杨慧红, 杨永彬. 人乳头瘤病毒亚型感染导致宫颈病变的调查[J]. 上海预防医学, 2020, 32(1): 67-70, 77. DOI: 10.19428/j.cnki.sjpm.2020.19351
引用本文: 杨慧红, 杨永彬. 人乳头瘤病毒亚型感染导致宫颈病变的调查[J]. 上海预防医学, 2020, 32(1): 67-70, 77. DOI: 10.19428/j.cnki.sjpm.2020.19351
YANG Hui-hong, YANG Yong-bin. Cervical lesions caused by HPV subtype infection[J]. Shanghai Journal of Preventive Medicine, 2020, 32(1): 67-70, 77. DOI: 10.19428/j.cnki.sjpm.2020.19351
Citation: YANG Hui-hong, YANG Yong-bin. Cervical lesions caused by HPV subtype infection[J]. Shanghai Journal of Preventive Medicine, 2020, 32(1): 67-70, 77. DOI: 10.19428/j.cnki.sjpm.2020.19351

人乳头瘤病毒亚型感染导致宫颈病变的调查

Cervical lesions caused by HPV subtype infection

  • 摘要:
    目的 通过调查不同亚型人乳头瘤病毒(HPV)感染与宫颈病变的关系,探讨HPV分型检测在宫颈疾病筛查中的应用价值。
    方法 收集2017年1月至2018年9月在上海市第一人民医院宫颈疾病门诊就诊HPV分型检测阳性的全部患者共1 851例。以病理学诊断为金标准进行阴道镜检查及宫颈组织活检,分析HPV各亚型的感染分布情况及其与宫颈病变的相互关系。
    结果在1 851例患者中,以高危型人乳头瘤病毒(HR-HPV)感染为主,HPV16检出率居首位,其次为HPV52、HPV58、HPV53等,其中病理组织活检结果阳性患者共234例,检出宫颈上皮内瘤变(CIN)2级以上病变者77例。HPV16型感染者CIN2级以上比例为11.8%(45/380),高于HPV52、HPV58等其他高危亚型感染者2.4%(32/1 328),差异有统计学意义(χ2=61.60,P < 0.001)。在年龄因素中,>35岁组HPV高危阳性比例为96.91%(1 225/1 264),高于≤35岁组94.38%(554/587),差异有统计学意义(χ2=6.898,P=0.009)。HPV分型检测检出CIN1级以上病变为12.64%(234/1 851),而液基薄层细胞学检测(TCT)检出CIN1级以上病变为8.59%(159/1 851),TCT作为筛查手段其检出率低于HPV检测方法(χ2=16.01,P < 0.001)。
    结论 HPV亚型感染依次以HPV16、HPV52、HPV58、HPV53、HPV18递减,HR-HPV感染与宫颈病变发生密切相关,且随着高危感染的升高,其宫颈病变程度也升高。HPV分型检测较TCT筛查宫颈病变检出率更高。

     

    Abstract:
    Objective To investigate the relationship between human papillomavirus (HPV) infection and cervical lesions, and to explore the application value of HPV typing in cervical disease screening.
    Methods Colposcopic examination and cervical biopsy were performed in 1 851 cases of HPV positive patients from January 2017 to September 2018 in the cervical disease clinic of Shanghai First People's Hospital.Pathological diagnosis was used as the gold standard to analyze the distribution of HPV subtypes and the relationship between HPV subtypes and cervical lesions.
    Results Among 1 851 patients, high-risk human papillomavirus (HPV) infection was the main type.The detection rate of HPV 16 was the highest, followed by HPV52, HPV58, HPV53 and so on.A total of 234 patients with positive biopsy results were found, and 77 patients with CIN2 or above lesions were detected.The ratio of CIN2 or above patients with HPV 16 was 11.8% (45/380), higher than 2.4% (32/1 328) of other high-risk subtypes such as HPV52 and HPV58.The difference was statistically significant(χ2=61.60, P < 0.001).In the age factor, the high-risk positive ratio of HPV in the 35-year-old group was 96.91% (1 225/1 264), higher than 94.38% (554/587) in the 35-year-old group.The difference was statistically significant (χ2=6.898, P=0.009).The detection rate of CIN1 disease was 12.64% (234/1 851) in HPV classification test, 8.59% (159/1 851) in liquid based thin layer cytology test (TCT), and the detection rate of TCT as a screening method was lower than that of HPV test method (χ2=16.01, P < 0.001).
    Conclusion The survey find that HPV subtypes are the most common in the order of HPV16, HPV52, HPV58, HPV53 and HPV18.HR-HPV infection was closely related to cervical lesions, and with the increase of high-risk infections, the degree of cervical lesions also increased.The detection rate of HPV typing is higher than that of TCT screening for cervical lesions.HPV genotyping has high sensitive and negative predictive value in screening cervical lesions.

     

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