健康体检者与妇科门诊患者及宫颈癌患者人乳头瘤病毒基因型分布特点分析

Distribution of human papillomavirus genotypes of healthy check-up people, patients of gynecology outpatient department, and patients with cervical cancer

  • 摘要: 目的 探讨不同健康状态女性人乳头瘤病毒(HPV)的感染情况和亚型分布特点,为HPV感染诊治和宫颈癌预防提供重要依据。方法 应用核酸分子快速导流杂交分型技术对遵义医学院附院2015年1-12月体检中心体检、妇科门诊就诊及肿瘤科确诊宫颈癌的女性患者22 419例进行HPV基因分型检测。结果 宫颈癌确诊患者HPV感染率最高为84.42%,单一感染占83.50%,其次是妇科门诊就诊女性为37.47%,单一感染占80.36%,最后是体检女性为13.24%,单一感染占86.30%,三组间HPV感染率差异有统计学意义(P<0.01); 各组之间HPV亚型分布不同,均以高危亚型感染为主,其中健康体检者亚型感染频率最高的前3位是52、58、16亚型,分别占19.36%、11.28%、11.02%,门诊就诊女性亚型感染频率最高的前3位是52、16、58亚型,分别占17.92%、14.54%、10.97%,宫颈癌确诊患者亚型感染频率最高的前3位是16、52、18亚型,分别占33.88%、28.10%、19.00%。体检女性51岁以上HPV感染率较高(P<0.01),门诊就诊女性HPV感染率最高的是61岁以上和15~20岁女性,分别为69.39%和53.61%(P<0.01),而宫颈癌确诊者HPV感染率各年龄段差异不显著。结论 HPV感染普遍存在于不同健康状态的女性中,均以单一感染高危型为主,且与年龄有关,加强对各年龄段不同人群HPV筛查对宫颈癌的预防具有必要性。

     

    Abstract: OBJECTIVE To explore the prevalence of human papillomavirus (HPV) infection in women with different heath state and observe the distribution of its subtypes so as to provide guidance for diagnosis and treatment of HPV infection as well as prevention of cervical cancer.METHODS A total of 22 419 women who received physical examination in physical examination center, were treated in gynecology outpatient department, and were diagnosed with cervical cancer in oncology department of Affiliated Hospital of Zunyi Medical College from Jan 2015 to Dec 2015 were enrolled in the study, and the genotypes of HPV were detected by using rapid flow-through hybridization typing of nucleic acid molecules.RESULTS The incidence rate of HPV infection was the highest (84.42%) in the patients confirmed with cervical cancer, of whom 83.50% had single infection; the incidence rate of HPV infection was 37.47% in the women who were treated in the gynecology outpatient department, of whom 80.36% had single infection; the incidence rate of HPV infection was 13.24% in the women who received the physical examination, of whom 86.30% had single infection, and there was significant difference in the incidence rate of HPV infection among the three groups (P<0.01).The HPV subtypes varied among the three groups, the high-risk HPV subtype infection was the most prevalent; the HPV52, 58, and 16 ranked the top 3 subtypes of HPV among the women who received the physical examination, accounting for 19.36%, 11.28%, and 11.02%, respectively.The HPV52, 16, and 58 ranked the top 3 subtypes of HPV among the women who were treated in the gynecology outpatient department, accounting for 17.92%, 14.54%, and 10.97%, respectively.The HPV16, 52, and 18 ranked the top 3 subtypes of HPV among the patients who were confirmed with cervical cancer, accounting for 33.88%, 28.10%, and 19.00%, respectively.The incidence rate of HPV infection was relatively high among the physical examination women who were aged more than 51 years old (P<0.01); among the women who were treated in the gynecology outpatient department, the incidence rate of HPV infection was 69.39% in the women aged more than 61 years old, 53.61% in the women aged between 15 and 20 years old (P<0.01); however, there was no significant difference in the incidence rate of HPV infection among the patients confirmed with cervical cancer in different age groups.CONCLUSIONThe HPV infection is prevalent among the women under different health state, the single high-risk HPV infection is dominant and associated with age.It is necessary to strengthen the screening of HPV among the different age groups of women so as to prevent the cervical cancer.

     

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