【摘要】 目的 分析新疆乌鲁木齐市女性人乳头瘤病毒（HPV）感染特点及HPV分型定量检测对宫颈病变的预测性能。方法 收集2022年1-12月于新疆医科大学第一附属医院妇科就诊并进行HPV检测的11 654例女性的HPV检测结果。根据年龄将所有就诊者分为低龄组（≤29岁）、青龄组（>29～39岁）、中龄组（>39～49岁）、中老龄组（>49～59岁）和老龄组（>59岁）。其中1 483例患者同时进行阴道镜活检和宫颈组织病理学检测，根据组织病理学诊断结果，将1 483例患者分为宫颈炎、宫颈上皮内瘤变（CIN）Ⅰ、CINⅡ、CINⅢ和宫颈癌，将CINⅠ及以上命名为CIN阳性，CINⅡ及以上命名为CINⅡ+，CINⅢ及以上命名为CINⅢ+。采用实时荧光定量PCR检测HPV亚型及病毒载量，比较不同民族、年龄、宫颈疾病女性HPV的检测结果，比较不同宫颈病变患者主要的HPV亚型病毒载量水平，采用受试者工作特征（ROC）曲线确定主要的HPV亚型预测CINⅡ+的病毒载量阈值。结果 在11 654例就诊者中，HPV感染率为30.60%，单一亚型感染占77.73%。HPV16、52、58是CIN阳性患者感染的主要型别，分别占38.89%、14.90%、11.11%。汉族、维吾尔族、回族和哈萨克族女性HPV感染率分别为31.89%、24.39%、31.76%和27.88%,4个民族HPV感染率比较，差异有统计学意义（χ²=40.929,P<0.001）。在11 654例就诊者中，老龄组HPV感染率最高（34.04%），中龄组HPV感染率最低（26.41%），不同年龄组间HPV感染率比较，差异有统计学意义（χ²=37.754,P<0.001）。在396例CIN阳性患者中，高危型HPV和单一亚型感染率随CIN级别升高而升高(χ²_趋势=9.994、7.233,P<0.01)。CINⅡ+患者HPV16、52、58病毒载量与宫颈炎患者相比，差异均有统计学意义（P<0.05）；且HPV16、52、58病毒载量预测CINⅡ+的最佳截断值分别为4.382、3.694、4.114copy/10⁴个细胞（经lg转化）。结论 新疆乌鲁木齐市女性HPV感染以单一亚型感染为主，HPV16、52、58是主要的感染型别，并且HPV标准化定量具有作为宫颈高级病变预测标志物的潜力。更多还原

【Abstract】 Objective To analyze the characteristics of human papillomavirus（HPV）infection among the female patients in Urumqi City of Xinjiang and the estimated performance of HPV genotyping quantitative detection for cervical lesions.Methods The HPV detection results of 11 654female patients visiting in the obstetrics and gynecology department of the First Affiliated Hospital of Xinjiang Medical University from January to December 2022were collected.According to age,all patients were divided into the low age group（≤29years old）,young age group （>29-39years old）,middle age group （>39-49years old）,middle and aged group（>49-59years old）and elderly group（>59years old）.Among them,1 483patients underwent colposcopy biopsy and cervical tissue pathological examination simultaneously.Based on the histopathological diagnosis results,1 483patients were divided into cervicitis,cervical intraepithelial neoplasia（CIN）Ⅰ，CINⅡ，CINⅢand cervical cancer,CINⅠand above were named as CIN positive,CINⅡand above were named as CINⅡ+，and CINⅢand above were named as CINⅢ+．Real-time fluorescence quantitative PCR was employed to detect HPV subtypes and viral loads.The HPV detection results were compared among the women with different ethnicities,ages and cervical diseases.The viral load levels of primary HPV subtypes were compared among the patients with different cervical lesions.The receiver operating characteristic（ROC）curve was utilized to determine the viral load threshold value of primary HPV subtypes for predicting CINⅡ+．Results Among 11 654visiting subjects,the HPV infection rate was 30.60%,in which the single subtype infection accounted for 77.73%.HPV16,52and 58were the main types of infection in CIN positive,accounting for 38.89%,14.90%and 11.11%,respectively.The HPV infection rates among Han,Uyghur,Hui and Kazakh women were 31.89%,24.39%,31.76%and 27.88%respectively.The HPV infection rates among the four ethnic groups showed statistically significant difference（χ²=40.929,P<0.001）.Among the 11 654visiting subjects,the HPV infection rate in the elderly group was the highest（34.04%）,while which in the middle age group was the lowest HPV infection rate（26.41%）.The HPV infection rate showed the statistically significant difference among different age groups（χ²=37.754,P<0.001）.Among the 396CIN positive patients,the infection rates of high-risk HPV and single subtype HPV were increased with the CIN grade increase(χ²_trend=9.994,7.233,P<0.01).The viral load of HPV16,52and 58had statistically significant difference between the patients with CINⅡ+and the patients with cervicitis（P<0.05）;moreover the optimal cutoff values of the viral load of HPV16,52and 58subtypes for predicting CINⅡ+were 4.382,3.694,4.114copy/10⁴ cells（lg conversion）respectively.Conclusion Female HPV infection is dominated by single subtype infections in Urumqi City,HPV16,52and 58are the main types of infection.Additionally,the HPV standardized quantification has the potential to serve as a predictive biomarker for advanced cervical lesions.更多还原