5 155例女性宫颈人乳头瘤病毒感染的流行病学特征及病理相关性研究

Epidemiological characteristics of 5 155 cases of cervical HPV infection and their pathological correlations

摘要

目的 分析湖北省荆门市中心医院门诊接受人乳头瘤病毒(HPV)筛查女性宫颈HPV感染的流行病学特征、亚型分布及其与宫颈病变的临床关联。方法 回顾性纳入2022年7月至2024年7月于荆门市中心医院妇科门诊接受HPV筛查的5 155例女性,按年龄分为6组:≤20岁组(n=54)、21~30岁组(n=791)、31~40岁组(n=1 757)、41~50岁组(n=1 371)、51~60岁组(n=968)及≥61岁组(n=214)。通过基因分型检测与病理诊断,评估感染模式及临床相关性。结果 单纯高危型、低危型及混合感染率分别为18.10%、3.38%和3.38%。高危型HPV感染率呈显著双峰年龄分布:≤20岁组(33.33%)与≥61岁组(39.25%),不同年龄组高危型HPV感染率差异有统计学意义(χ²=81.430,P＜0.001)。高危型单一感染中各亚型构成,前五位为HPV52(23.5%)、HPV16(13.9%)、HPV58(13.3%)、HPV53(10.6%)及HPV51(7.2%)。低级别鳞状上皮内病变(LSIL)、高级别鳞状上皮内病变(HSIL)与宫颈癌患者中,HPV16检出率分别为20.0%、44.3%和55.5%,差异具有统计学意义(χ²=35.036,P＜0.001)。结论 研究揭示≤20岁青年女性和≥61岁老年期女性为高危HPV易感人群。HPV16(55.5%)在宫颈癌患者中呈高检出率,提示应将相关亚型纳入区域疫苗防控重点。建议基于病毒亚型及病理分级实施差异化临床管理策略。

Abstract

Objective To investigate epidemiological characteristics,subtype distribution and correlations of cervical human papillomavirus (HPV) infection in the cervix with clinicopathological features in women who underwent HPV screening in Jingmen Municipal Central Hospital,Hubei province. Methods 5 155 women who underwent HPV screening in Jingmen Central Hospital from July 2022 to July 2024 were retrospectively selected for cohort study.The participants were stratified into six age groups:≤20 years age group (n=54),21-30 years age group (n=791),31-40 years age group (n=1 757),41-50 years age group (n=1 371),51-60 years age group (n=968),and ≥61 years age group (n=214).HPV genotyping and histopathological diagnosing were performed to analyze HPV infection patterns and their associations with clinical cervical lesions. Results The prevalence rates of single type of high-risk HPV (HR-HPV) infection,single type of low-risk HPV (LR-HPV) infection and mixed HPV infection were 18.10%,3.38% and 3.38% respectively.HR-HPV infection presented a significant bimodal age distribution,with peak prevalence rates observed in the ≤20 years cohort (33.33%) and ≥61 years cohort (39.25%),and there was statistically significant difference in the infection rate of HR-HPV among the six age groups (χ²=81.430,P＜0.001).In rank of distribution of single high-risk HPV subtype infections,the top five were HPV52 (23.5%),HPV16 (13.9%),HPV58 (13.3%),HPV53 (10.6%) and HPV51 (7.2%).The detection rates of HPV16 in these patients with low-grade squamous intraepithelial lesions (LSIL),the patients with high-grade squamous intraepithelial lesions (HSIL),and those patients with cervical cancer (CC) were 20.0%,44.3% and 55.5% respectively,and the difference was statistically significant (χ²=35.036,P＜0.001). Conclusion The study reveals that the young women (≤20 years) and the old women (≥61 years) are high-risk populations for HR-HPV infection.The detection rate of HPV16 (55.5%) significantly elevates in cervical cancer patients,suggesting that in region-specific vaccine development strategies for prevention and control,such subtypes of HR-HPVs should be prioritized.Strategic recommendations include:(1) implementing risk-stratified clinical management protocols based on virological subtyping and histopathological grading,and (2) optimizing population-level surveillance for genotype-specific vulnerable age cohorts of women.

关键词

人乳头瘤病毒 / 宫颈上皮内病变 / 宫颈癌 / 疫苗 / 流行病学

Key words

human papillomavirus (HPV) / cervical intraepithelial neoplasia (CIN) / cervical cancer / vaccine / epidemiology

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基金资助

湖北省荆门市科技计划项目(2022YDKY136)