北京地区35～64岁农村妇女高危型HPV感染情况分析

发布时间：2019-02-11 20:33

【摘要】：目的通过采用高危型人乳头瘤病毒(HPV)作为宫颈癌初筛方法,了解北京地区35~64岁农村妇女高危型HPV感染现状及高危型HPV作为初筛的效果。方法回顾性分析2014年10月至2015年3月北京市5个农村两癌筛查区县,年龄35~64岁农村户籍人口20 076名,以高危型HPV作为初筛进行宫颈癌筛查试点的结果,使用SPSS17.0软件对数据进行描述性分析。结果北京地区35~64岁20 076名农村妇女中,高危型HPV总感染率为7.6%(1 535/20 076),其中单一感染排前五位的高危亚型分别是HPV16型219例,占14.3%,HPV52型146例,占9.5%,HPV58型101例,占6.6%,HPV18型84例,占5.5%,HPV51型66例,占4.3%。高危型HPV混合感染率为7.6%(116/1 535),最多同时感染四种高危亚型。35~40岁、41~45岁、46~50岁、51~55岁、56~60岁、61~64岁高危型HPV检测率分别为50.0%(192/384)、38.9%(330/848)、33.0%(388/1 177)、6.3%(298/4 757)、3.4%(251/7 438)和1.4%(76/5 472)。除高危型HPV16/18感染者外,其他型感染者细胞学阳性检出率为13.0%(154/1 188);转诊阴道镜检查率为2.3%(461/20 076);阴道镜下活检组织病理学检出CIN2 27例,CIN3 39例,宫颈微小浸润癌2例,浸润癌1例,癌及癌前病变检出率为343.7/10万,宫颈癌检出率为14.9/10万,早诊率为98.6%(68/69);在宫颈高级别病变及癌中,HPV16/18亚型感染占71.0%(49/69)。结论 HPV16、52和58型是北京地区35~64岁农村妇女单一感染的主要基因亚型,高危型HPV检出率最高为35~40岁,HPV16/18感染是导致宫颈高级别病变及癌的主要亚型。用高危型HPV作为初筛方法,初筛阳性病历检出率提高,而且用高危型HPV分流后,细胞学的工作量明显减少。
[Abstract]:Objective to investigate the current situation of high-risk HPV infection and the effect of high-risk HPV screening in 35 ~ 64 year old rural women in Beijing by using high-risk human papillomavirus (HPV) as the primary screening method for cervical cancer. Methods from October 2014 to March 2015, 20 076 rural residents aged 35 to 64 years old in two rural areas and counties of Beijing were retrospectively analyzed. The results of screening cervical cancer with high-risk type HPV as a primary screening test were analyzed retrospectively. SPSS17.0 software is used to describe the data. Results among 20 076 rural women aged 35 to 64 years in Beijing, the total infection rate of high-risk type HPV was 7.6% (1 535 / 20 076), among which 219 cases of HPV16 type were the top five high risk subtypes of single infection, accounting for 146 cases of HPV52 type. There were 101 cases of HPV58, 84 cases of HPV18 and 66 cases of HPV51, accounting for 4.3%. The mixed infection rate of high risk HPV was 7.6% (116 / 1,535), and the highest four high risk subtypes were infected simultaneously. The detection rates of high-risk HPV in 35 or 40, 41 / 45, 46 / 50, 51 / 55, 56 / 60, 61 / 64 years of age were 50.0% (1922 / 384), respectively. 38.9% (330 / 848), 33.0% (388 / 1 177), 6.3% (298 / 4,757), 3.4% (251 / 7,438) and 1.4% (76 / 5,472). The positive rate of cytological examination was 13.0% (15.4 / 1 188) and the rate of colposcopy referral was 2.3% (461 / 20 076). Under colposcopy, 27 cases of CIN2, 39 cases of CIN3, 2 cases of small invasive carcinoma of the cervix, 1 case of invasive carcinoma, the detection rate of cancer and precancerous lesion were 343.7 / 100,000 and 14.9 / 100,000, respectively. The early diagnosis rate was 98.6% (68 / 69); HPV16/18 subtype infection accounted for 71.0% (49 / 69) of high grade cervical lesions and carcinomas. Conclusion HPV16,52 and 58 type are the main gene subtypes of single infection in 35 ~ 64 years old rural women in Beijing area. The highest detection rate of high risk type HPV is 35 ~ 40 years old. HPV16/18 infection is the main subtype leading to cervical high grade lesion and cancer. Using high risk type HPV as primary screening method, the positive rate of primary screening was increased, and the workload of cytology was significantly reduced after shunt of high risk type HPV.
【作者单位】：首都医科大学附属北京妇产医院北京妇幼保健院妇女保健科;
【基金】：2014年国家自然科学基金(71373166)
【分类号】：R737.33

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