HPV多重混合感染的女性病人宫颈病变特征分析

目的分析人乳头瘤病毒(human papilloma virus，HPV)多重混合感染女性病人中宫颈病变的发生情况与分布特点，探讨HPV多重混合感染与宫颈病变相关性。方法收集2017年3月至2019年5月在淮北矿工总医院就诊的19~90岁女性病人6 382例宫颈脱落细胞标本, HPV基因亚型采用PCR-DNA反向点杂交法进行HPV基因亚型检测，宫颈刮片通过细胞病理学和阴道镜检查指导的活组织进行检查。统计分析HPV多重感染型别、亚型数以及不同年龄段的宫颈病变发生与分布情况。结果6 382例病人的HPV阳性率为16.36%，其中HPV多重亚型感染344例，阳性占比32.95%，感染率5.4%。多重混合感染高危亚型构成比的前3位依次为HPV52、HPV16和HPV58型。HPV多重感染以及低级别上皮内病变与高级别上皮内病变的分布集中于41~50岁年龄段，而CC主要分布于51~60年龄段。HPV多重混合感染以高低危混合型为主，高危混合型次之，最后是低危混合型。高危混合型宫颈病变率为21.31%高于低危混合型的2.94%和高低危混合型的6.39%(P<0.01)，低危混合型与高低危混合型严重宫颈病变率差异无统计学意义(P>0.05)。结论HPV多重感染基因型(高危混合型)的致病力与宫颈病变(宫颈癌除外)具有相关性。41~50岁以及51~60岁的人群是宫颈病变以及宫颈癌发病的高风险年龄段。

Analysis of cervical lesion characteristics in female patients with HPV multiple-infection

ObjectiveTo investigate the distribution of cervical lesions in female patients with HPV multiple infection and the association between HPV multiple-infection and cervical lesions.MethodsA total of 6 382 individuals ranging in 19-90 years old from Huaibei Miners General Hospital from March 2017 to March 2019 were recruited.Cervical scrapings were examined by cytopathology and colposcopy-directed biopsies.HPV genotyping was performed by using PCR-reverse dot blotting system.The data of the distribution and subtypes of cervical lesions among HPV multiple-infection at different age groups were analyzed using Spss19.0.ResultsThe HPV positive rate of 6 382 patients was 16.36%(1 044/6 832), including 344 cases with multiple subtypes of HPV infection.In addition, the HPV multiple-infection rate was 5.4%.The top three high-risk subtypes prevalence of HPV multiple-infection were HPV52, HPV16 and HPV58.The distribution of HPV multiple-infection of LSIL and HSIL were mainly in the 41-50 age group, while cervical cancer mainly distributed in the 51-60 age group.HPV multiple mixed-infections were mainly high-risk HPV coinfections, followed by high-risk and low-risk coinfections, and the low-risk coinfections.The difference of cervical lesions between high-risk HPV coinfections and high-risk and low-risk coinfections was statistically significant(P<0.01).However, the incidence rate between high-risk HPV coinfections and low-risk coinfections was not statistically significant(P>0.05).ConclusionsThe pathogenicity of HPV multiple-infection genotype(high-risk coinfection) is associated with cervical lesions(except cervical cancer).The females from 41 to 60 years old is the high-risk age for cervical lesions and cervical cancer.