高危型人乳头瘤病毒感染率及亚型分布与宫颈病变程度的相关性分析

目的探讨妇女高危型人乳头瘤病毒(HR-HPV)感染率及亚型分布与宫颈病变程度的相关性。方法回顾性分析2018年1月至2019年12月绍兴市3 307例妇女细胞学检查和HPV筛查结果。细胞学检查采用液基薄层细胞检测(TCT),HPV筛查采用聚合酶链式反应(PCR)-反向点杂交法,采用SPSS18.0软件进行统计学分析。结果3 307例受检妇女TCT结果未见上皮内病变细胞或恶性细胞(NILM)、非典型鳞状上皮细胞(ASC)和癌前病变(SIL)患者分别占90.84%、6.86%和2.30%。HPV阳性率19.11%,HR-HPV占82.52%。NILM、ASC和SIL患者HPV阳性率分别为14.38%、59.47%和85.53%,HR-HPV构成比分别为80.82%、83.33%和90.38%。HPV排前5的基因型为HPV52、HPV16、HPV58、HPV81和HPV53,但ASC和SIL患者最常见HPV16感染。HPV阳性患者重叠感染率为25.95%,SIL患者重叠感染率明显高于NILM和ASC患者(χ²=19.75和13.14,P <0.05)。HPV阳性率≥51岁年龄组明显高于其他所有年龄组,31~50岁年龄组明显高于≤30岁年龄组,差异均有统计学意义(χ²=24.23、29.31和5.90,P<0.05)。结论本地区SIL患者HPV阳性率、HR-HPV构成比和重叠感染率均明显高于NILM患者,HPV阳性率、HR-HPV构成比和重叠感染率与宫颈上皮内病变程度密切相关。随着年龄增大HPV阳性率呈上升趋势,应重视中老年妇女的宫颈癌筛查和防治教育。

Correlation analysis between the infection rate and subtype distribution of high risk human papillomavirus and degree of cervical lesions

Objective To know the correlation between high risk human papillomavirus(HR-HPV) infection rate,subtype distribution and degree of cervical lesions in women. Methods Cytological examination and HPV screening results of 3 307 women in Shaoxing from January 2018 to December 2019 were retrospectively analyzed. Cytological examination was performed by liquid based thin layer cell test(TCT), while HPV screening was performed by PCR-based reverse blot hybridization. SPSS18.0 statistical software was used for data analysis. Results Among the 3 307 women,NILM, ASC and SIL were detected as 90.84%, 6.86% and 2.30%, respectively. HPV positive rate was 19.11%, and HRHPV rate 83.12%. The HPV positive rates of NILM, ASC and SIL patients were 14.38%, 59.47% and 85.53%,respectively, and the proportions of HR-HPV were 80.82%, 83.33% and 90.38%. The top 5 genotypes were HPV52,HPV16, HPV58, HPV81 and HPV53, with the most common HPV16 infections in ASC and SIL patients. The multiple infection rate of HPV positive patients was 25.95%, and that of SIL patients was significantly higher than that of NILM and ASC patients(X²=19.75 and 13.14, P<0.05). The HPV positive rate in the group≥51 years was significantly higher than that in all other age groups, and that in the age group between 31-50 years was significantly higher than that in the group≤30 years, with statistically significant differences(X²=24.23, 29.31 and 5.90, P<0.05). Conclusion The HPV positive rate, HR-HPV proportion and multiple infection rate of SIL patients are significantly higher than that of NILM patients in this areas, which are closely related to the degree of cervical lesions.With the increase of age, the positive rate of HPV is on the rise. We should pay more attention to cervical cancer screening and prevention education for middle-aged and elderly women.