胡敏敏. 上海市某三甲医院医务人员HPV感染及宫颈病变细胞分型[J]. 上海预防医学, 2020, 32(4): 329-333, 346. DOI: 10.19428/j.cnki.sjpm.2020.19513
引用本文: 胡敏敏. 上海市某三甲医院医务人员HPV感染及宫颈病变细胞分型[J]. 上海预防医学, 2020, 32(4): 329-333, 346. DOI: 10.19428/j.cnki.sjpm.2020.19513
HU Min-min. HPV infection and cervical lesion cytotyping among medical staff in a class A hospital of Shanghai[J]. Shanghai Journal of Preventive Medicine, 2020, 32(4): 329-333, 346. DOI: 10.19428/j.cnki.sjpm.2020.19513
Citation: HU Min-min. HPV infection and cervical lesion cytotyping among medical staff in a class A hospital of Shanghai[J]. Shanghai Journal of Preventive Medicine, 2020, 32(4): 329-333, 346. DOI: 10.19428/j.cnki.sjpm.2020.19513

上海市某三甲医院医务人员HPV感染及宫颈病变细胞分型

HPV infection and cervical lesion cytotyping among medical staff in a class A hospital of Shanghai

  • 摘要:
    目的探讨女性医务人员宫颈病变的细胞学分型及其与人乳头状瘤病毒(human papillomavirus, HPV)感染的关系。
    方法收集2015—2017年复旦大学附属妇产科医院1 093位女性医务人员宫颈细胞学筛查结果及2017年1 085例HPV筛查结果,细胞学采用SurePath液基细胞制片,HPV检测采用硕世21分型试剂盒。采用单因素和多因素回归分析,研究宫颈阴道镜活检的病理结果和HPV感染情况关系。
    结果被调查对象HPV感染率为10.0%(108/1 085),但随年龄增长HPV感染率呈上升趋势不明显(χ2=4.43, P=0.11)。HPV感染者中高危型占95.37%(103/108),主要感染的高危型HPV由高到低依次为HPV52、HPV53、HPV58、HPV16。3年的细胞学阳性率分别为1.5%,1.6%和4.0%。HPV和/或细胞学阳性病例中有66例行阴道镜活检,活检阳性患者中细胞学阳性、HPV阳性、HPV16型阳性、2015及2016年细胞学均阴性的比例分别为41.1%、19.1%、60%和29.7%。多重logistic回归分析显示细胞学结果是独立的危险因素,OR=7.87 (95%CI:1.85~33.54)。
    结论医务人员HPV感染率低于普通人群,但高危型HPV感染构成比很高,建议女性自有性生活起应定期开展HPV检测,早期发现高危型HPV感染,预防宫颈癌的发生。在低感染率的人群中宫颈细胞学筛查的敏感性和特异性均高于HPV筛查,细胞学的筛查周期应不超过1年。

     

    Abstract:
    ObjectiveTo study the relationship between cytology of cervical lesion and HPV in female medical workers.
    MethodsFrom Fudan University Hospital of Obstetrics and Gynacology the results of cervical cytology screening in 1 093 female medical staff in 2015-2017 and results of HPV screening in 1 085 cases in 2017 were collected.SurePath liquid-based cell preparation was used for cytology and the segr-21 typing kit was used for HPV detection.The relationship between the pathological results of cervical colposcopy biopsy and HPV infection was studied by single factor and multiple factor regression analysis.
    ResultsThe rate of HPV infection for subjects in the study was 10.0% (108/1 085), with increase in age, the infection rate showed an insignificant rising trend(χ2=4.43, P=0.11).High-risk HPV infection accounted for 95.37% (103/108), and the major high-risk HPV infections were HPV 52, HPV53, HPV58, and HPV16 in descending order.The 3-year cytological positive rates were 1.5%, 1.6% and 4.0%, respectively.Sixty-six of the HPV and/or cytological positive cases underwent colposcopy biopsy, and the proportion of cytology being positive, HPV positive, HPV16 positive, cytology negative in 2015 and 2016 was 41.1%, 19.1%, 60% and 29.7%, respectively.Multiple logistic regression showed that cytology was an independent risk factor, OR=7.87 (95%CI:1.85-33.54).
    ConclusionThe rate of HPV infection in medical staff is lower than that in the general population, but the composition ratio of high-risk HPV infection is very high.It is recommended that women should undergo HPV test regularly from sexual life; early detection of high-risk HPV infection could prevent the occurrence of cervical cancer.The sensitivity and specificity of cervical cytology screening prove to be higher than those of HPV screening in people with low infection rate, and the cytology screening cycle should not exceed one year.

     

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