23296例女性宫颈高危型HPV感染情况分析

目的研究民航总医院就诊女性宫颈高危型人乳头瘤病毒(high risk-human papillomavirus,HR-HPV)感染情况及分型特点。为北京地区预防HPV感染和防治宫颈癌提供科学依据。方法选择2016年10月至2019年4月于民航总医院妇产科就诊并行高危型HPV检测的女性23296例,对其结果进行回顾性分析,分析高危型HPV感染情况,比较不同年龄组、不同亚型HPV感染情况。结果高危型HPV感染率为17.21%。其中单一HPV感染率13.00%,多重HPV感染率4.21%。HPV亚型感染率的前四位依次为HPV52型(感染率3.68%)、HPV16(感染率3.07%)、HPV58(感染率为3.04%)、HPV51(感染率1.89%)。HPV的感染率呈现反抛物线分布,在<20岁的女性中HPV的感染率最高,后逐渐下降,到30~45岁的感染率到达最低点,后逐渐升高,到>60岁到达第二高峰。结论1.本研究HPV感染率总体处于中等感染水平。2.<20岁人群是HPV感染的高危人群,建议在性生活前注射HPV疫苗,可以最有效的阻断HPV感染。3.应重视45岁后患者的HPV感染,尤其是持续性HPV感染,应积极行阴道镜检查,早期发现子宫颈上皮内瘤变及宫颈癌变。     

成都市1490例妇女HPV感染现状及危险因素分析

目的 探讨成都市妇女人乳头瘤病毒(human papilloma virus,HPV)感染现状及危险因素.方法 选择成都市体检的妇女1490例作为研究对象,展开HPV筛查,得出HPV的阳性感染率,分析HPV感染与宫颈炎、宫颈上皮内瘤样变以及宫颈癌等妇科疾病之间的关系,同时对HPV感染的危险因素进行调查分析.结果 1490例妇女中192名妇女为HPV阳性,HPV的阳性感染率为12.86％.HPV阳性妇女宫颈炎、宫颈上皮内瘤样变以及宫颈癌的发生率分别为41.67％、20.31％和8.69％,显著高于非HPV阳性妇女宫颈炎、宫颈上皮内瘤样变以及宫颈癌的发生率7.01％、1.93％和0.15％,差异具有统计学意义(P＜0.01).经常被动吸烟与熬夜、初次性行为年龄小以及首次妊娠年龄早以及有宫颈癌家族史是HPV感染的危险因素.结论 成都市妇女HPV阳性感染率较高,应当引起卫生部门的高度重视,并应该针对HPV感染的危险因素展开宣传和教育,以便降低妇女HPV的感染、保护妇女的身心健康.     

女性HPV感染与宫颈鳞状上皮内病变

目的 研究女性HPV感染与其宫颈鳞状上皮内病变关系,为临床预防宫颈癌发生发展提供基础数据.方法 537例HPV感染阳性患者样本来源于解放军第210医院妇科门诊,分析患者感染HPV基因亚型与数量及患者年龄数据,研究其与患者宫颈鳞状上皮内病变统计学关系.结果 单一高危亚型HPV感染患者宫颈鳞状上皮内病变发病率高于单一低危亚型HPV感染患者,差别有统计学意义(P＜0.05).单一高危亚型HPV感染患者4种具体宫颈鳞状上皮内病变发病率均高于低危亚型HPV感染患者,其中ASC-H及LSIL发病率差别有统计学意义(P＜0.05).不同类型多重HPV感染患者宫颈鳞状上皮内病变发病率差别未见统计学意义(P＞0.05).多重HPV感染患者宫颈鳞状上皮内病变发病率高于单一HPV感染患者,差别有统计学意义(P＜0.05).多重HPV感染患者ASC-US发病率高于单一HPV感染患者,差别有统计学意义(P＜0.05).HPV感染患者宫颈鳞状上皮内病变发病率在41 ～ 50年龄组最高,65.04％(80/123),与其它各年龄组比较差别均有统计学意义(P＜0.05).结论 HPV感染基因亚型种类、数量及感染者年龄均与宫颈鳞状上皮内病变发生有一定关联,其中高危亚型HPV感染、多重HPV感染与中年妇女三种因素,与宫颈鳞状上皮内病变发生发展关系密切.     

