上海市松江区人乳头瘤病毒感染情况分析

doi:10.3969/j.issn.1673-8640.2017.08.008

摘要/Abstract

摘要：

目的探讨上海市松江区不同年龄段妇女人乳头瘤病毒（HPV）感染情况及亚型分布,并结合病理结果分析HPV对宫颈细胞的致病性,为松江区宫颈癌的防治提供依据。方法收集上海市松江区中心医院2016年2月1日–3月31日妇科门诊5 039例患者的宫颈分泌物,进行HPV基因分型检测,并结合患者年龄、HPV亚型以及病理结果分析松江区妇女HPV的感染及致病情况。结果在5 039例样本中HPV阳性1 140例,感染率为22.6%,其中单一感染798例,多重感染342例;各年龄组HPV感染率为：<20岁组29.5%,21~30岁组21.0%,31~40岁组21.7%,41~50岁组21.7%,51~60岁组30.0%,>60岁组28.8%,各年龄组HPV感染率差异有统计学意义（P=0.000 161）。感染率排在前5位的HPV亚型分别是16型（17.0%）、52型（14.6%）、58型（12.8%）、54型（8.2%）和51型（8.2%）。HPV高危组（HPV16型和18型≥非典型鳞状上皮细胞（ASCUS）级别的病变明显高于HPV低危组（除HPV16型和18型以外的亚型）和阴性对照组（P<0.05）。结论上海市松江区51~60岁妇女HPV的感染率最高,HPV16型、18型对宫颈细胞有较强的致病性,对高危人群进行HPV筛查将为宫颈癌的防治提供依据。

关键词: 人乳头瘤病毒, 感染率, 亚型, 年龄分布, 致病性, 松江区

Abstract:

Objective To investigate human papillomavirus（HPV）infection and subtype distribution in Shanghai Songjiang,to analyze HPV pathogenicity on cervical cells,and to provide a reference for the control and prevention of cervical cancer. Methods A total of 5 039 female outpatients' cervical secretion samples from Shanghai Songjiang Central Hospital were collected from February 1st to March 31st in 2016. HPV genotyping was performed,and the subtype distribution in different ages was analyzed. HPV pathogenicity on cervical cells was evaluated. Results There were 1 140 positive samples,including 798 cases of single infection and 342 cases of multiple infection,and the infection rate was 22.6%. The infection rates were 29.5% in < 20-year-old group,21.0% in 21-30-year-old group,21.7% in 31-40-year-old group,21.7% in 41-50-year-old group,30.0% in 51-60-year-old group and 28.8% in >60-year-old group（P=0.000 161）. The top 5 subtypes were type 16（17.0%）, 52（14.6%）, 58（12.8%）, 54（8.2%）and 51（8.2%）. The proportion of lesion ≥ atypical squamous cells of undetermined significance （ASCUS）in high-risk HPV group（HPV type 16 and 18）was higher than those in low-risk HPV group（other subtypes,except HPV type 16 and 18）and negative control group（P<0.05）. Conclusions HPV infection rate in 51-60-year-old group is the highest in Shanghai Songjiang. HPV type 16 or 18 is more likely to cause cervical cell lesion. HPV screening for high-risk population is helpful for the prevention and treatment of cervical cancer.

Key words: Human papillomavirus, Infection rate, Subtype, Age distribution, Pathogenicity, Songjiang

中图分类号:

R446.5

黄路遥, 许燕燕, 娄晓丽, 曹辉, 夏万宝, 侯彦强. 上海市松江区人乳头瘤病毒感染情况分析[J]. 检验医学, 2017, 32(8): 695-699.

HUANG Luyao, XU Yanyan, LOU Xiaoli, CAO Hui, XIA Wanbao, HOU Yanqiang. Human papillomavirus infection in Shanghai Songjiang[J]. Laboratory Medicine, 2017, 32(8): 695-699.

图/表 5

参考文献 17

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HPV型别	例数	百分比（%）
高危型
16型	196	17.0
18型	72	6.3
31型	30	2.6
33型	74	6.5
35型	41	3.6
39型	67	5.9
45型	14	1.2
51型	93	8.2
52型	167	14.6
53型	51	4.5
56型	57	5.0
58型	146	12.8
59型	57	5.0
66型	37	3.2
67型	36	3.2
68型	68	6.0
73型	6	0.5
低危型
6型	72	6.3
11型	47	4.1
40型	51	4.5
42型	14	1.2
43型	47	4.1
44型	30	2.6
54型	94	8.2
55型	59	5.2
57型	1	0.1

HPV型别	例数	百分比（%）
高危型
16型	196	17.0
18型	72	6.3
31型	30	2.6
33型	74	6.5
35型	41	3.6
39型	67	5.9
45型	14	1.2
51型	93	8.2
52型	167	14.6
53型	51	4.5
56型	57	5.0
58型	146	12.8
59型	57	5.0
66型	37	3.2
67型	36	3.2
68型	68	6.0
73型	6	0.5
低危型
6型	72	6.3
11型	47	4.1
40型	51	4.5
42型	14	1.2
43型	47	4.1
44型	30	2.6
54型	94	8.2
55型	59	5.2
57型	1	0.1

年龄组别（岁）	例数	阳性例数	阳性率（%）
﹤20	146	5	3.4
21~30	1 742	63	3.6
31~40	1 568	69	4.4
41~50	986	28	2.8
51~60	444	20	4.5
﹥60	153	11	7.2
合计	5 039	196	17.0

年龄组别（岁）	例数	阳性例数	阳性率（%）
﹤20	146	5	3.4
21~30	1 742	63	3.6
31~40	1 568	69	4.4
41~50	986	28	2.8
51~60	444	20	4.5
﹥60	153	11	7.2
合计	5 039	196	17.0

组别	例数	NILM	≥ASCUS
阴性对照组	162	148	18
HPV低危组	108	93	15
HPV高危组	132	90	42^*#