摘要
目的检测并分析门诊和体检中心就诊的女性人群中人乳头瘤病毒(HPV)感染情况并进行危险因素分析。方法回顾性分析2016年5月至2018年8月接受HPV感染检测的9 409例体检女性和门诊患者的临床资料,包括:患者姓名、年龄、月经史、初次性生活年龄、细胞学检查情况,其中有6 201例调查对象同时进行宫颈液基细胞学(TCT)检测。按照患者的年龄阶段分为五组,另根据TCT细胞病理结果分为五组,观察年龄和细胞病变程度与HPV感染的关系。并根据临床资料进行危险因素分析。结果 HPV检测结果阳性2 740例,阳性率为29.12%,高危型HPV检出2 187例,低危型HPV检出553例;在高危型HPV感染中,以HPV-52、HPV-16、HPV-58为主,感染率最高的是HPV-52;在低危型HPV感染中,以HPV-81、HPV-42、HPV-43为主,感染率最高的是HPV-81。在各年龄组患者中,31~40岁组阳性率最高(39.23%),HPV阳性率差异有统计学意义(P <0.001)。未见上皮内病变或恶性病变(NILM)组、宫颈炎症(cervitis)组、非典型鳞状上皮细胞病变(ASC)组、低级别鳞状上皮内病变(LSIL)组、高级别鳞状上皮内病变(HSIL)组的HPV阳性例数分别为889例(16.08%)、36例(27.91%)、261例(63.66%)、67例(88.16%)和56例(94.92%),HPV阳性率差异有统计学意义(P <0.001)。危险因素分析提示初次性生活年龄与HPV感染有关,25岁以前有性生活者感染概率是25岁以前无性生活者的3.444倍。结论深圳地区女性人群感染HPV以高危型为主,31~40岁人群HPV的感染率最高,其次是绝经后的中老年女性。且HPV阳性率与TCT细胞病理学病变程度有线性关系。性生活年龄<25岁是HPV感染的独立危险因素,针对重点人群开展HPV感染筛查,对于本地宫颈癌的防控具有重要的意义。
Objective To analyze the infection rate of HPV in women at clinic and in health examination centre and analyze its risk factor. Methods The clinical data and HPV detection result of 9 409 women and TCT detection result of 6 201 women were analyzed retrospectively from May 2016 to August 2018. All the cases were divided into five groups according to the age. According to TCT result,6 201 subjects were divided into no intraepithelial lesions or malignant lesions(NILM)group(n = 5 527),cervitis group(n = 129),atypical squamous cell hyperplasia(ASC)group(n = 410),low grade squamous intraepithelial lesions(LSIL)group(n = 76),and highgrade squamous intraepithelial lesion(HSIL)group(n = 59). The relationship among age,cytopathic effect and HPV infection was investigated and logistic regression analysis was used to explore the risk factors of HPV infection. Results There were 2 740 HPV positive cases,with a positive rate was 29.12%,among which there were 2178 cases of high-risk HPV and 553 cases of low-risk HPV. Of high risk HPV infection,HPV-52 was the most common subtype,followed by HPV-16 and HPV-58. HPV-8,HPV-42 and HPV-43 were the top three subtypes of lowrisk HPV infection and HPV-81 was the most frequently-seen subtype. The positive rate reached the highest in the group aged from 31 to 40(39.23%)and the difference was statistically significant(P < 0.001). The positive cases in NILM group,cervitis group,ASC group,LSIL group and HSIL group were 889(16.08%),36(27.91%),261(63.66%),67(88.16%)and 56(94.92%) respectively and the positive rate difference was statistically significant(P < 0.001). Risk factor analysis indicated that the age of sexual debut was associated with HPV infection and the infection rate was 3.444 times higher in subjects having sexual debut younger than 25 years dd. Conclusion HPV infection in the female population is mainly high-risk subtype,and the infection rate was the highest among the patients aged from 31 to 40,and then postmenopausal women. The positive rate is increased with the severity of TCT result. The age of sexual debut younger than 25 is the independent risk factor of HPV infection. Taking specific control measures based on epidemiological feature of Shenzhen is of great significance for the prevention and control of cervical cancer.
作者
任婷玉
廖奕浪
黄婷婷
王静
肖晓蔚
韦唯
周义文
REN Tingyu;LIAO Yilang;HUANG Tingting;WANG Jing;XIAO Xiaowei;WEI Wei;ZHOU Yiwen(Clinical Laboratory Center,Shenzhen Hospital of Southern Medical University,Shenzhen 518000,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2020年第7期969-973,共5页
The Journal of Practical Medicine
基金
广东省自然科学基金项目(编号:2018A030313740)
广东省医学科学技术研究基金项目(编号:B2018013)
深圳市宝安区2019年基础医疗卫生研究项目(编号:2019JD433)
南方医科大学深圳医院苗苗计划项目(编号:2018MM02)
南方医科大学深圳医院苗苗计划项目(编号:2018MM01)
深圳市三名工程医学项目(编号:SZSM201612023)。
关键词
人乳头瘤病毒
感染
宫颈病变
human papillomavirus
infection
cervical lesion
