摘要
目的分析高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染在不同级别宫颈鳞状上皮内病变中的亚型分布特点,探讨HR-HPV分型检测对宫颈病变诊治的指导价值.方法采用回顾性病例对照分析方法,收集2020年1~12月于北京天坛医院行阴道镜检查+宫颈活检,病理证实CIN 2和CIN 3共183例,CIN 1共137例,同时收集病理结果为正常/炎症改变285例,所有患者均有HR-HPV感染.结果CIN 2/3组中,HR-HPV检出率最高的前5位分别为HPV16(47.54%)、HPV52(21.31%)、HPV58(12.57%)、HPV31(8.74%)、HPV 18(8.20%),以HR-HPV单一感染多见,其中HPV16亚型感染最常见(42.27%).单因素分析表明,不同年龄段、不同怀孕次数和不同HPV16感染状态下,宫颈病变程度差异有统计学意义(P<0.05);HR-HPV多重感染与宫颈病变程度进展有显著的相关关系(P<0.001).多因素Logistic回归结果表明,"HPV16阳性"以及"HPV31阳性"为宫颈病变程度的独立危险因素.结论HR-HPV感染在CIN 2/3组中,以HPV16/52/58/31/18感染多见;相对其他HR-HPV亚型,HPV16、HPV31以及多个亚型的混合感染与宫颈病变程度具有较大相关性,临床上应当给予高度重视,加强管理和随访.
Objective To analyze the subtype distribution characteristics of high-risk human papillomavirus(HR-HPV)infection in different grades of cervical squamous intraepithelial lesions,and to explore the guiding value of HR-HPV typing in the diagnosis and treatment of cervical lesions.Methods A retrospective case-control analysis method was used to collect patients underwent colposcopy+cervical biopsy in Beijing Tiantan Hospital from January to December 2020.Including 183 cervical intraepithelial neoplasia(CIN)2/3 cases,137 CIN 1 cases and 285 normal cervix/chronic cervicitis cases.All cases were pathologically confirmed and all patients had HR-HPV infection.Results In the CIN 2/3 group,the top 5 HR-HPV detection rates were HPV16(47.54%),HPV52(21.31%),HPV58(12.57%),HPV31(8.74%),and HPV18(8.20%),respectively.HR-HPV single infection was more common,and HPV16 subtype infection was the most common(42.27%).Univariate analysis showed that there were significant differences in the degree of cervical lesions among different age groups,different times of pregnancy and different HPV16 infection status;Multiple HR-HPV infection was significantly correlated with the progression of cervical lesions(P<0.001).Multivariate Logistic regression and variable screening results showed that"HPV16 positive"and"HPV31 positive"were independent risk factors for the degree of cervical lesions.Conclusion In the CIN 2/3 group,HR-HPV infection was more common with HPV16/52/58/31/18 infection;compared with other HR-HPV subtypes,HPV16,HPV31 and mixed infection of multiple subtypes were associated with the progression of cervical lesions.It should be highly valued in clinical practice,and management and follow-up should be strengthened.
作者
李海霞
李春霞
杨保军
赵辉
冯力民
Li Haixia;Li Chunxia;Yang Baojun;Zhao Hui;Feng Limin(Department of Obsterics and Gynecology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,P.R.China)
出处
《中国计划生育和妇产科》
2022年第6期60-64,共5页
Chinese Journal of Family Planning & Gynecotokology
关键词
人乳头瘤病毒
高危型
宫颈病变
human papillomavirus
high-risk
cervical lesions
