无锡市113207名妇女宫颈人乳头瘤病毒感染状况分析

目的了解无锡市妇女宫颈人乳头瘤病毒(HPV)感染状况及基因分型特点,为宫颈癌的筛查和防治工作提供依据。方法研究对象为2013年1月1日~6月30日参加无锡市免费宫颈癌筛查的113 207名妇女,年龄35~64岁,根据常住地址分为城区和农村。113 207名妇女接受妇科、阴道分泌物检查和HPV检测,再选择性进行宫颈液基薄层细胞学检查(TCT)、阴道镜检查及组织病理学诊断。结果 113 207名妇女中,HPV检出率为12.98%,高危型HPV检出率为12.60%。不同地区(城区、农村)妇女HPV检出率、高危型HPV检出率差异均有高度统计学意义(P<0.01),均为农村高于城区。≥55岁年龄组HPV检出率为13.92%,位居第1位,且该年龄组妇女HPV检出率、高危型HPV检出率和HPV多重感染率与其他年龄组之间差异有高度统计学意义(P<0.01)。单一感染占77.52%,多重感染占22.48%。农村地区妇女单一感染、多重感染率均高于城区(P<0.01)。感染HPV型别前5位分别是HPV52、HPV16、HPV58、HPV68、HPV18。结论高危型HPV感染是宫颈癌前病变和宫颈癌的主要原因,采用HPV检测作为初筛方法,再选择性进行宫颈TCT、阴道镜检查及宫颈组织病理学诊断的宫颈癌筛查方案,是切实可行的。农村和绝经后妇女HPV感染问题需引起关注。HPV亚型分布存在地域性差异。

Analysis of cervical human papilloma virus infection status in 113 207 women in Wuxi City

Objective To understand cervical human papilloma virus（HPV） infection status and genotyping characteristics of women in Wuxi City for providing suggestions on screening and prevention of cervical cancer. Methods 113 207women attended free of uterine cervix cancer screening in Wuxi City from 1 January to 30 June in 2013 were selected as research objects, aged 35 to 64 years old, and according to the permanent address, they were divided into urban and rural areas. Examination of gynecologic, vaginal secretions and HPV detection were carried out in 113 207 women, then the cervical prep cytologic test（TCT）, vaginoscopy and histopathologic diagnosis were done selectively. Results HPV detection rate was 12.98%, and high-risk HPV detection rate was 12.60% among 113 207 women. The differences of HPV detection rates, high-risk HPV detection rates in different areas（urban and rural） were statistically significant（P 0.01）, both rural areas were high than urban areas. HPV detection rate was 13.92% in 55 and over age group,ranking first, and the differences of HPV positive rate, high-risk HPV detection rate and HPV multiple infection rate between this age group and other age groups were statistically significant（P 0.01）. The single HPV type infection was77.52%, the multiple HPV type infection was 22.48%. The single and multiple HPV type infection rates of women in rural areas were higher than in urban（P 0.01）. HPV52, HPV16, HPV58, HPV68 and HPV18 were the top five frequent types. Conclusion High-risk type HPV infection was the main cause of uterine cervix cancer and uterine cervix cancer precancerous change. Using HPV testing as a primary screening method, then selectively using the cervical TCT, vaginoscopy and histopathologic diagnosis was a feasible screening program. Besides, HPV infection in rural and postmenopausal women need attention. HPV subtypes distribution has a certain regional characteristics.