成都地区妇女HPV感染的流行病学特征及与宫颈病变的关系

目的：探讨成都地区妇女宫颈人乳头状瘤病毒（human papillomavirus，HPV）感染的分子流行病学特征及其与宫颈癌前病变的关系。方法：收集四川省人民医院2015年1月-2017年1月在妇科门诊就诊并进行HPV分型检测的患者8 204例，其中4 390例患者同时行宫颈液基细胞学检查，229例患者同时行病理学检查。结果：HPV感染率为23.28%，其中高危型HPV感染占58.53%。HPV感染以单一感染（72.88%）为主，HPV52、58、16型最常见，而在多重感染中，62.13%为二重感染，以52型合并其他高危型（58、16、53型）感染最常见。不同年龄组的HPV感染率差异有统计学意义（P＜0.001），其中≤20岁年龄组HPV感染率（61.76%）最高。高危型HPV感染率随着细胞学诊断级别的升高而升高，且高危型HPV感染率在细胞学异常人群中显著高于细胞学正常人群（P=0.025）。高危型HPV感染可存在于各级CIN及宫颈癌病变，而低危型HPV感染只存在于CINⅠ。结论：HPV基因型的分布具有明显的年龄和区域分布特异性，且HPV感染率与宫颈病变严重程度呈正相关。研究结果对研制适合成都地区妇女的特异性HPV疫苗，以及宫颈癌的筛查与防治具有参考价值。

Molecular Epidemiological Characteristics of HPV Infection and the Relationship with Cervical Lesion in Chengdu China

Objective：To study the molecular epidemiological characteristics of cervical human papillomavirus (HPV) infection and the relationship with cervical precancerous lesion among women in Chengdu China. Methods：A total of 8 204 patients who tested HPV infection during January 2015 to January 2017 were enrolled. All patients had the HPV genotyping detection, among them 4 390 patients were requested the cervical cytology test and 229 patients had pathological diagnosis. Results：In 8 204 cases, the HPV infection rate was 23.28%, including 58.53% of high-risk HPV infection. Most of HPV infections were single infection (72.88%), mainly caused by HPV52, HPV58 and HPV16, while in those multiple HPV infections the double infections took priority of 62.13%, mainly caused by HPV52 combined with HPV58, HPV16 and HPV53. There was significant difference in the HPV infection rate of different age groups (P＜0.001), and this rate in the ≤20 age group was highest (61.76%). The increasing rate of high-risk HPV infection was along with the diagnosis grade of cytology, and this rate in people with cytological abnormality was significantly higher than that in normal people（P=0.025）. The high-risk HPV infection was related to the different grade of CIN and cervical cancer, however the low-risk HPV infection was only correlated with CINⅠ. Conclusions：The distribution of HPV genotypes has significant difference in the different age group and region, while the HPV infection rate is positively related with cervical lesions. This study can provide more reasonable reference for the development of specific HPV vaccine that suit for the women in Chengdu, and for the screening of cervical lesions and the prevention of cervical cancer.