宫颈癌前病变或HPV阳性危险因素流行病学调查研究(1)
[摘要]目的 观察HPV在宫颈癌前病变组与宫颈癌组中的感染情况，探讨不同HPV亚型与宫颈癌前病变及宫颈癌的相关性。方法 选取2015年1月～2016年11月我院救治的101 134例患者，依据病理结果将筛选的患者分成三组：宫颈癌组(n=19 368例)、宫颈癌前病变组(n=36 361例)和宫颈炎组(n=45 405例)。经HPV阳性情况检测、HPV-DNA 亚型检测，计算各组患者的HPV阳性感染率。结果 在HPV阳性感染病例中，宫颈炎组的HPV 检测阳性率显著低于宫颈癌前病变组(χ2=43.21，P<0.05)，宫颈癌前病变组的HPV阳性感染率显著高于宫颈癌组(χ2=53.21，P<0.05)，在统计学上有显著性差异。宫颈癌组以HPV16型、HPV18型感染(分別为49.97%、41.12%)为主要亚型。宫颈癌前病变组中的CINⅠ患者中的HPV52型、HPV33型及HPV16型感染(分别为35.33%、12.50%及19.63%)为主要亚型；CINⅡ患者中的HPV58型、HPV18型及HPV16型感染(分别为25.64%、23.14%及16.25%)为主要亚型；CINⅢ患者中的HPV58型、HPV52型及HPV16型感染(分别为18.82%、18.59%及36.90%)为主要亚型。宫颈癌组均是单一感染，无二重感染、三重及多重感染；宫颈癌前病变组CINⅠ、CINⅡ、CINⅢ二重感染发生率显著高于三重及多重感染率。结论 宫颈癌前病变组中感染率的主要HPV亚型有HPV16、18、52及58型，其中宫颈癌组中感染的两种HPV亚型是：HPV18、HPV16，并且就多重感染率而言，宫颈癌前病变组比宫颈癌组高。HPV检测对宫颈疾病的防治具有较高的有效性，可以帮助患者了解和提前预防宫颈病变，对于疾病的预防，控制以及预后评价具有重大意义。
[关键词]宫颈癌前病变；HPV；流行病学
[中图分类号] R737 [文献标识码] A [文章编号] 1674-4721(2018)4(a)-0101-04
Epidemiological research on the risk factors of cervical precancerous lesions or HPV positivity
ZHANG Shan-shan DING Mei
Center of Physical Examination，Integrated Traditional Chinese and Western Medicine Hospital in Guangzhou City of Guangdong Province，Guangzhou 510800， China
[Abstract]Objective To observe the infection of HPV in cervical precancerous lesion group and cervical cancer group in order to explore the correlation between different subtypes of HPV and cervical precancerous lesions as well as cervical cancer.Methods A total of 101 134 patients treated in our hospital from January 2015 to November 2016 were selected as research objects.According to the pathological results，they were divided into three groups：cervical cancer group(n=19 368)，cervical precancerous lesion group(n=36 361)， and cervicitis group(n=45 405).The positivity rate of HPV was calculated after HPV test and HPV-DNA subtype detection.Results Among HPV positive infection cases，the positivity rate of HPV in the cervicitis group was significantly lower than that of the cervical precancerous group(χ2=43.21，P<0.05)，and the positivity rate of HPV in the cervical precancerous lesion group was greatly higher compared with that in the cervical cancer group(χ2=53.21，P<0.05)， which were displayed statisticaldifferences.The main subtypes in the cervical cancer group were infection of HPV16 and HPV18 accounting for 49.97% and 41.12%， respectively.For CINⅠpatients in the cervical precancerous lesion group，the infection of HPV52，HPV33，and HPV16 were the main subtypes accounting for 35.33%，12.50%， and 19.63%，accordingly.For CINⅡ patients in the cervical precancerous lesion group，the infection of HPV58，HPV18，and HPV16 were the main subtypes，25.64%，23.14%，and 16.25% accordingly.For patients with CINⅢ in the cervical precancerous lesion group， the infection of HPV58，HPV52，and HPV16 were the main subtypes accounting for 18.82%，18.59%，and 36.90%.In the cervical cancer group，participants were only presented with single infection，withoutdouble，triple or multiple infection.In the cervical precancerous lesion group，double infection rates in CIN，CIN，and CINⅢ patients were significantly higher than those in triple and multiple infection.Conclusion In the cervical precancerous lesion group， the main subtypes of HPV infection are HPV 16，HPV 18，HPV 52，and HPV 58.In the cervical cancer group， the two main subtypes of HPV infection are HPV 18 and HPV 16.On multiple infection rate，the cervical precancerous lesion group was higher compared with that in the cervical cancer group.HPV detection has a higher effectiveness in the prevention and treatment of cervical diseases，which can help patients understand and prevent cervical lesions in advance.It is of great significance on the disease prevention， control and prognosis evaluation., 百拇医药(张珊珊 丁妹)