广东某地区妇女高危型HPV感染特点及年龄结构分布

目的通过对门诊患者人乳头瘤病毒（HPV）基因型检测,分析本地区高危型HPV感染特点以及年龄构成分布。方法收集了8681例样本,采用导流杂交基因芯片技术进行21种HPV亚型基因型的分型检测。结果HPV总感染率为22．0％,高危型感染率为16．08％,以16亚型最多见（27．42％）,其次是52亚型（21．82％）;高危型HPV感染以单一型为主（78．58％）,多重型感以双重感染多见;不同年龄段的HPV感染率差异有统计学意义（xz=302．88,P〈0．01）,不同年龄的高危型HPV感染率差异亦有统计学意义（x2=321．60,P〈0．01）。结论广东该地区高危型HPV感染率略高,且具有明显的年龄分布异质性,提示预防性疫苗的使用应考虑年龄因素。     

太原地区404例女性HPV感染状况及基因分型统计分析

目的探讨太原地区女性人乳头瘤病毒(HPV)感染情况以及基因分型分布及特点。方法采用人乳头瘤病毒基因分型检测试剂盒(PCR技术及导流杂交技术)对太原地区404例女性进行21种HPV亚型分析。结果 404例检测者共检测到HPV阳性患者213例,阳性率为52.7%。21种HPV亚型(除HPV 42、43型外)均有检出,其中检出率较高的高危型有HPV 16(34.4%),HPV 58(13.4%),HPV 53(8.7%);检出率最高的低危型是HPV 6(2.2%)。阳性检出者中单一亚型感染占59.6%,多种亚型感染占40.4%;在多重感染中,伴随着合并感染的亚型数增加,比例逐渐下降。结论利用PCR技术和杂交技术检测女性HPV感染情况,对宫颈癌的早期诊断、预防及疗效观察具有重要的应用价值。     

HPV感染与宫颈癌前病变

宫颈癌是一个由癌前病变逐渐衍变为癌的连续的病理过程。目前认为宫颈癌前病变,即宫颈上皮内瘤变与HPV感染有关。HPVs是一种双链小DNA病毒,由病毒蛋白外壳和核心DNA物质构成。病毒基因组分为早期基因区、晚期基因区及长调控区;其中早期区编码的E6、E7蛋白对于病毒的复制起关键作用。生殖道HPVs在有性活动的人群中普遍存在,在有性生活的女性中,至少有75%将在人生中的某个时间感染HPV。感染HPV后绝大多数人可以自然消退。只有感染了高危亚型、同时又具备其他高危因素的妇女才可能进展为HSIL或宫颈癌。因此对于HPV的感染既要重视,又不必恐惧。目前的治疗主要是针对由HPV引起的宫颈或外生殖器的局部病变。     

徐州地区女性宫颈感染人乳头瘤病毒基因亚型分析

目的：了解徐州地区不同年龄段女性生殖道人乳头瘤病毒（HPV）感染状况及其分布规律,为徐州地区HPV分子流行病学研究提供依据。方法：以2009年2月～2009年5月来我院就诊的1299例可疑患者为对象,采集其阴道宫颈分泌物标本。用凯普医用核酸分子杂交系统（简称H ybriMax）进行21种HPV（8304、6、11、16、18、31、33、35、39、42、43、45、44、51、52、53、56、58、59、66、68）基因型的分型检测,分析常见感染亚型和分布规律。结果：HPV阳性总检出率为26.02%（338/1299）,高危型主要为HPV16,其余依次为HPV58、52、68、33、53、18感染。低危型主要为HPV11、6、8304感染;〈35岁、35～44岁、〉44岁各年龄组中HPV阳性率分别为26.92%、26.79%、22.27%;宫颈癌患者以HPV16感染为主。结论：HPV6、11、16、58、52、68、33是徐州地区HPV感染的主要型别;不同年龄段HPV阳性率无显著性差异（P〉0.05）;对HPV阳性者进行定期跟踪是防治宫颈癌的重点。     

