41.0%,低危型7.2%,多型感染8.9%.2285例HPV感染高峰年龄在30～34岁(11.3%),40～44岁年龄段下降到7.6%,各年龄段HPV感染检出率差异有显著性意义(P＜0.01).结论门诊高危人群HPV感染率57.1%,常见型别为HPV16、58、52、53、33、6、CP8304、11、31和18型;人群感染高峰在30～34岁年龄段.     

福建闽东地区畲族妇女宫颈HPV感染的检测

目的对福建闽东地区畲族妇女进行宫颈人乳头状瘤病毒(HPV)亚型感染的筛查,以探讨其分布规律。方法采用核酸分子杂交分型技术,对闽东地区19～73岁有性生活的畲族妇女进行宫颈HPV基因分型检测。结果165例样本中,HPV感染者41例,整体感染率24.85%。检出10种高危型HPV(HPV-16,18,31,33,45,52,56,58,59,68)34例,感染率为20.61%(34/165例);检出4种低危型HPV(HPV-6,53,44,CP8304)7例,感染率为4.24%(7/165例)。单一亚型占78.05%(32/41例),双重或多重亚型占21.95%(9/41例),以二重感染多见。感染率居前3位的是:HPV-52(8.48%)、HPV-58(5.45%)、HPV-16(4.85%)。结论闽东地区畲族妇女HPV感染率和多重感染比例均较高,以高危型HPV52型感染最多,HPV感染亚型分布有一定的区域性,值得关注。     

高危型人乳头状瘤病毒感染的自然清除状况分析

目的 研究宫颈病理结果正常而高危型人乳头状瘤病毒(HPV)检测阳性的妇女HPV感染的自然清除情况.方法 选取2006年8月至2008年8月于上海市长宁区妇幼保健院门诊行高危型HPV检测结果阳性、而宫颈病理检查结果为正常的妇女,随访HPV感染状态(随访时间中位数为11.6个月),分析HPV感染自然清除所需的时间及相关影响因素.结果 入选本研究的妇女共172例,平均年龄(34±10)岁(18～62岁);随访过程中有107例(62.2%,107/172)HPV感染自然清除,总体HPV感染自然清除时间的中位数为11.3个月(95%CI为10.6～16.6个月).不同年龄组中,<30岁、30～39岁、40～49岁、>49岁妇女HPV感染清除时间的中位数分别为11.3、12.0、10.9和8.5个月,4者比较,差异无统计学意义(P=0.384).HPV感染自然清除妇女的病毒相对拷贝数中位数为22.6,HPV持续阳性者为95.0,两者比较,差异无统计学意义(P=0.061).结论 宫颈病理结果正常且高危型HPV检测阳性的妇女在无临床干预的情况下,大部分的HPV感染能自然清除,年龄、病毒拷贝数对HPV感染自然清除无明显影响.     

HPV亚型在宫颈疾病中的分布特点

目的:探讨HPV亚型在宫颈疾病谱中,即从正常宫颈(慢性宫颈炎)、宫颈上皮内瘤变(CINⅠ、CINⅡ和CINⅢ)到宫颈癌连续发展中的分布特点。方法:回顾分析2005年6月～2008年6月在我院妇科因宫颈疾病就诊的189例患者HPV亚型检测的结果。结果:HPV总感染率56.1%(106/189),复合感染率22.6%(24/106)。正常者HPV感染率19.1%(12/63),检测到的HPV亚型主要是HPV52,58,53,16和33。CINⅠ者HPV感染率57.9%(22/38),最常见的HPV亚型是HPV52,其次是HPV58,16,33和18。CINⅡ者HPV感染率70.5%(31/44),HPV52,16,58,33和18等亚型最常见。CINⅢ者HPV感染率89.3%(25/28),HPV亚型以HPV16,52,58,31,33为主。宫颈癌患者,HPV阳性率100%(16/16),HPV16检测率最高,其次是HPV18,52,58和33。结论:宫颈疾病谱中最常见的高危型HPV亚型是HPV16。不同宫颈病变中HPV亚型感染的差异可能反映了其潜在转归能力,同时提示临床医师应关注宫颈疾病患者高危HPV亚型情况。     

