中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
Chinese Journal of Woman and Child Health Research
2015年
5期
955-957,958
,共4页
人乳头状瘤病毒感染%人乳头状瘤病毒分型%人乳头状瘤病毒亚型分布%宫颈病变
人乳頭狀瘤病毒感染%人乳頭狀瘤病毒分型%人乳頭狀瘤病毒亞型分佈%宮頸病變
인유두상류병독감염%인유두상류병독분형%인유두상류병독아형분포%궁경병변
HPV infection%HPV subtype%HPV subtype distribution%cervical lesion
目的:探讨咸阳地区妇科门诊患者人乳头状瘤病毒( HPV)感染亚型分布及其与宫颈病变的关系。方法选取2009年1月至2013年2月在咸阳市区3家三级医院妇科门诊行宫颈HPV病毒分型及薄层液基细胞学筛查的患者共3573例,其中HPV分型(包括19种高低危亚型)检测呈阳性者为966例,细胞学阳性者[≥未确定意义的不典型鳞状细胞( ASCUS )]572例,两者均为阳性者354例;对HPV分型检测或薄层液基细胞学两者任一阳性结果者行阴道镜下组织病理学检查,共1169例。依据病检结果分析HPV感染亚型与宫颈病变的相关性。结果咸阳地区妇科门诊患者HPV检测阳性率为27.04%;高危型HPV阳性率24.55%,HPV16阳性率12.26%,占高危型HPV的45.34%。30岁及以下HPV检查阳性率最高,30岁以上随年龄增长各年龄组HPV检查阳性率逐渐降低,除了≤20岁组与21~30岁组差异无统计学意义外(P>0.05),21~30岁组与31~40岁组、31~40岁组与41~50岁组、41~50岁组与51~60岁组、51~60岁组与>60岁组的阳性率比较差异均有统计学意义(χ2值分别为5.08、8.93、37.48、4.28,均P<0.05)。 HPV16在宫颈上皮内瘤样病变CINⅡ、CINⅢ及鳞状细胞癌( SCC)中检出率均为最高,分别为50.59%、78.13%、81.82%。 HPV16较HPV58、18、52、33致CINⅡ以上病变的发生率明显增高,经比较差异均有统计学意义(χ2值依次为53.93、62.84、93.01、93.01,均P<0.01)。结论咸阳地区妇科门诊患者高危型HPV感染的优势型别依次为HPV16、52、58、18和33。 HPV16在宫颈癌及癌前病变的发生和发展中起关键作用。同时,HPV58、18、52、33在该地区也具有较高的致病性。高危型HPV基因分型诊断在宫颈癌筛查及防治过程中具有重要意义。
目的:探討鹹暘地區婦科門診患者人乳頭狀瘤病毒( HPV)感染亞型分佈及其與宮頸病變的關繫。方法選取2009年1月至2013年2月在鹹暘市區3傢三級醫院婦科門診行宮頸HPV病毒分型及薄層液基細胞學篩查的患者共3573例,其中HPV分型(包括19種高低危亞型)檢測呈暘性者為966例,細胞學暘性者[≥未確定意義的不典型鱗狀細胞( ASCUS )]572例,兩者均為暘性者354例;對HPV分型檢測或薄層液基細胞學兩者任一暘性結果者行陰道鏡下組織病理學檢查,共1169例。依據病檢結果分析HPV感染亞型與宮頸病變的相關性。結果鹹暘地區婦科門診患者HPV檢測暘性率為27.04%;高危型HPV暘性率24.55%,HPV16暘性率12.26%,佔高危型HPV的45.34%。30歲及以下HPV檢查暘性率最高,30歲以上隨年齡增長各年齡組HPV檢查暘性率逐漸降低,除瞭≤20歲組與21~30歲組差異無統計學意義外(P>0.05),21~30歲組與31~40歲組、31~40歲組與41~50歲組、41~50歲組與51~60歲組、51~60歲組與>60歲組的暘性率比較差異均有統計學意義(χ2值分彆為5.08、8.93、37.48、4.28,均P<0.05)。 HPV16在宮頸上皮內瘤樣病變CINⅡ、CINⅢ及鱗狀細胞癌( SCC)中檢齣率均為最高,分彆為50.59%、78.13%、81.82%。 HPV16較HPV58、18、52、33緻CINⅡ以上病變的髮生率明顯增高,經比較差異均有統計學意義(χ2值依次為53.93、62.84、93.01、93.01,均P<0.01)。結論鹹暘地區婦科門診患者高危型HPV感染的優勢型彆依次為HPV16、52、58、18和33。 HPV16在宮頸癌及癌前病變的髮生和髮展中起關鍵作用。同時,HPV58、18、52、33在該地區也具有較高的緻病性。高危型HPV基因分型診斷在宮頸癌篩查及防治過程中具有重要意義。
목적:탐토함양지구부과문진환자인유두상류병독( HPV)감염아형분포급기여궁경병변적관계。방법선취2009년1월지2013년2월재함양시구3가삼급의원부과문진행궁경HPV병독분형급박층액기세포학사사적환자공3573례,기중HPV분형(포괄19충고저위아형)검측정양성자위966례,세포학양성자[≥미학정의의적불전형린상세포( ASCUS )]572례,량자균위양성자354례;대HPV분형검측혹박층액기세포학량자임일양성결과자행음도경하조직병이학검사,공1169례。의거병검결과분석HPV감염아형여궁경병변적상관성。결과함양지구부과문진환자HPV검측양성솔위27.04%;고위형HPV양성솔24.55%,HPV16양성솔12.26%,점고위형HPV적45.34%。30세급이하HPV검사양성솔최고,30세이상수년령증장각년령조HPV검사양성솔축점강저,제료≤20세조여21~30세조차이무통계학의의외(P>0.05),21~30세조여31~40세조、31~40세조여41~50세조、41~50세조여51~60세조、51~60세조여>60세조적양성솔비교차이균유통계학의의(χ2치분별위5.08、8.93、37.48、4.28,균P<0.05)。 