陕西省某医院2014-2016年子宫颈癌筛查女性人乳头瘤病毒感染率

目的分析子宫颈癌筛查女性人乳头瘤病毒(Human papillomavirus,HPV)感染率。方法选取2014-2016年某医院接受子宫颈癌筛查的女性,检测21种HPV亚型核酸,开展子宫颈细胞病理学诊断,包括无上皮内病变细胞或恶性细胞(NILM)即正常、不明意义非典型细胞(ASCUS)、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)和浸润性子宫颈癌(ICC),分析HPV阳性率。结果调查对象HPV总阳性率为25.9%(4475/17255),其中NILM、ASCUS/LSIL、HSIL、ICC女性HPV阳性率分别为21.4%、62.7%、77.8%、91.3%;各HPV亚型阳性率在0.04%(HPV43)-7.7%(HPV16)之间。二价、四价、九价HPV疫苗覆盖HPV亚型累积阳性率分别为9.4%、10.3%、18.9%;在NILM、ASCUS/LSIL、HSIL、ICC女性中九价疫苗覆盖HPV亚型阳性率分别为14.4%、48.4%、72.1%、88.7%。结论调查医院子宫颈癌筛查女性HPV感染率高;HPV疫苗未完全覆盖感染的HPV亚型,接种疫苗后仍应进行常规子宫颈癌筛查。

Human papillomavirus infection rates among women receiving cervical cancer screening in a hospital of Shaanxi province during 2014-2016

Objective To determine human papillomavirus(HPV)infection rates among women being screened for cervical cancer.MethodsWe recruited women who were being screened for cervical cancer in a Shaanxi hospital between 2014 and 2016.We detected nucleic acid sequences for 21 HPV subtypes and confirmed cervical cytological diagnoses,including negative for intraepithelial lesions or malignancy(NILM)assessed as normal,atypical squamous cells of undetermined significance(ASCUS),low-grade squamous intraepithelial lesions(LSIL),high-grade squamous intraepithelial lesions(HSIL),and invasive cervical cancer(ICC).We determined HPV positivity rates overall,by diagnosis,and by HPV type.Results The overall HPV positivity rate was 25.9%(4475/17255).Positivity rates among subjects diagnosed as NILM,ASCUS/LSIL,HSIL,and ICC were 21.4%,62.7%,77.8%,and 91.3%,respectively.Positivity rates for HPV subtypes ranged from 0.04%(HPV43)to 7.7%(HPV16).Cumulative positivity rates of HPV subtypes covered by 2-,4-,and 9-valent HPV vaccines were 9.4%,10.3%,and 18.9%.Positivity rates of HPV subtypes covered by 9-valent vaccine among subjects diagnosed with NILM,ASCUS/LSIL,HSIL,and ICC were 14.4%,48.4%,72.1%,and 88.7%.Conclusions The HPV infection rate was high among women receiving cervical cancer screening in the study hospital.HPV vaccines did not covered all detected HPV genotypes;women should continue to receive routine cervical cancer screening after HPV vaccination.