目的: 探讨不同人乳头瘤病毒（human papillomavirus,HPV）基因亚型的感染情况及高危型HPV亚型感染与子宫颈疾病间的关系。方法: 选取我院妇科门诊就诊的1 669例患者行HPV基因分型检测,HPV检测结果为阳性的患者在知情同意后行阴道镜检查,对镜下表现可疑的患者进一步行子宫颈组织活检。结果: 1 669例患者中HPV阳性567例,总HPV阳性率为33.97%,HPV亚型感染率前5位由高到低依次为HPV-16（9.05%）、HPV-52（7.85%）、HPV-58（6.29%）、HPV-CP8304（5.81%）、HPV-53（3.71%）。不同年龄段中,≤30岁者为HPV感染的高峰年龄段。在567例HPV阳性的患者中,高危型HPV亚型感染患者共454例,占总HPV感染者的80.07%。病灶组织活检结果为高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion, HSIL)以上的患者中,高危型HPV亚型感染的前5位由高到低依次为HPV-16（58例）、HPV-52（26例）、HPV-58（25例）、HPV-18（10例）、HPV-31（6例）。结论: HPV感染人群高峰有年轻化趋势,HPV基因分型检测在子宫颈疾病诊断中具有重要价值,其中HPV-16、HPV-52、HPV-58、HPV-18、HPV-31与子宫颈癌的关系密切。
Objective: To investigate the infection of different genotypes of papillomavirus (HPV) and the relationship between high-risk HPV genotype and cervical lesion in females. Methods: HPV genotype detection was performed in 1 669 subjects. Colposcopy was conducted in positive cases after informed consent was obtained and biopsy was performed in suspected cases under colposcopy. Results: Five hundred and sixty-seven cases of the 1 669 subjects were HPV positive, with a positive rate of 33.97% (567/1 669). The five leading frequencies of HPV genotype were HPV-16 (9.05%), HPV-52 (7.85%), HPV-58 (6.29%), HPV-CP8304 (5.81%), HPV-53 (3.71%). Women ≤30 were at the peak of HPV infection when compared with other ages. Four hundred and fifty-four cases of 567 HPV positive subjects were infected with high-risk HPV genotype. The five leading frequencies of high-risk HPV infection with high grade squamous intraepithelial lesion (HSIL) in biopsy were HPV-16 (58 cases), HPV-52 (26 cases), HPV-58 (25 cases), HPV-18 (25 cases), HPV-31 (6 cases). Conclusions: The peak age for HPV infection is getting younger, and HPV genotype detection has significant value in the diagnosis of cervical lesion, especially HPV-16, HPV-52, HPV-58, HPV-18, HPV-31, they are closely associated with cervical cancer.
[1] 程娇影, 卞美璐, 李敏, 等. 不同子宫颈癌筛查方案应用价值评价[J]. 中国妇产科临床杂志,2012,2(13):115-118.
[2] Muñoz N, Bosch FX, de Sanjosé S, et al. Epidemiologic classification of human papillomavirus types associated with cervical cancer[J]. N Engl J Med,2003,348(6):518-527.
[3] 谢军. 人乳头瘤病毒(HPV)-DNA分型检测在30岁以下妇女宫颈病变诊断中的价值[J]. 中国实验诊断学,2011, 15(10):1747-1748.
[4] 王雪春, 孙蓬明, 林芬, 等. 某地区HPV不同亚型感染与宫颈病变的相关研究[J]. 国际检验医学杂志,2011, 32(10):1024-1026.
[5] 李春龙, 廖洪, 杨瑛, 等. HPV分型及其高危亚型与宫颈病变的相关性分析[J]. 检验医学与临床2015,12(8):1109-1111.
[6] 章文华. 宫颈上皮内瘤变的阴道镜检查和治疗[M]. 北京: 人民卫生出版社,2009:45.
[7] 陈嘉雯, 余丽, 谈伙荣, 等. HPV分型检测在产科中的应用[J]. 实验与检验医学,2014,32(3):299-301.
[8] 谢建逾, 余娟, 董国强. 762例妇女宫颈高危型HPV感染与宫颈病变的相关性研究[J]. 检验医学与临床,2012, 9(20):2533-2535.
[9] Gravitt PE, Rositch AF, Silver MI, et al.A cohort effect of the sexual revolution may be masking an increase in human papillomavirus detection at menopause in the United States[J]. J Infect Dis,2013,207(2):272-280.
[10] Franceschi S, Herrero R, Clifford GM, et al.Variations in the age-specific curves of human papillomavirus prevalence in women worldwide[J]. Int J Cancer,2006,119(11):2677-2684.
[11] Zhao FH, Lewkowitz AK, Hu SY, et al.Prevalence of human papillomavirus and cervical intraepithelial neoplasia in China: a pooled analysis of 17 population-based studies[J]. Int J Cancer,2012,131(12):2929-2938.
[12] 潘凌亚. HPV感染与宫颈癌前病变[J]. 基础医学与临床,2006,26(12):1297-1300.
[13] 李筱梅, 郑英, 张庆. 宫颈癌发病的年轻化趋势与人乳头状瘤病毒感染的关系[J]. 中国实用妇科与产科杂志,2000,16(12):741-742.
[14] Hong H, He TF, Ni HX, et al.Prevalence and genotype distribution of HPV infection among women in Ningbo, China[J]. Int J Gynaecol Obstet,2015,131(1):96-99.
