【摘要】 目的:了解大连地区女性生殖道人乳头瘤病毒(human papillomavirus,HPV)感染亚型分布特征和宫颈上皮内瘤变(CIN)患病率,并探讨两者之间的关系。方法:2010年3月~2011年9月,对大连市2885名22~59岁有性生活的女性进行以人群为基础的流行病学调查。入组妇女接受宫颈液基细胞学检查(thinprep cytology test,TCT)和人乳头瘤病毒分型检测,细胞学检查结果为未明确意义的不典型鳞状上皮细胞(ASCUS)及以上者和HPV阳性者接受阴道镜检查,必要时行病理活检,以病理结果作为诊断CIN的金标准。结果:入组女性HPV检出率为15.94%,HR-HPV检出率为11.33%,其中前7位感染亚型为HPV16、58、52、31、33、68、18;各年龄组间HR-HPV阳性率差异无统计学意义,感染率最高的是26~30岁组,年龄组别HPV感染率曲线呈"V"字型。CIN现患率为3.71%,CINⅠ、CINⅡ、CINⅢ患病率分别为2.91%、0.52%、0.28%。HPV阳性第一个高峰年龄组与CIN患病第一个高峰年龄组间相差10年。HR-HPV阳性者中CIN发病率为28.44%,HR-HPV阴性者中CIN发病率为0.55%。结论:HR-HPV感染是CIN的主要因素,大连市女性HPV感染的主要亚型为HPV16型。更多还原

【Abstract】 Objective: To understand the distribution characteristics of human papillomavirus( HPV) infection subtypes in genital tract and prevalence rate of cervical intraepithelial neoplasia( CIN) in women in Dalian area,explore their relationship. Methods: A population-based epidemiological study was conducted among 2 885 sexually active women aged 22-59 years old in Dalian city from March 2010 to September 2011. Cervical thinprep cytology test( TCT) and HPV genotyping were performed; the women diagnosed as atypical squamous cells of undetermined significance( ASCUS) and above by TCT and the women with positive HPV underwent pathological biopsy if necessary. Pathological results were designed as gold standard for diagnosing CIN. Results: The detection rates of HPV and high-risk HPV( HR-HPV) were 15. 94% and 11. 33%,respectively. The top seven infection subtypes were HPV16,58,52,31,33,68,and 18. There was no statistically significant difference in positive rate of HR-HPV among different age groups. The infection rate was the highest in 26-30-year-old group. The HPV infection curve for different age groups showed " V" type. The prevalence rate of CIN was 3. 71%. The prevalence rates of CIN Ⅰ,CINⅡ and CINⅢ were 2. 91%,0. 52% and 0. 28%,respectively. The lapse between age group of the first highest peak of HPV positive rate and age group of the first highest peak of CIN prevalence rate was 10 years. The incidence rate of CIN was 28. 44% among women with positive HR-HPV and 0. 55% among women with negative HR-HPV. Conclusion: HR-HPV infection is a major factor in development of CIN. The major subtype of HPV infection is HPV-16 subtype among the women in Dalian city.更多还原