我国山西省子宫颈癌高发区人乳头瘤病毒感染调查

目的在子宫颈癌高发区调查妇女生殖道高危型别人乳头瘤病毒(HPV)感染状况,探讨浓缩子宫颈癌高危人群的方法,为子宫颈癌的免疫和化学预防提供科学依据和人群基础.方法选取30～50岁的已婚妇女为对象.研究分两阶段进行,第一阶段为妇女自己取样检查法,签署知情同意书后,受检妇女在医师的指导下自己采集阴道分泌物,然后调查其人口学基本信息;第二阶段由医师进行直接取样.将收集到的子宫颈脱落细胞放入装有固定液的试管保存,应用第2代杂交捕获(Hybrid Capture 2)试验进行HPV DNA检测.标本中检出的HPV DNA≥2.0 pg/ml即为感染阳性.两份标本的检测结果中任一项阳性即认作感染阳性.数据用VFP软件两遍录入后,进行核对纠错,应用SPSS软件进行统计分析.结果共调查9 683名妇女,人群顺从性为75.4%.该人群HPV感染率为27.5%,阳城县HPV感染率高于襄垣县(P＜0.001).不同年龄组(30～,35～,40～,45～50)的HPV感染率分别为24.5%、27.4%、28.2%、27.4%,经统计学检验无显著性差异(P=0.604).山区HPV感染率显著高于半山区(P=0.001).教育程度为非正式上过学、小学、初中、高中及以上妇女的HPV感染率分别为26.1%、26.6%、27.5%、30.0%,经统计学检验无显著性差异(P=0.106).结论本研究是迄今国内规模最大的调查,人群顺从性较高,其结果能代表这一高发区妇女HPV感染的分布状况.山西襄垣和阳城县30～50岁妇女呈HPV持续高感染状态,对这一年龄阶段的妇女进行子宫颈癌的防治已经成为当务之急.一个9 683人的队列已成功建立,它可同时用于子宫颈癌的病因学、早期诊断方法以及免疫和化学预防研究.

Population-based study of human papillomavirus infection in high-risk area for cervical cancer in Shanxi Province,China

OBJECTIVES: To investigate the prevalence of oncogenic type of human papillomavirus (HPV) infection and identify the high risk population for conducting immuno/chemoprevention of cervical cancer. METHODS: All married women aged 30 to 50 with no history of hysterectomy, pelvic radiation and non-pregnant from certain villages of Xiangyuan and Yangcheng County were invited. This study was conducted through two phases. In phase one, subjects sampled the vaginal secretions using the collectors after signing the informed consent. And physicians sampled exfoliated cells from cervix in the phase two. All the specimens were tested with the Hybrid Capture 2 test. The data was managed and analyzed by VFP and SPSS software. RESULTS: There were 9,683 women participated in this study. Local women welcomed this study and population compliance rate was 75.4%. In tested population, we found 2,666 subjects of HPV DNA positive and HPV prevalence was 27.5%. The rates of different age group were 24.5% (30-34 yrs), 27.4% (35-39 yrs), 28.2% (40-44 yrs), 27.4% (45-50 yrs) respectively and had no significant differences (P = 0.604). The rates were slightly increased with the higher education level and had no differences (P = 0.106). The rate in mountain areas was higher than that in half-mountain areas (P = 0.001). CONCLUSIONS: The prevalence of HPV infection is indeed high in this region. Local women and health professionals welcome the activities of cervical cancer screening and prevention. It is an emergent task to improve their sanitary condition and prevent them from cervical cancer in these women. A women health cohort is established successfully among high HPV exposed women in rural China. The extensive biologic specimen repository has been successfully established to simultaneously study the etiology, early detection, and immuno/chemoprevention of cervical cancer.