Risk factors for cervical cancer in China: a case-control study

OBJECTIVES: To determine the prevalence of human papillomavirus types and investigate the risk factors for cervical cancer in Hubei, China. METHODS: We conducted a case-control study to investigate risk factors. RESULTS: HPV DNA was detected in 94.55% of patients with cervical carcinoma, and 23.64% of control subjects. The most common HPV type in cervical cancer was HPV type 16 (81.82%), followed by HPV 58 (6.36%). HPV infected patients have a higher risk of developing cervical carcinoma, which is 75.79 times more than non-infected people. The other risks were age at first intercourse (p = 0.017) and number of live births (p = 0.032). A history of previous cytologic screening was associated with a substantial reduction in risk (p = 0.001). CONCLUSIONS: The three principal reasons that Hubei has a high rate of women developing cervical carcinoma are HPV infection, age at first sexual intercourse and number of live births. Cervical cytology screening provides efficacious protection.     

High- and Intermediate-Risk Human Papillomavirus Infection in Sexually Active Adolescent Females

STUDY OBJECTIVE: To determine the prevalence of high- and intermediate-risk type human papillomavirus (HPV) infection and cervical dysplasia in an urban Swiss adolescent population attending the local Adolescent Clinic, using a liquid-based Pap test combined with risk type HPV DNA testing. To determine the prevalence of Chlamydia trachomatis in the same study population. DESIGN: Observational study. SETTING: The Adolescent Clinic of the Department of Obstetrics and Gynaecology at the University Clinic, Geneva, Switzerland. PARTICIPANTS: 134 women between 14 and 20 years of age were enrolled in the study. MAIN OUTCOME MEASURES: A standardized patient file on demographic and sexual history information was compiled and completed by physical examination, including a Pap test with adjunct high- and intermediate-risk type HPV DNA detection. RESULTS: Of the 134 specimens analyzed for HPV, 115 patients were negative and 19 (14.2%) were positive for HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, or 68. A significant association between HPV infection and having had more than one lifetime sexual partner was found (P <.05). Six (31.6%) of the HPV-positive and three (2.6%) of the HPV-negative specimens had a low-grade squamous intraepithelial lesion (SIL) by cytology. Abnormal Pap test was related to HPV infection (odds ratio, 46.2; 95% confidence interval, 7.4 to 287.4) and, inversely, to age at first sexual intercourse (odds ratio, 0.98; 95% confidence interval,.97 to 1.0). CONCLUSION: High- and intermediate-risk type HPV infection is a frequent finding in our study group and is linked to having had more than one lifetime sexual partner. No association was found between HPV infection and other potential risk factors such as patient's age, age at first intercourse, frequency of intercourse during the three months prior to the investigation, smoking habits, or alcohol consumption.     

Human papillomavirus prevalence and predictors for cervical cancer among high-risk women from Rio de Janeiro, Brazil

We assess the prevalence of human papillomavirus (HPV) and cofactors for cervical severe disease, as contribution for vaccine strategies at the right moment in which Brazilian health authorities have approved an anti-HPV vaccine. A case-control study was undertaken with 201 women who attended a public health service with previous abnormal cytology. The HPV status was ascertained by consensus primers My09/11 and typed by 6, 11, 16, 18, 31, 33, 35, and 58 specific primers. Patients diagnosed with high-grade squamous intraepithelial lesions (HSIL) and cervical cancer were referred as cases (n = 84). Patients with normal/inflammatory cervix or carrying benign cervical lesions were included in controls (n = 117). The overall prevalence of HPV infection was 75.6%, with 91.7% among cases. In spite of HPV 16 being the most frequent type (53.3%), 27.6% of infections were attributed to nonvaccine types. High-risk HPV were strongly associated to older women (OR = 6.7). Otherwise, age at the first intercourse (OR = 7.10), three or more parities (OR = 3.05), abortion episodes (OR = 4.80), and smoking (OR = 3.83) conferred a heavy effect in younger women. Among mediators affecting the progress from HSIL to cancer, age played the main role in easing the progression (OR = 1.09, P = 0.002) followed by education level (OR = 4.20, P = 0.066). White ethnia showed to be a protective factor (OR = 0.32, P = 0.055). Predictors from HPV exposure to malignant disease include demographic and behavioral factors. Public policies such as improvement of education and continued prevention campaigns might contribute to reduce this picture. This work also gives background, in identifying a target population, for implementing future vaccine strategies.     

