妇科门诊女性人乳头瘤病毒感染型别分布特征及临床分析

目的 分析妇科门诊女性人乳头瘤病毒(HPV)感染率、HPV型别分布及不同人群、不同年龄组HPV感染特征,探讨其与宫颈病变的关系.方法 采用导流杂交基因芯片法对妇科门诊5 869名女性进行HPV分型检测.结果 5 869例样本中,HPV总感染率为23.6%,HPV高危型检出率占19.6%,低危型为6.7%,HPV感染率较高型别依次为HPV16、52、11、58、6、18、53、33;1385例HPV阳性中,存在HPV亚型单一感染(72.1%)、双重感染(21.3%)及三重以上感染(6.6%).宫颈癌患者HPV感染率(91.7%)明显高于宫颈炎患者(χ²=207.426, P<0.001)和健康体检者(χ²=252.211, P<0.001),宫颈癌患者HPV感染率较高亚型为HPV16、18、31、33、58、45.不同年龄女性HPV的感染率差异有统计学意义(χ²=36.486, P<0.01),≤25岁HPV感染率最高(32.5%),其次是>50岁(28.4%).结论 妇科门诊女性HPV感染以高危型为主,低危型为次,同时存在HPV高、低危亚型混合感染以及多重感染,HPV感染型别分布具有人群特点和地域差异;不同人群HPV感染率存在差异,宫颈癌患者HPV感染率最高,除HPV16、18外,其他HPV高危亚型也与宫颈病变及宫颈癌密切相关;≤25岁和>50岁是HPV感染高危人群.

Clinical analysis and type distribution of human papilloma virus among gynecologic outpatients

Objective To explore the infection rate and characteristics of human papilloma virus (HPV) among gynecologic outpatients, distribution of HPV types, and the relationship between HPV and cervical neoplasms. Methods Flow-through hybridization and gene chip ttechnique was employed to detect HPV genotypes of 5 869 gynecologic outpatients. Results The total infection rate was 23.6%, the detection rate of HR-HPV and LR-HPV was 19.6% and 6.7%, respectively. The most common type of HPV was HPV16, followed by 52, 11, 58, 6, 18, 53 and 33. Of the 1,385 HPV cases, 72.1% acquired single subtype of HPV, 21.3% had two different subtypes, and 6.6% had more than three different subtypes. HPV infection rate in patients with cervical cancer (91.7%) was significantly higher than that in patients with cervicitis (χ²=207.426, P<0.001) and healthy controls (χ²=252.211, P<0.001). HPV16,18, 31, 33, 58 and 45 were most commonly found in patients with cervical cancer. HPV infection rate was significant (χ²=36.486, P<0.01) in different age groups, the highest (32.5%) was in women under 25 years old, followed by 28.4% in women above 50 years old. Conclusion Among gynecologic HPV outpatients, most were infected with HR-HPV, some with LR-HPV, and a few with both HR- HPV and LR-HPV or with multiple HPV. There were obviousregional differences and characteristics of HPV type distribution in different population groups. The highest rate of HPV infection was in patients with cervical cancer. HPV 16, 18, and other HR- HPV were found to be closely related with cervical lesions and cervical cancer. Women under 25 and above 50 years old were high-risk groups.