宁波地区1035例女性感染HPV基因类型分析

目的了解宁波地区各年龄段女性感染人乳头瘤病毒（human papilloma virus,HPV）基因类型分布及多重感染分布状况,为预防HPV感染和宫颈癌防治提供理论依据。方法利用反向杂交技术分男1对2007年1月～2008年12月来医院就诊的1035例可疑患者进行23种HPV基因亚型检测,其中包括18种与宫颈癌密切相关的高危亚型（HPV16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、73、83、MM-4）及5种低危亚型（HPV6、11、42、43、44）。结果患者阳性检出率为37．68％（390／1035）,其中单一HPV亚型感染占68．72％（268／390）,2重HPV亚型感染为21．03％（82／390）,3重HPV亚型感染为6．67％（26／390）,4重HPV亚型感染为2．82％（11／390）,5重、6重、7重HPV亚型感染各占0．26％（1／390）;项目阳性检出率为2．35％（559／23805）,其中高、低危型检出率分别为1．58％（375／23805）与0．77％（184／23805）,高危型中主要为HPV16、58、33、18感染,低危型主要为HPV11、6感染。各年龄段感染的比率为≤20岁33．33％（2／6）,（21—30）岁47．62％（130／273）,（31—40）岁35．69％（111／311）例,（41—50）岁32．76％（96／293）例和〉50岁33．55％（51／152）例;各年龄段项目阳性的比率为3．62％,3．11％,2．21％,1．83％和2．23％。结论HPV16、11、6、58、33、18是宁波地区HPV感染的主要型别,各年龄段均为感染的高峰人群,对HPV阳性者进行定期的跟踪,是防治尖锐湿疣与宫颈癌的重点。     

湖北地区宫颈疾病患者HPV基因型及其年龄分布

目的:分析湖北地区宫颈疾病患者人乳头状瘤病毒(HPV)感染的基因型分布及与年龄的关系。方法:4 314例宫颈疾病患者,年龄21-86岁,按5岁一组分为10组,收集各组宫颈脱落细胞样本,应用PCR-基因芯片技术进行HPV分型检测,统计分析各组HPV总感染率和各亚型感染率及其年龄分布特点。结果:HPV总感染率为28.86%(1 245/4 314)。以单纯高危型HPV(hrHPV)为主,感染率为23.78%(1 026/4 314),单纯低危型HPV(lrHPV)感染率只占2.30%(99/4 314),余为混合感染。高危型中又以HPV16型最多,感染率为9.23%(398/4 314),其次为HPV52和58型,感染率为5.42%(234/4 314)和4.75%(205/4 314)。HPV总感染率以21-25岁组(29.97%)和51-55岁组(31.75%)最高,最低为31-35岁组(25.19%)和65岁组(25.42%),但各组间差异无显著性(P0.05)。单一感染率明显较多重感染率高(20.91%vs 7.95%,P0.01)。结论:加强湖北地区宫颈疾病患者HPV感染的筛查和监测,有利于该地区女性人群生殖器疣和宫颈癌防治以及流行病学研究。     