Prevalence and risk factors of HPV infection among high-risk rural and urban Lithuanian women

AIMS: To investigate the prevalence, persistence and risk factors of high oncogenic risk human papillomavirus (HPV) among urban and rural women of reproductive age coming to consult a gynaecologist. METHODS: A prospective cohort study in urban (Kaunas) and rural (Marijampole) regions of Lithuania. The data were collected in 8 healthcare institutions from women seeking consultation of gynaecologists using a questionnaire for finding out demographic, social, behavioural and biomedical factors. HPV DNA was determined by molecular hybridization method (hybrid capture version II) determining HPV of high oncogenic risk. RESULT: 1,120 women participated in the study. The prevalence of high-risk HPV among the studied women was 25.1%. It was higher among the urban women than among the rural women. The prevalence of high-risk HPV was increased if the subjects had 2 or more sexual partners during the last 12 months (OR 2.81; 95% CI 1.83-4.32), were 19 years of age or younger (OR 2.68; 95% CI 1.47-4.91), were smoking (OR 1.81; 95% CI 1.16-2.81), and had secondary or lower education level (OR 1.43; 95% CI 1.01-2.04). This infection was obviously associated with high- and low-grade squamous intraepithelial changes of the cervix (OR 1.66, 95% CI = 1.08-2.53). CONCLUSION: The incidence rate for cervical cancer in Lithuania is one of the highest in comparison with other European countries. HPV infection was also particularly common in the studied population. About one-fourth of the women were infected with high-risk HPV infection. Young and less educated women were found to be the group that was most exposed to HPV, and therefore public health interventions and education seem to be essential in programs aimed at reducing the incidence of cervical cancer.     

Smoking,alcohol, sexual behaviour and drug use in women with cervical human papillomavirus infection

Objective: The aim of the study was to determine if smoking is associated with cervical human papillomavirus infection (CHPI) independent of sexual risk factors. Setting: Two family planning clinics and one youth clinic in Sweden. Subjects: Human papillomavirus (HPV) DNA was found in cervical samples of 66 (6.8%) of 972 women attending for contraceptive advice, using Southern blot tests. Results: Among women with cervical human papillomavirus infection (CHPI), 33 (50%) were smokers, as compared to 307 (33.9%) among a comparison group of HPV-negative women (odds ratio = 2.0, 95% CI = 1.2–3.2). After stepwise adjustment for number of lifetime partners, number of partners last six months, age at first intercourse, alcohol use, drug abuse and history of or current sexually transmitted disease other than CHPI, the odds ratio decreased to 1.4 (95% CI = 0.8–2.4). Recent use of alcohol and ever use of narcotics were also significantly correlated to CHPI in crude analyses, but vanished in multifactorial analyses after adjustment for the mentioned sexual risk behavioral factors. Conclusions: The results of this study indicate that smoking, alcohol and drug abuse are risk markers, but not causal factors, for CHPI. Correspondence to: D. Hellberg     

Prevalence and risk factors for human papillomavirus DNA in cervical cytology

Objectives

This study aimed to detect the presence and prevalence of HPV-DNA in the cervical swab samples obtained from patients with cervical cancer, premalignant cervical lesions and benign cervical smear results, and to identify the potential risk factors influencing this prevalence.

Study design

Smear preparations were examined and classified according to the Bethesda system. HPV-DNA detection and genotyping was carried out using polymerase chain reaction combined with reverse hybridization line-probe assays. Age, smoking habit, age at first sexual intercourse, number of sexual partners, number of term births, contraceptive method, progesterone therapy, history of sexually transmitted diseases, history or existence of warts, existence of cervical infection and the history of circumcision of male sexual partners were recorded.

Results

Six hundred and forty-two women (96 women with abnormal cervical cytology and 546 women with normal cytology) provided cervical samples. Multiplex PCR testing revealed that prevalence of HPV-DNA was 38.9% in our study population. HPV-DNA was detected in 78.3% of the women with cervical cancer and 76.9% of the women with HGSIL. Abnormal cervical cytology was observed in 30% of HPV-DNA positive cases and in 5.4% of HPV-DNA negative cases. Our findings also indicate that smoking habit, number of sexual partners, history of sexually transmitted diseases, and abnormal cervical cytology were associated with HPV infection. With respect to parity, there was a decreased risk of HPV infection with the increase in the number of births.

