徐州地区人乳头瘤病毒感染及病毒分型与宫颈病变的关系

目的了解徐州及其周边地区女性生殖道人乳头瘤病毒(HPV)分型感染的情况,分析HPV基因分型检测对宫颈疾病的实际诊断价值,为宫颈病变的防治与临床诊断提供可靠依据。方法选择2016年12月至2017年11月在徐州市中心医院体检并进行HPV分型检测的13 755例女性患者为研究对象,其中468例女性患者经过病理诊断确诊为宫颈病变,对其完成了阴道脱落细胞液基细胞学检查(TCT)和阴道镜下组织病理学检查,以病理诊断为宫颈病变诊断的"金标准",分析高危型HPV感染与宫颈病变的关系。结果在13 755例女性患者中,HPV阳性2 752例,阳性率20.0%;21种HPV亚型均被检出。高危型HPV亚型感染中,HPV16、52、53、58、56五种亚型最为常见;其中单一感染2 020例,占阳性患者的73.4%,多重感染732例,占阳性患者的26.6%;感染的高峰年龄为≤20岁组,随着年龄增长,HPV感染率逐渐下降,>50岁组为第二个高峰。随着宫颈病变程度的增加,HPV高危型感染阳性率呈现逐渐升高的趋势。结论徐州及周边地区女性HPV基因型的分布具有明显的年龄和区域分布特异性。HPV分型检测筛查宫颈病变敏感性和阴性预测值高。

Investigation of human papillomavirus infection and virus genotyping in patients with cervical lesion in Xuzhou

Objective To study the genotypic infection status of human papillomavirus(HPV) in the female in Xuzhou, and to analyze the diagnostic value of HPV genotyping in cervical disease, so as to provide reliable basis for cervical cancer prevention. Methods A total of 13 755 patients who underwent physical examination and HPV typing in Xuzhou Central Hospital from December 2016 to November 2017 were enrolled. Among them, 468 patients were diagnosed with cervical lesions by case diagnosis. Exfoliated cell-based cytology(TCT) and histopathological examination under colposcopy were used to analyze the relationship between high-risk HPV infection and cervical lesions with pathological diagnosis as the "gold standard" for cervical lesion diagnosis. Results Among the 13 755 women, 2 752 cases were HPV positive, and the positive rate was 20.0%. 21 HPV subtypes were detected. Among the high-risk HPV subtype infections, HPV 16, 52, 53, 58, and 56 were the most common subtypes;2020 cases were single infection, accounting for 73.4% of positive patients, and 732 cases were multiple infections, accounting for 26.6% of positive patients;The peak age was ≤20 years old, and the HPV infection rate gradually decreased with age increasing, and the >50 age group was the second peak. As the degree of cervical lesions increased, the positive rate of HPV high-risk infections showed a gradual increase. Conclusions The distribution of HPV genotypes is significantly different among different age groups and regions in Xuzhou. HPV genotyping is of high sensibility and negative predictive value in screening cervical lesions.