RANTES在HPV感染的子宫颈鳞癌及癌前病变中的表达

目的 探讨趋化因子RANTES在人乳头瘤病毒(HPV)感染的子宫颈鳞癌及癌前病变中的表达.方法 用免疫组化方法 对133例HPV阳性病例子宫颈组织中趋化因子RANTES进行检测.其中正常子宫颈组织10例,子宫颈上皮内瘤变Ⅰ、Ⅱ、Ⅲ级各30例,子宫颈鳞癌33例.结果 RANTES在子宫颈鳞癌组的阳性表达率较CIN组和正常对照组显著增高(P<0.01),其阳性表达强度亦较CIN组和正常对照组显著增高(P<0.01).CIN组内的阳性表达率和阳性表达强度随分级升高而增高,且各组之间比较差异均具有统计学意义(P<0.05);CINⅢ组的阳性表达率和阳性表达强度较正常对照显著增高(P<0.05);CINⅠ、Ⅱ与正常组比较其阳性表达率和阳性表达强度均无统计学意义(P>0.05).结论 RANTES与HPV感染的子宫颈鳞癌及癌前病变密切相关.     

厦门地区女性人乳头瘤病毒感染状况调查

目的 对厦门地区妇女宫颈人类乳头瘤病毒（human papilloma virus,HPV）亚型进行筛查,以探讨其分布规律.方法 采用凯普医用核酸分子快速杂交仪,对7683名2013年1月-2013年12月到厦门市174医院妇科门诊或病房就诊的女性进行生殖道21种HPV感染基因亚型筛查.结果 7683例样本中,HPV感染者1421例,阳性率18.50％.感染人群主要集中在30～39岁.其中高危型HPV阳性率为16.01％,低危型HPV阳性率为2.49％.单一基因型别者1148例,阳性率为14.94％;双重感染者220例阳性率为2.86％;三重以上感染者53例,阳性率为0.70％;HPV感染阳性率居前6位的基因型分别为HPV-52（3.64％）、HPV-16 （3.33％）、HPV-58（2.98％）、HPV-53（2.16％）、HPV-CP8304（1.91％）和HPV-18（1.09％）.结论 厦门地区妇女HPV感染率高,且以高危型单一基因亚型感染为主;感染基因型别主要以HPV-52、16、58、53、CP8304和18为主,具有一定的地域差异性;52及58型感染率高,对于疫苗的研制和开发有参考意义.     

The relationship between the cervical and anal HPV infection in women with cervical intraepithelial neoplasia

BackgroundMore than 90% of cases of anal cancers are caused by high-risk human papillomavirus (HR HPV) infection and a history of cervical intraepithelial neoplasia (CIN) is established as possible risk factor.ObjectivesTo demonstrate relationship between anal and cervical HPV infection in women with different grades of CIN and microinvasive cervical cancer.Study designA total of 272 women were enrolled in the study. The study group included 172 women who underwent conization for high-grade CIN or microinvasive cervical cancer. The control group consisted of 100 women with non-neoplastic gynecologic diseases or biopsy-confirmed CIN 1. All participants completed a questionnaire detailing their medical history and sexual risk factors and were subjected to anal and cervical HPV genotyping using Cobas and Lynear array HPV test.ResultsCervical, anal, and concurrent cervical and anal HPV infections were detected in 82.6%, 48.3% and 42.4% of women in the study group, and in 28.0%, 26.0% and 8.0% of women in the control group, respectively. The prevalence of the HR HPV genotypes was higher in the study group and significantly increased with the severity of cervical lesion. Concurrent infections of the cervix and anus occurred 5.3-fold more often in the study group than in the control group. Any contact with the anus was the only significant risk factor for development of concurrent HPV infection.ConclusionsConcurrent anal and cervical HR HPV infection was found in nearly half of women with CIN 2+. The dominant genotype found in both anatomical locations was HPV 16. Any frequency and any type of contact with the anus were shown as the most important risk factor for concurrent HPV infection.     

