HPV分型研究在宫颈癌筛查中的意义

目的:探讨HPV分型流行病学特征及其与宫颈癌前病变的关系。方法:选择陕西省人民医院2014年1月-2014年12月在妇科门诊就诊、有性生活史并行宫颈液基细胞学（TCT）检查的患者10 885例，其中2 677例患者同时行宫颈感染人乳头瘤病毒（HPV）分型筛查。结果:TCT异常率（≥ASCUS）7.6%； HPV感染率 34.8%，其中高危型HPV占76.93%，低危型HPV占23.93%；混合感染（2种以上HPV亚型感染）占20.28%，高危型HPV感染主要型别为HPV16、HPV52、HPV58；低危型HPV感染主要型别为HPV6、HPV11、HPV43；未发现HPV26、73、83型阳性病例；≤29岁及≥50岁年龄段为HPV感染及TCT异常的高峰年龄段；HPV 感染率随着细胞学诊断级别及病理学诊断级别的升高而显著上升。结论:不同年龄段HPV 分型感染率及 TCT 异常率不同，HPV 感染率与宫颈病变严重程度呈显著正相关。

The significance of HPV genotypes in cervical cancer screening

Objective:To study the epidemiological characteristics of different genotypes of human papillomavirus (HPV)and their relationship with cervical precancerous lesions. Methods:A total of 10 885 patients who had sex life and requested cervical screening were enrolled from the outpatient section of Gynec in the study. All the patients un-derwent cervical cytology tests(TCT),among them 2 677 patients had cervical HPV subtype screening. Results:TCT- positive rate(≥ASCUS)was 7. 6% . HPV infection rate was 34 . 8 % ,among which 76 . 93 % were high - risk, 23. 93% were low - risk,and 20. 28% were mixed infection(infected from two or more HPV subtypes). The high -risk HPV infections were mainly caused by HPV16,HPV52 and HPV58 while the low - risk infections were mainly caused by HPV6,HPV11 and HPV43. No infection was found caused by HPV26,HPV73 or HPV83. ≤29 years and≥50 years were peak ages of both HPV infection and cytology abnormality. HPV infection rates increased significantly as the deterioration of cytological and pathology diagnosis. Conclusion:HPV infection rate and TCT positive rate varied among different ages.HPV infection rate was significantly correlated with the severity of cervical lesion.