目的: 统计本院临床及体检受试妇女宫颈脱落细胞人乳头状瘤病毒（human papillomavirus,HPV）病毒的感染情况,分析本地成年女性HPV感染的流行病学特征,为HPV的预防和治疗提供依据。方法: 回顾分析2017年10月至2020年12月本院妇科门诊及体检中心58 883例女性宫颈脱落细胞的HPV分型检测结果,对不同年龄阶段及不同宫颈疾病类型（慢性宫颈炎、宫颈上皮瘤变、宫颈恶性肿瘤）患者的25种常见HPV亚型分布进行统计分析。结果: 58 883例受检者中共检出HPV阳性者9 168例,总检出率为15.57%,其中单重感染和多重感染者分别为6 971例和2 197例。检出率居前三位的HPV亚型分别为HPV52（3.31%）、HPV58（2.05%）、HPV16（1.92%）。HPV的检出率与女性年龄相关,其中<20岁及21~30岁女性的HPV检出率分别为37.34%及19.52%,检出率明显高于其他年龄组。2 105例宫颈病变患者中,慢性宫颈炎患者中感染率居前3位的HPV亚型为HPV52（16.92%）、HPV58（10.68%）、HPV16（10.16%）;宫颈上皮瘤变患者中感染率居前3位的HPV亚型为HPV52（22.22%）、HPV16（17.46%）、HPV58（14.29%）;宫颈恶性肿瘤患者中感染率居前的HPV亚型为HPV16（29.59%）、HPV52（11.24%）、HPV58（10.06%）。结论: 上海地区女性的HPV总检出率在15.57%,检出率居前3位的HPV亚型分别为HPV52、HPV58、HPV16 型,这3种亚型在宫颈病变患者中检测率也最高,与宫颈癌发生相关,这与既往国外报导HPV16和HPV18亚型是最常见致癌亚型略有不同。

Objective: To survey the status of infection of human papillomavirus (HPV) in cervical exfoliated cells and identify the local epidemiological characteristics of HPV infections. Methods: The HPV subtype test was carried out on cervical exfoliated cells obtained from 58 883 female subjects in the gynecological clinic and physical examination center from October 2017 through December 2020. The results were retrospectively reviewed and distribution of 25 common HPV subtypes in patients of different age groups and with different types of cervical disease (chronic cervicitis, cervical neoplasia, cervical malignant tumor) were analyzed. Results: Of 58 883 female subjects surveyed, 9 168(15.57%) cases were positive for HPV infection, including 6 971 single infection cases and 2 197 multiple infection cases. The HPV52 (3.31%), HPV58 (2.05%), and HPV16 (1.92%) were subtypes mostly detected. The HPV infection rate in females aged under 20 (37.34%) and between 21-30 (19.52%) were significantly higher than subjects of other age groups. Of 2 105 patients with cervical lesions, the HPV52 (16.92%), HPV58 (10.68%) and HPV16 (10.16%) were mostly identified in patients with chronic cervicitis; the HPV52 ( 22.22%), HPV16 (17.46%), HPV58 (14.29%) were mostly associated with cervical epithelial neoplasia; and the HPV16 (29.59%), HPV52 (11.24%), HPV58 (10.06%) were the most common subtypes detected in patients with cervical malignant tumors. Conclusions: The HPV infection rate in females of Shanghai is 15.57%, and the HPV52, HPV58, and HPV16 are the predominant subtypes detected. The three subtypes are also highly associated with patients with cervical lesions and cervical cancer, which indicates that the HPV52, HPV58, and HPV16, instead of HPV16 and HPV18 suggested in foreign epidemic studies, are the carcinogenic subtypes of HPV in Shanghai.