Conclusions

Estimates of the prevalence of HPV infection vary greatly around the world, so the factors that contribute to the rare occurrence of cervical cancer after HPV infection might also differ from country to country. Information gathered from this study could be used to prioritize limited screening and treatment services given to woman who have specific characteristics that may put them at an increased risk of HPV disease.     

A matched prospective study of human immunodeficiency virus serostatus, human papillomavirus DNA, and cervical lesions detected by cytology and colposcopy.

OBJECTIVE: To compare the prevalence and type of human papillomavirus (HPV) infections in the genital tract of human-immunodeficiency-virus- (HIV) seropositive and -seronegative women matched for cytology and to examine prospectively the relationship of HPV DNA, colposcopic findings and cervical squamous intraepithelial lesions (SIL) in these matched seropositive and seronegative cohorts. METHODS: A matched prospective study of HIV-seropositive and -seronegative women undergoing cytologic screening, colposcopy, and testing for HPV DNA and other infections at each visit. RESULTS: Twenty-three HIV-seropositive women were matched with 23 seronegative women by cervical cytology reading, lifetime number of sexual partners, age, and follow-up length. Fourteen pairs of these women had follow-up visits every 4 months, for 56 and 53 total visits in seropositive and seronegative women, respectively. After matching, the groups had a similar overall prevalence of HPV DNA and of HPV oncogenic (high risk) types at baseline. On follow up, HIV-seropositive women were more likely than seronegative women to develop SIL (38% vs. 10%), less likely to have negative cytology (34% vs. 60%, overall P = 0.03), more visits with HPV DNA detected (68% vs. 40% P = 0.04), and more visits with multiple HPV DNA types detected (18% vs. 0%, P = 0.02). Colposcopic lesions in the seropositive women were more likely to have sharp borders or mosaicism or to be thick white (P = 0.009). CONCLUSIONS: After matching for baseline Papanicolaou smear readings, these data suggest that over time seropositive women have more visits that yield abnormal cytology, more persistent HPV DNA detection, and more colposcopic abnormalities than seronegative women.     

妊娠期妇女子宫颈细胞学检查结果异常的相关因素分析

目的 探讨妊娠期妇女宫颈细胞学检查结果异常的相关因素.方法 选择2007年9月至2008年9月在首都医科大学附属北京妇产医院产科定期产前检查的妊娠12～36周的妇女,除外先兆流产、胎膜早破、前置胎盘等并发症共12 112例,于初次产前检查时常规行宫颈液基细胞学检查(TCT),同时记录妊娠期妇女的职业、受教育程度、户口地址、家庭收入、民族、初次性生活年龄、性伴侣个数、避孕方法、孕产史、妇科伴随症状、相关肿瘤家族史、既往妇科病史、吸烟史,并记录当天妇科检查情况,分析TCT结果异常的相关危险因素.结果 资料完整的妊娠期妇女共11 906例,资料满意率为98.30%(11 906/12 112).其中,TCT结果正常10 354例,占86.96%(10 354/11 906)、未明确诊断意义的不典型鳞状上皮细胞(ASCUS)1134例,占9.52%(1134/11 906)、未明确诊断意义的不典型腺上皮细胞(ACUS)112例,占0.94%(112/11 906)、低度鳞状上皮内病变(LSIL)229例,占1.92%(229/11 906)、高度鳞状上皮内病变(HSIL)74例,占0.62%(74/11 906),宫颈鳞癌3例,占0.02%(3/11 906).多因素非条件logistic回归分析结果显示,与ASCUS及AGUS相关的危险因素包括初次性生活年龄(OR_(ASCUS)=2.90、OR_(AGUS)=7.32)、性伴侣个数(OR_(ASCUS)=1.49、OR_(AGUS)=2.02)、流产次数(OR_(ASCUS)=1.68、OR_(AGUS)=3.50);与LSIL、HSIL相关的危险因素包括初次性生活年龄(OR_(LSIL)=6.34、OR_(HSIL)=9.26)、性伴侣个数(OR_(LSIL)=1.69、OR_(HSIL)=1.65)、流产次数(OR_(LSIL)=1.53、OR_(HSIL)=5.33)、吸烟(OR_(LSIL)=1.84、OR_(HSIL)=1.77);与TCT结果异常(包括ASCUS、AGUS、LSIL、HSIL)相关的感染因素包括滴虫性阴道炎(P<0.01)、人乳头状瘤病毒(HPV)感染(P<0.01);柱状上皮异位与TCT结果异常密切相关(χ~2=43.269,P=0.000),但与柱状上皮异位的程度无关.结论 妊娠期妇女宫颈细胞学检查结果异常发生的相关因素与非妊娠期相同.     

