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目的:调查无锡新区妇女人乳头瘤病毒(high risk human papillomavirus,HPV)感染状况,分析HPV型别和年龄分布特征,HPV型别在宫颈病变患者中的分布特征,并探讨HPV检测作为宫颈癌初筛方法的可行性。方法:2012年无锡新区宫颈癌筛查项目初筛方法采用HPV基因分型检测,HPV检测结果阳性的受检者转诊进行液基细胞学检查,细胞学检查结果异常者再行阴道镜下活检,病理组织学检查作为最终诊断标准。结果:总计11 322例35~64岁妇女参与了此次宫颈癌筛查,HPV结果阳性者1 286例,总感染率为11.36%;癌前病变检出58例,检出率为512.28/10万;宫颈癌检出7例,检出率为61.83/10万。在总人群中,检出率前3位的型别是HPV16(2.70%)、HPV52(2.07%)和HPV58(1.93%);在宫颈病变患者中,检出率最高的型别为HPV16(47.69%),其次为HPV58(24.61%)和HPV18(9.23%)。55~59岁年龄组HPV感染率最高,为11.88%,各年龄组之间HPV检出率差异无统计学意义,χ2=4.763,P=0.445;45~49岁年龄组高度癌前病变(≥CINⅡ)检出率高于其他年龄组。结论:HPV型别在总人群与宫颈病变人群中的分布存在差异,除HPV16和HPV18之外,HPV58的致癌能力可能明显高于其他高危型HPV;40~59岁是宫颈癌筛查的重点人群。与以往筛查结果相比,此次试点的筛查方法值得进一步推广。
Objective: To investigate the prevalence of high-risk human papillomavirus (HPV) infection in women in Wuxi New District, analyze the distribution of HPV type and age, and the distribution of HPV type in patients with cervical lesions. Feasibility of sieving method. Methods: The screening method of cervical cancer screening project of Wuxi New District in 2012 was detected by HPV genotyping. The subjects with positive HPV test were referred for liquid-based cytology examination. The abnormal results of cytology were treated by colposcopy biopsy , Histopathological examination as the final diagnostic criteria. Results: A total of 11 322 women aged 35-64 years participated in the screening of cervical cancer. Among them, 1 286 were positive for HPV, the total infection rate was 11.36%; 58 cases were detected precancerous lesions with a detection rate of 512.28 / 10 Million; cervical cancer detected in 7 cases, the detection rate was 61.83 / 100,000. Among the total population, the top three types of HPV were HPV16 (2.70%), HPV52 (2.07%) and HPV58 (1.93%). Among the patients with cervical lesions, the highest detection rate was HPV16 %), Followed by HPV58 (24.61%) and HPV18 (9.23%). The prevalence of HPV infection in 55-59 age group was the highest (11.88%). There was no significant difference in HPV detection rate among all age groups (χ2 = 4.763, P = 0.445) CIN Ⅱ) detection rate higher than other age groups. Conclusion: There are differences in the distribution of HPV types between the general population and cervical lesions. Except for HPV16 and HPV18, HPV58 may be significantly more carcinogenic than other high-risk HPV types. 40-59 years old are the key population of cervical cancer screening . Compared with the previous screening results, the pilot screening method worth further promotion.