山西省襄垣县宫颈癌危险因素分析

目的：在宫颈癌高发区调查其危险因素,为现阶段宫颈癌的防治工作提供依据。方法：在宫颈癌高发区山西省襄垣县,对1997年妇女采用6种宫颈癌检查方法筛查后,进行问卷调查,卷卷内容包括：基本信息,月经婚孕史,性行为及卫生习惯,避孕史,既往疾病和肿瘤家族史等,进行高危型人乳头瘤病毒（HPV）检测,病理学诊断为宫颈高度鳞状上皮病变以上者86例,非癌及非鳞状上皮病变者共1784例作为对照.结果：高危型HPV感染率为20．8％（415／1997）,病例组HPV感染率为97．7％,而对照组为14．2％,单因素分析后,具有显著统计意义的变量有：高危型HPV感染,初次性交年龄,流产史,性伴侣数,怀孕治疗史及肿瘤家族史等。logistic回归分析结果表明,高危型HPV感染,性伴侣数和肿瘤家族史与宫颈癌的发生呈显著关联,此外,HPV感染与男,女婚外性行为均有显著的统计学联系,且随性伴侣数呈趋势性增高,结论：襄垣县妇女子宫颈癌高发的主要危险因素是高危型HPV感染。HPV感染与该地区性生活,月经期及产褥期卫生不洁有直接关联。

Analysis of risk factors for cervical cancer in Xiangyuan County, Shanxi Province

Objectives To investigate the risk factors for cervical cancer in the areas of high incidence, and provide evidence for current intervention of cervical cancer Methods In the areas of Xiangyuan County, Shanxi Provicne with high incidence of cervical cancer, 1 997 women were interviewed using a questionnaire, including baseline information, menstrual, marital and pregnancy histories, sexual behavior, health habits, contraception, medical history and family history of cancer, etc , after its screening with six kinds of methods All subjects, including 84 cases with pathological diagnosis of greater than cINI, and 1 784 cases with pathological diagnosis of normal, were tested for high risk HPV. Results The overall rates of HPV infection were 20 8% (415/1 997) in high risk subjects, 97 7% and 14 2% in the cases and control groups, respectively Univariate analysis showed that risk factors with statistical significance included high risk HPV infection, age at first sexual intercourse, history of pregnancy and abortion, the number of sexual partners and family history of cancer Analysis with non conditional logistic regression model revealed high risk HPV infection, multiple sexual partners and family history of cancer associated obviously with occurrence of cervical cancer In addition, there was significantly positive relationship between HPV infection, which incresed with the number of sexual partners, and extramarital sexual activity both in males or females Conclusions The main risk factor for cervical cancer in this region was high risk HPV infection, which related to sexual behavior, hygienic habits during menstruation and puerperium It was particularly important to detect and treat precancerous lesions and to implement behavior modification In addition, further research on genetic susceptibility was suggested