陈婷婷 汤雅玲

[关键词] 人乳头瘤病毒;宫颈癌;年龄分布;疫苗

[中图分类号] R711.74          [文献标识码] B          [文章编号] 1673-9701（2021）15-0062-03

High-risk HPV infection status and age distribution among 49 652 women in Xiamen

CHEN Tingting1， 2   TANG Yaling1

1.Department of Obstetrics and Gynecology， the First Affiliated Hospital of Xiamen University， Xiamen   361003， China;

2.Graduate School of Fujian Medical University， Fuzhou   350122， China

[Abstract] Objective To analyze the infection rate and age distribution of high-risk human papillomavirus（HR-HPV） among women in Xiamen， Fujian， to provide evidence for preventing high-risk HPV infection and reducing the incidence of cervical cancer. Methods Used hybrid capture 2 （HC2） technology， 49 652 specimens receiving opportunistic screening in The First Affiliated Hospital of Xiamen University from January 2015 to July 2017 were tested for 13 high-risk HPV types（HPV-16， 18， 31， 33， 35， 39， 45， 51， 52， 56， 58， 59 and 68）. The high-risk HPV infection rate and age distribution were analyzed. Results Among 49 652 specimens receiving opportunistic screening for high-risk HPV infection， 8965 were positive for high-risk HPV infection， with a total positive rate of 18.06%. The peak ages of high-risk HPV infection were <30 years old and between 50-70 years old. The positive rate of women was 20.24% （1821/8997） for <30 years old， 16.57% （5475/33 047） for 30-49 years old， 22.13% （1614/7294） for 50-70 years old， and 17.52%（55/314） for >70 years old. There were statistically significant differences in the positive rates of high-risk HPV infection among the age groups（P<0.05）. Among positive high-risk HPV infection specimens， 7， 148 were classified as HPV-16/18， of which 536 were HPV-16 positive， accounting for 7.50%， and 279 were HPV-18 positive， accounted for 3.90%. Conclusion There are differences in the age distribution of high-risk HPV infection among women in Xiamen， Fujian. HPV screening and testing should be strengthened in all age groups， and HPV vaccines should be selectively and reasonably vaccinated to reduce the incidence of cervical cancer in the region.

[Key words] Human papillomavirus; Cervical cancer; Age distribution; Vaccine

臨床上宫颈癌发病率在女性恶性肿瘤中占比极高。2018年一项综合全球多个国家肿瘤流行病统计数据的分析报告显示子宫颈癌发病率及死亡率均在女性恶性肿瘤位居第四[1]（发病率6.6%，死亡率7.5%）。但各个国家经济水平及医疗卫生水平不同，宫颈癌的发病率和死亡率也存在差异。2019年国家癌症中心发布的报告显示，我国子宫颈癌居女性恶性肿瘤第 5 位[2]。已知高危型人乳头瘤病毒（High-risk human papillomavirus，HR-HPV）的持续感染是引起宫颈癌及高级别宫颈上皮内瘤变的主要原因。因此，通过检测是否感染高危型 HPV 可有效地判断其发生宫颈癌的几率，从而帮助其预防宫颈癌的发生。为了解福建厦门地区女性感染高危型HPV 的情况，以便为该地区女性防治宫颈癌提供科学的依据，本研究对2015年1月至 2017年7月期间在厦门大学附属第一医院（总院及两家分院）妇产科门诊、住院部及体检中心进行高危型HPV检查的49 652例的标本进行回顾性研究，现报道如下。

1 对象与方法

1.1 研究对象

2015年1 月至 2017 年 7月期间在我院门诊、住院部及体检中心进行高危型HPV检测的女性患者49 652例，年龄15～94岁，平均（38.37±9.13）岁。本研究无需签署知情同意书。

1.2 标本采集

采样前 3 d不进行阴道冲洗、使用药物及性交等。用窥阴器暴露宫颈，用宫颈刷置于宫颈口，顺时针旋转 5周以获取足量的上皮细胞，然后取出宫颈刷置于样本保存管内密闭送检。室温保存，1周内完成检测。……