宫颈上皮内瘤样病变患者高危型HPV感染基因分型分析

目的了解宫颈上皮内瘤变患者的高危型HPV的感染及其分型和不同程度宫颈病变的主要感染型别情况。方法应用型特异PCR检测宫颈癌前病变的患者的主要高危型HPV-16、18、33、58的感染及其分型情况的相关性研究。结果在本研究宫颈上皮内瘤变患者98例中,4种高危型HPV的总阳性例数为73例,HPV总的感染率为74.5%,存在多重感染。其中HPV-16、18、33、58的总感染率分别为53.1%、38.7%、17.3%和30.6%。CIN的Ⅰ/Ⅱ/Ⅲ3组患者的4种高危型HPV的感染率分别为42.9%、61.1%和93.2%。结论主要高危型HPV在宫颈上皮内瘤变患者中感染的主要型别依次为HPV16、HPV18、HPV58、HPV33,主要为HPV16和HPV18型;不同程度CIN的高危型HPV的总感染率不同,随病变程度的加重而增加。     

Cervical infections by multiple human papillomavirus (HPV) genotypes: Prevalence and impact on the risk of precancerous epithelial lesions

A large proportion of human papillomavirus (HPV) infections is sustained by multiple genotypes. The effect of multiple infections on the risk of cervical intraepithelial neoplasia (CIN) and the potential efficacy of vaccine on these infections are controversial. We performed viral typing by SFP₁₀‐LIPA on a consecutive series of 1,323 women undergoing colposcopy, 69% of whom had cervical biopsy, and correlated CIN severity with the type and number of HPVs. Overall prevalence of HPV‐DNA was 68.9%, 97.3% in CIN1, and 98.1% in CIN≥2. HPV positivity correlated with younger age (35.9 vs. 37.3 years, P = 0.026) and history of CIN (P < 0.001). Multiple types were detected in 44.2% of cases, including 63.1% CIN1 and 80.8% CIN≥2. Twenty‐three different types were detected, HPV‐16, 31 and 52 being the most frequent. Infections by HPV‐6, 11, 16, or 18 occurred in 59.4% of CIN1 and 71.3% of CIN≥2. Number of viral types and class of oncogenic risk were linearly correlated with CIN severity (P < 0.0001) by univariate and multivariate analyses controlling for age and history of CIN. The effect of the number of HPV types was maintained after exclusion from the model of infections by HPV‐6, 11, 16, and 18. Frequency, distribution, and clinical correlates of multiple HPV infections highlight the importance of assessing individual types in the management and the prediction of outcome of women with abnormal baseline cytology and point to potential limitations in current vaccine strategies. J. Med. Virol. 81:703–712, 2009 © 2009 Wiley‐Liss, Inc.     

The human papillomavirus (HPV) vaccine,HPV related diseases and cervical cancer in the post-reproductive years

Prophylactic HPV vaccines have demonstrated high efficacy against a range of HPV related diseases. They have been widely adopted as population health interventions in many jurisdictions and their routine use has been endorsed by the WHO. The development of these vaccines comes after an increased understanding of the natural history and epidemiology of HPV infection and disease in both males and females. Persistent HPV infection with oncogenic types induces malignant transformation in a range of epithelia including the cervix, anogenital regions, the penis and a number of head and neck sites. In relation to HPV disease prevention in the post-reproductive years, most infections occur soon after commencement of sexual activity but new infections do occur throughout the age spectrum. This reduces the likely impact of prophylactic vaccines in this population. The major impact on HPV related disease in this age group will come from advances in screening and early detection of HPV and neoplastic precursors. The most appropriate prevention for any individual man or women in this age group will be an individualised combination of vaccination, screening and early detection depending on the individual's own circumstances.     