HPV16재궁경상피내류양병변CINⅡ、CINⅢ급린상세포암( SCC)중검출솔균위최고,분별위50.59%、78.13%、81.82%。 HPV16교HPV58、18、52、33치CINⅡ이상병변적발생솔명현증고,경비교차이균유통계학의의(χ2치의차위53.93、62.84、93.01、93.01,균P<0.01)。결론함양지구부과문진환자고위형HPV감염적우세형별의차위HPV16、52、58、18화33。 HPV16재궁경암급암전병변적발생화발전중기관건작용。동시,HPV58、18、52、33재해지구야구유교고적치병성。고위형HPV기인분형진단재궁경암사사급방치과정중구유중요의의。
Objective To discuss HPV infection subtype distribution among gynecological outpatients in Xianyang district and its relation with cervical lesions.Methods Between January 2009 and February 2013, totally 3 573 outpatients undergoing HPV genotyping and liquid-based cytology check were selected in three tertiary hospitals in Xianyang district.There were 966 cases with HPV genotype positive ( including 19 kinds of high-and low-risk subtype) and 572 cases with cytological positive ( ASCUS) .Both positive results were found in 354 cases.For 1 169 patients with any positive results, colposcopy and cervical biopsy were performed.The correlation between subtypes of HPV infection and cervical lesions was analyzed according to pathological examination results.Results HPV testing positive rate was 27.04%.HR-HPV positive rate was 24.55%, and HPV16 positive rate was 12.26% accounting for 45.34% of HR-HPV.The highest positive rate of HPV was found among women aged below 30.With age increasing, HPV positive rate declined gradually.There were significant differences in HPV positive rate among different age groups except for group aged≤20 years and group aged 21-30 years (χ2 value was 5.08, 8.93, 37.48 and 4.28, respectively, all P<0.05).The detection rates of HPV16 in CINⅡ, CINⅢand squamous cell cancer (SCC) were highest, and they were 50.59%, 78.13%and 81.82%, respectively.Compared with HPV58, HPV18, HPV52 and HPV33, HPV16 caused CINⅡor above more easily, and the difference was statistically significant (χ2 value was 53.93,62.84,93.01 and 93.01, respectively, all P<0.05).Conclusion The most common high-risk HPV genotypes infected in outpatients in Xianyang district are HPV16, HPV52, HPV58, HPV18 and HPV33.HPV16 plays a key role in the genesis and development of cervical cancer and precancerous lesions.HPV58, HPV18, HPV52, and HPV33 are also pathogenic in this area.High-risk HPV genotyping is therefore very important in cervical cancer screening and the process of prevention and diagnosis.