[关键词]宫颈癌前病变；HPV；流行病学
[中图分类号] R737 [文献标识码] A [文章编号] 1674-4721(2018)4(a)-0101-04
Epidemiological research on the risk factors of cervical precancerous lesions or HPV positivity
ZHANG Shan-shan DING Mei
Center of Physical Examination，Integrated Traditional Chinese and Western Medicine Hospital in Guangzhou City of Guangdong Province，Guangzhou 510800， China
[Abstract]Objective To observe the infection of HPV in cervical precancerous lesion group and cervical cancer group in order to explore the correlation between different subtypes of HPV and cervical precancerous lesions as well as cervical cancer.Methods A total of 101 134 patients treated in our hospital from January 2015 to November 2016 were selected as research objects.According to the pathological results，they were divided into three groups：cervical cancer group(n=19 368)，cervical precancerous lesion group(n=36 361)， and cervicitis group(n=45 405).The positivity rate of HPV was calculated after HPV test and HPV-DNA subtype detection.Results Among HPV positive infection cases，the positivity rate of HPV in the cervicitis group was significantly lower than that of the cervical precancerous group(χ2=43.21，P<0.05)，and the positivity rate of HPV in the cervical precancerous lesion group was greatly higher compared with that in the cervical cancer group(χ2=53.21，P<0.05)， which were displayed statisticaldifferences.The main subtypes in the cervical cancer group were infection of HPV16 and HPV18 accounting for 49.97% and 41.12%， respectively.For CINⅠpatients in the cervical precancerous lesion group，the infection of HPV52，HPV33，and HPV16 were the main subtypes accounting for 35.33%，12.50%， and 19.63%，accordingly.For CINⅡ patients in the cervical precancerous lesion group，the infection of HPV58，HPV18，and HPV16 were the main subtypes，25.64%，23.14%，and 16.25% accordingly.For patients with CINⅢ in the cervical precancerous lesion group， the infection of HPV58，HPV52，and HPV16 were the main subtypes accounting for 18.82%，18.59%，and 36.90%.In the cervical cancer group，participants were only presented with single infection，withoutdouble，triple or multiple infection.In the cervical precancerous lesion group，double infection rates in CIN，CIN，and CINⅢ patients were significantly higher than those in triple and multiple infection.Conclusion In the cervical precancerous lesion group， the main subtypes of HPV infection are HPV 16，HPV 18，HPV 52，and HPV 58.In the cervical cancer group， the two main subtypes of HPV infection are HPV 18 and HPV 16.On multiple infection rate，the cervical precancerous lesion group was higher compared with that in the cervical cancer group.HPV detection has a higher effectiveness in the prevention and treatment of cervical diseases，which can help patients understand and prevent cervical lesions in advance.It is of great significance on the disease prevention， control and prognosis evaluation., 百拇医药(张珊珊 丁妹)