Predictors of human papilloma virus (HPV) infection in Italian women

HPV infection is a “necessary cause” of cervical cancer and it is sexually transmitted. Due to upcoming mass vaccination investigation on risk factors for infection is the basis to implement prophylactic strategy even in older women. The aim of the study was to evaluate predictors of high‐risk (HR) HPV infection in adult women. Between 2006 and 2008, 100 women aged >18 years, with no previous treatment for cervical lesions, were screened for HR HPV infection in Rome, Italy. Risk factors for HPV infection were investigated through a questionnaire including: ethnicity, religion, education, marital status, sexual behavior, gynecological and obstetrical history, smoking and alcohol intake. Multivariate analysis identified the “never married–separated/divorced” status (OR: 3.38; 95% CI: 1.14–10.12) as predictor of HPV infection, while having a higher age at the first sexual intercourse (FSI) shows a protective effect (OR: 0.84; 95% CI: 0.71–1.00). A trend for the association between the infection and having more than three lifetime partners was also observed (OR: 2.57; 95% CI: 0.86–7.71). No significant association was found for other demographic characteristics investigated. These findings provide a contribution in the knowledge of an adult population defining a “high‐risk” sexual behavioral profile and could be helpful to target prophylactic strategies in older woman. J. Med. Virol. 82:1921–1927, 2010. © 2010 Wiley‐Liss, Inc.     

Willingness to HPV self-sampling for cervical cancer screening and its predictors among women attending outpatient clinics in Meru District,Arusha Region,Northern Tanzania

BackgroundThe ability for women to self-collect human papillomavirus (HPV) samples can potentially reduce the risk of cervical cancer and increase screening coverage.ObjectivesTo assess the willingness to HPV self-sampling for cervical cancer screening and its predictors among women attending outpatient clinics in Arusha region, northern Tanzania.MethodsA hospital-based cross-sectional study was conducted among 706 women aged 18–55 years in Meru District Hospital and Usa River Health Centre from March to April 2019. Face-to-face intervies were conducted using a questionnaire. Data analysis was performed using Stata version 14.0. The log-binomial regression was used to determine factors associated with willingness to self-collection of HPV samples.ResultsMajority (70%) of the women were willing to self-collection of HPV samples for cervical cancer screening and was associated with attending Meru District hospital (PR=2.02, 95%CI 1.77–2.31); good knowledge about cervical cancer warning signs (PR=1.11, 95%CI 1.01–1.22), prevention (PR=1.13, 95%CI 1.04–1.20), and symptoms (PR=1.61, 95%CI 1.33–1.93); and having formal employment (PR=1.22, 95%CI 1.07–1.37).ConclusionThe majority of women were willing to self-collect HPV samples for cervical cancer screening. Self-collection is, therefore, an acceptable and viable means of screening for cervical cancer, which has great implications for Tanzania from a health policy perspective.     

Association between HLA-DRB1 polymorphism, high-risk HPV infection and cervical neoplasia in southern Chinese

Multiple determinants are involved in the progression of human papillomavirus (HPV)-infected cervical lesion to invasive cancer. Human leukocyte antigen (HLA) polymorphism seems to play a role. This study examined the association between HLA-DRB1 polymorphism, high-risk HPV infection, and the development of cervical neoplasia in southern Chinese. Three hundred and seventy women with cervical neoplasia (43 cervical intraepithelial neoplasia grade II, 154 grade III, and 173 invasive cancers) and 323 controls were recruited for HLA-DRB1 typing by a sequence-based approach. Cervical specimens were collected for HPV detection by a consensus primer-based polymerase chain reaction, and with the type of HPV identified by hybridization with type-specific oligonucleotide probes. A protective effect of HLA-DRB1*12 for cervical neoplasia was observed, and with stronger associations when subgroup analyses were carried out for patients infected with HPV16 and HPV58. The protective effect of HLA-DRB1*13 that had been reported from other populations was not observed. The data obtained in this study showed that HLA-DRB1*03 conferred a higher risk for HPV18-infected, but not for HPV16-, HPV52-, or HPV58-infected cervical lesions. Although, HPV52 was reported as uncommon worldwide, it was found to be the second most prevalent type in the southern Chinese population. However, no additional risk association was observed when subgroup analyses were performed for HPV52-infected patients. The current study shows that, among southern Chinese, the outcome of HPV-infected cervical lesions is associated with HLA-DRB1 polymorphism. These associations often vary with the type of HPV infection.