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目的:调查安康地区女性人乳头瘤病毒(HPV)感染的基因型别及年龄分布特征,分析其与宫颈癌的关系,为宫颈癌防治及HPV疫苗研发提供可靠的依据。方法:收集2010年6月-2012年8月间在本院及安康市部分县级医院妇产科就诊的2736名女性的液基细胞学和组织学标本,分为8个年龄组:16-24岁119例、25-29岁230例、30-34岁343例、35-39岁472例、40-44岁574例、45-49岁512例、50-54岁206例、55-86岁280例,进行病理学分类及HPV分型检测,分析不同年龄组及不同类型宫颈组织中的HPV感染率。结果:2736例女性中发生HPV感染720例(26.32%),共检出21种型别,感染率最高的基因型别是HPV16(25.05%),其他常见型别依次为HPV58、HPV52、HPV6、HPV11。单一感染占76.25%,多重感染占23.75%。HPV感染率在16-24岁、35-39岁和55-86岁三个年龄段出现高峰;而高危型HPV的感染率在35-39岁和55-86岁两个年龄段分别出现高峰。HPV的检出率随着宫颈病变的严重程度而增加,其中正常或炎症人群的HPV感染率显著低于宫颈病变及宫颈鳞状细胞癌患者(均P<0.05),且意义未明的不典型鳞状细胞(ASCUS)、CIN1-3及宫颈鳞状细胞癌患者的HPV感染率对比结果存在显著差异(P<0.05)。CIN1组、CIN2-CIN3组及宫颈鳞状细胞癌组单一感染率逐渐增加(P<0.05),且其二重、三重感染率比较差异均有统计学意义(P<0.05)。结论:安康地区HPV16型别感染较广,临床需加强对HPV16型单一感染宫颈病变患者的癌症预防工作。
Objective: To investigate the genotypes and age distribution of female human papillomavirus (HPV) infection in Ankang region and analyze its relationship with cervical cancer so as to provide a reliable basis for the prevention and treatment of cervical cancer and HPV vaccine development. Methods: The liquid cytology and histology specimens of 2736 females attending obstetrics and gynecology department of our county and some county hospitals in Ankang from June 2010 to August 2012 were collected and divided into 8 age groups: 16- 119 in 24 years, 230 in 25-29, 343 in 30-34, 472 in 35-39, 574 in 40-44, 512 in 45-49, 206 in 50-54, 55-86 280 cases of age, pathological classification and HPV typing detection, analysis of different age groups and different types of cervical tissue HPV infection. Results: Of the 2736 women, there were 720 cases (26.32%) of HPV infections, of which 21 were detected. The highest genotype was HPV16 (25.05%). Other common types were HPV58, HPV52, HPV6, HPV11. Single infection accounted for 76.25%, multiple infections accounted for 23.75%. HPV infection rates peaked in three age groups of 16-24 years old, 35-39 years old and 55-86 years old, while the prevalence of high-risk HPV peaked at 35-39 years old and 55-86 years old respectively. The detection rate of HPV increased with the severity of cervical lesions, in which the HPV infection rate of normal or inflammatory population was significantly lower than that of cervical lesions and cervical squamous cell carcinoma (all P <0.05), and the atypical squamous cell carcinoma of unknown significance The HPV infection rates of ASCUS, CIN1-3 and cervical squamous cell carcinoma were significantly different (P <0.05). The single infection rates of CIN1, CIN2-CIN3 and cervical squamous cell carcinoma increased gradually (P <0.05), and the rates of double and triple infection were significantly different (P <0.05). CONCLUSIONS: In Ankang area, the HPV16 type is more widely infected and the clinical work needs to be strengthened to prevent cancer in patients with HPV16 type single cervical lesions.