Relationship of pregnancy to human papillomavirus among human immunodeficiency virus-infected women

OBJECTIVE: Because parity is a reported risk factor for cervical cancer, we sought to estimate the effects of pregnancy on the prevalence, incident detection, and copy number of human papillomavirus (HPV) among human immunodeficiency virus (HIV)-infected women, patients at high risk for cervical cancer. METHODS: Human immunodeficiency virus-infected women who had a pregnancy in the Women's Interagency HIV Study (n = 178) and the Women and Infants Transmission Study (n = 450) underwent serial type-specific HPV DNA testing using MY09/MY11 polymerase chain reaction. During pregnancy and during the prepregnancy and postpregnancy periods, we assessed HPV prevalence, incident detection, and HPV copy number (estimated using hybridization signal strength) of both oncogenic and nononcogenic HPV. All binary-regression analyses incorporated generalized estimating equations to address the repeated observations of the same women over time, and were further adjusted for parity, gestational age, smoking, antiretroviral use, number of lifetime sexual partners, and oral contraceptive use. RESULTS: The prevalence and copy number of oncogenic and nononcogenic HPV did not significantly differ between pregnancy and either the prepregnancy or postpregnancy periods. Incident HPV detection was significantly lower for both oncogenic and nononcogenic HPV during pregnancy compared with the postpregnancy period (relative risk 0.534, 95% confidence interval 0.390-0.732, P < .001 and relative risk 0.577, 95% confidence interval 0.428-0.779, P < .001, respectively), but not compared with the prepregnancy period CONCLUSION: Among HIV-infected women, the incident detection of HPV is lower during pregnancy compared with postpregnancy, while prevalence and copy number do no differ between pregnancy and either prepregnancy or postpregnancy. LEVEL OF EVIDENCE: II-3.     

徐州地区宫颈癌患者人乳头瘤病毒基因型检测分析

目的：通过对宫颈癌患者人乳头瘤病毒（ＨＰＶ）基因检测分析,了解徐州地区宫颈癌ＨＰＶ感染情况及ＨＰＶ感染与宫颈癌临床生物学行为之间的关系。方法：采用核酸分子杂交系统对１４２例宫颈癌患者行ＨＰＶ分型检测,并统计分析。结果：①１４２例宫颈癌患者中,１３６例ＨＰＶ阳性,ＨＰＶ感染率９５．７８％。其中单一感染１１７例（８６．０３％）,多重感染１９例（１３．９７％）,两者感染率差异有统计学意义（Ｐ＜０．０１）。②共检测出１３种基因型：单一感染８种,由高到低依次为ＨＰＶ１６（６６．１８％）、１８（６．６２％）、３１（５．８８％）、５８（２．２１％）、４５（２．２１％）、３３（１．４７％）、６（０．７４％）和ＣＰ８３０４（０．７４％）。而ＨＰＶ６８（２．９４％）、５２（２．２１％）、６６（１．４７％）、３９（０．７４％）、１１（０．７４％）仅出现在多重感染中。ＨＰＶ１６总感染率为７７．９４％,明显高于其他各型（Ｐ＜０．０１）。而ＨＰＶ１８总感染率７．３５％与ＨＰＶ３１、５８、３３相比差异无统计学意义（Ｐ＞０．０５）。③ＨＰＶ感染率在宫颈癌各临床分期、组织病理学分级间差异无统计学意义（Ｐ＞０．０５）。④ＨＰＶ多重感染与宫颈癌临床分期间无确定关系,但随着病理分级的加重呈降低的趋势。结论：徐州地区宫颈癌患者以ＨＰＶ单一感染为主,主要为ＨＰＶ１６,其次为ＨＰＶ１８、３１、５８;未发现多重感染增加宫颈癌的发生风险;ＨＰＶ感染不影响宫颈癌的进展及肿瘤细胞的分化。