济南市正常女性、宫颈癌前病变及宫颈癌患者中HPV感染型别分布的研究

发布时间：2018-01-29 20:27

  本文关键词： 人乳头瘤病毒 宫颈上皮内瘤变 宫颈癌 基因型　出处：《山东大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的： 研究济南市正常人群、宫颈癌前病变及宫颈癌患者中HPV感染型别的分布,探讨济南市高危人群高危型HPV感染在不同年龄组的分布差异和HPV感染的常见亚型与宫颈病变级别的相关性。 方法： 收集2009年3月至2013年3月在济南市中心医院妇科门诊行HPV检查的健康查体人群资料共9976例,HPV感染阳性者1618例。采用HPV分型检测方法对HPV阳性者进行分型,同时进行液基细胞学检查。对HPV阳性,细胞学结果为意义不明确的非典型鳞状细胞及以上者进行阴道镜检查及组织病理学活检,对诊断为宫颈上皮内瘤变及以上的患者,回顾分析其HPV分型及与疾病相关性。 结果： 1.济南市HPV感染阳性率为16.22%,其中高危型HPV的阳性率为11.73%,低危型HPV阳性率为7.96%。常见高危型HPV由高到低为HPV16、18、33型,常见低危型HPV由高到低为HPV11、6型。 2.HPV感染率以25-34岁女性最高(17.6%),之后随年龄的增长HPV感染率呈下降趋势。高危型HPV感染阳性率有两个年龄高峰,第一个在25-34岁(13.8%),第二个在45-54岁(13.2%),低危型HPV感染阳性率有一个年龄高峰,在25岁以下(9.4%),之后随年龄的增长逐渐下降。 3.高危型HPV阳性率随着宫颈病变级别的升高而升高,宫颈病变的程度与年龄无明显相关性。 4.不同级别宫颈病变中HPV亚型分布由高到低排列：宫颈癌中依次为：HPV16、18、33型,CINIII中依次为：HPV16、18、58、33、56型；CIN II中依次为：HPV16、18、31、58、52、56、66型；CIN I中依次为：HPV16、18、59型。 5.各年龄组HPV单一感染人数均多于多重感染人数。单一感染及多重感染均在25-34岁年龄组呈现最高峰,然后逐渐下降,在≥55岁年龄组降到最低点。在各级别宫颈病变之间多重感染率差别无统计学意义(P0.05)。 结论： 1.济南市常见的高危型HPV亚型为HPV16、18、33型,低危型HPV亚型为HPV11、6型。首次检测出济南地区不同级别宫颈病变中高危型HPV亚型分布,根据检出率由高到低如下：宫颈癌中为：HPV16、18、33型,CINIII中为：HPV16、18、58、33、56型；CINⅡ中为：HPV16、18、31、58、52、56、66型；CIN I中为：HPV16、18、59型。目前第一代HPV预防性疫苗适用于济南地区女性接种以预防宫颈癌。 2.HPV感染与年龄相关,在25-34岁达到最高峰,之后随年龄的增长HPV的感染率呈下降趋势。高危型HPV感染率有两个年龄高峰,25-34岁为第一个高峰,45-54岁为第二个高峰；低危型HPV感染率在25岁以下就达到高峰,之后随着年龄的增长逐渐下降。 3.随着宫颈病变程度的加重高危型HPV的感染率增加。宫颈癌及癌前病变的发病与高危型HPV感染密切相关。 4.HPV感染以单一感染为主,多重感染与宫颈癌及癌前病变的发生率无直接关系。
[Abstract]:Objective: To study the distribution of HPV infection type in normal population, precancerous lesion and cervical cancer patients in Jinan. To investigate the distribution of high risk HPV infection in different age groups and the correlation between the common subtypes of HPV infection and the grade of cervical lesions in high risk population in Jinan. Methods: From March 2009 to March 2013, we collected data of 9 976 health examiners who were examined by HPV in gynecological outpatient department of Jinan central hospital from March 2009 to March 2013. 1618 cases were positive for HPV infection. HPV positive cases were classified by HPV typing method, and liquid-based cytology was performed. HPV was positive. Cytological results showed that atypical squamous cells with unclear significance were examined by colposcopy and histopathological biopsy. The patients with cervical intraepithelial neoplasia or above were diagnosed as cervical intraepithelial neoplasia or above. HPV classification and its correlation with disease were analyzed retrospectively. Results: 1. The positive rate of HPV infection was 16.22 in Jinan, and the positive rate of high-risk type HPV was 11.73%. The positive rate of low risk type HPV was 7.96. The common high risk type HPV from high to low was HPV16 / 1833, and the common low risk type HPV from high to low was HPV11 / 6 type. 2. The infection rate of HPV was the highest in women aged 25 to 34 years, and then decreased with the increase of age. The positive rate of high risk HPV infection had two age peaks. The first was aged 25-34 and the second was 13.22.The positive rate of low-risk HPV infection had a peak at an age of 9.4% under the age of 25). After that, it gradually declined with the increase of age. 3. The positive rate of high risk HPV increased with the increase of cervical lesion grade, and there was no significant correlation between the degree of cervical lesion and age. 4. The distribution of HPV subtypes in cervical lesions of different grades ranged from high to low. In cervical cancer, the order was: 1: HPV16, 1833, CINIII, 1: HPV16, 1858, respectively. Type 33C56; In CIN II, the order was: type 1: HPV16, 1831, 582, 562, 6N66; In CIN I, the order is: HPV16 / 1859. 5. The number of HPV single infection was higher than that of multiple infection in all age groups. Both single infection and multiple infection showed the highest peak in the age group of 25-34 years, and then decreased gradually. In the age group of 鈮，

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