引用本文:杨达平,刘勇青,梁金艳,粟连秀.广西贵港地区妇女宫颈上皮内瘤变与HPV基因型别关系的研究[J].中国临床新医学,2020,13(12):1241-1245.
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广西贵港地区妇女宫颈上皮内瘤变与HPV基因型别关系的研究
杨达平,刘勇青,梁金艳,粟连秀
537100 广西,贵港市人民医院病理科(杨达平,梁金艳,粟连秀);537100 广西,贵港市中医医院病理科(刘勇青)
摘要:
[摘要] 目的 探讨广西贵港地区宫颈上皮内瘤变患者中人乳头瘤病毒(HPV)的感染情况,为本地区卫生疾控部门制定HPV疫苗接种及宫颈癌相关防治策略提供理论依据。方法 选择2012-01~2017-09在贵港市人民医院和贵港市中医医院经病理活检确诊的宫颈上皮内瘤变患者1 985例,年龄19~81岁,户籍均为广西贵港市。所有患者病理活检确诊前未接受放疗、化疗,收集其HPV基因分型检测结果和病理检查结果。根据病理检查结果将研究对象分为低级别上皮内瘤变组(1 012例)和高级别上皮内瘤变组(973例),分析两组的HPV感染率及不同HPV亚型感染情况。分析HPV感染率与患者年龄的相关性。结果 本组共有1 636例患者感染HPV,感染率为82.4%。高级别上皮内瘤变组HPV感染率为87.8%,低级别上皮内瘤变组HPV感染率为77.3%,两组比较差异有统计学意义(P<0.05)。高级别上皮内瘤变组单一感染率和多重感染率分别为56.1%和31.7%,低级别上皮内瘤变组为50.2%和27.1%,两组差异有统计学意义(P<0.05)。高级别上皮内瘤变组高危亚型和低危亚型感染率分别为87.4%和6.5%,低级别上皮内瘤变组为73.1%和15.9%,两组比较差异均有统计学意义(P<0.05)。HPV基因型检测结果显示,高级别上皮内瘤变组检出主要基因型的前5顺位为HPV-16、HPV-58、HPV-52、HPV-33和HPV-18,低级别上皮内瘤变组检出主要基因型的前5顺位为HPV-52、HPV-58、HPV-16、HPV-51和HPV-18,均为高危亚型。Spearman秩相关分析结果显示,患者年龄与HPV感染率呈负相关(rs=-0.900,P=0.037)。结论 HPV感染是广西贵港地区妇女发生宫颈上皮内瘤变的重要致病因素,HPV-16、HPV-58、HPV-52、HPV-33和HPV-18亚型是该地区主要流行亚型,感染人群以青、中年女性为主,建议当地妇女选择九价HPV疫苗进行接种。
关键词:  人乳头瘤病毒  基因亚型  宫颈上皮内瘤变
DOI:10.3969/j.issn.1674-3806.2020.12.14
分类号:R 711.74
基金项目:贵港市科学研究与技术开发项目(编号:贵科攻1701007)
Study on the relationship between cervical intraepithelial neoplasia and human papilloma virus genotypes in women in Guigang area of Guangxi
YANG Da-ping, LIU Yong-qing, LIANG Jin-yan, et al.
Department of Pathology, Guigang City People′s Hospital, Guangxi 537100, China
Abstract:
[Abstract] Objective To investigate the infection of human papilloma virus(HPV) in patients with cervical intraepithelial neoplasia in Guigang area of Guangxi, and to provide theoretical basis for the health and disease control departments in this area to formulate HPV vaccination and cervical cancer relevant prevention and control strategies. Methods From January 2012 to September 2017, 1 985 patients with cervical intraepithelial neoplasia confirmed by pathological biopsy in Guigang City People′s Hospital and Guigang Traditional Chinese Medicine Hospital were selected. The age of the patients ranged from 19 to 81 years old. All the patients were registered in Guigang City, Guangxi. All the patients did not receive radiotherapy and chemotherapy before the confirmed diagnosis of pathological biopsy, and the results of their HPV genotyping and pathological examination were collected. According to the results of the pathological examination, the research subjects were divided into low-grade intraepithelial neoplasia group(1 012 cases) and high-grade intraepithelial neoplasia group(973 cases). HPV infection rate and the infection of different HPV subtypes were analyzed in the two groups. The correlation between HPV infection rate and the patients′ age was analyzed. Results A total of 1 636 cases were infected with HPV in this study, and the infection rate was 82.4%. The HPV infection rate was 87.8% in the high-grade intraepithelial neoplasia group, and 77.3% in the low-grade intraepithelial neoplasia group, with a significant difference between the two groups(P<0.05). The single infection rate and the multiple infection rate in the high-grade intraepithelial neoplasia group were 56.1% and 31.7%, respectively, and those in the low-grade intraepithelial neoplasia group were 50.2% and 27.1%, respectively, with significant differences between the two groups(P<0.05). The infection rates of high-risk and low-risk subtypes in the high-grade intraepithelial neoplasia group were 87.4% and 6.5%, respectively, and those in the low-grade intraepithelial neoplasia group were 73.1% and 15.9%, respectively, with significant differences between the two groups(P<0.05). The HPV genotype test results showed that the main genotypes(top 5 positions) detected in the high-grade intraepithelial neoplasia group were HPV-16, HPV-58, HPV-52, HPV-33, and HPV-18, and those detected in the low-grade intraepithelial group(top 5 positions) were HPV-52, HPV-58, HPV-16, HPV-51 and HPV-18, all of which were high-risk subtypes. Spearman correlation analysis showed that the patients′ age was negatively correlated with the HPV infection rate(rs=-0.900, P=0.037). Conclusion HPV infection is an important pathogenic factor for cervical intraepithelial neoplasia in women in Guigang area of Guangxi. HPV-16, HPV-58, HPV-52, HPV-33 and HPV-18 subtypes are the main epidemic subtypes in this area, and young and middle-aged women are the mainly infected people. It is suggested that the local women choose the nine-valent HPV vaccine for vaccination.
Key words:  Human papilloma virus(HPV)  Gene subtype  Cervical intraepithelial neoplasia