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目的了解无锡市35~65岁妇女子宫颈人乳头瘤病毒(HPV)感染流行病学特征。方法回顾分析2013年子宫颈癌普查中采用飞行时间质谱检测法对宫颈刷片进行HPV分型测定(14种高危型、2种低危型)的数据。结果参加筛查191 829例,失败795例,占0.41%;成功191 034例,阳性24 234例,感染率12.68%;以单基因亚型感染为主(18 921例,占阳性例数78.08%),前10位均为高危基因亚型,前5位依次是HPV 52(3 789例,15.64%)、HPV 16(2 849例,11.76%)、HPV 58(2 238例,9.23%)、HPV 68(1 368例,5.64%)、HPV 18(1 279例、5.28%),2种低危型HPV 6(第13位,493例,2.03%)、HPV 11(第17位,222例,0.92%);多重感染以二重感染最为常见(4 189例,占78.84%),多重感染HPV基因亚型构成排位与单基因亚型感染率排位相似,2种低危型基因亚型排最后2位;以5岁为一年龄段,低年龄段到高年龄段HPV感染率呈上升趋势(χ2=72.47,P<0.01),有明显变化的年龄段是35~39岁、40~49岁及50~65岁(相邻之间比较χ2值分别为8.91和34.21,均P<0.01),单基因亚型总体感染率在40~59岁最高(13.97%,与前后年龄段11.19%、12.40%比较差异均有统计学意义,χ2值分别为17.06和28.77,均P<0.01),其中感染率随年龄增长而升高的有HPV 58、HPV 66,降低的有HPV 52、HPV 39、HPV 6、HPV 45、HPV 11,多重感染则呈先降后升的不对称U型趋势(谷底在40~49岁,14.60%)。结论无锡地区HPV感染以单基因高危亚型52、16、58、68、18型感染最为常见,高发年龄段单基因亚型为40~59岁年龄段,多重感染则需关注35~39岁和60~65岁2个年龄段。
Objective To understand the epidemiological characteristics of cervix human papillomavirus (HPV) infection in 35 ~ 65 years old women in Wuxi City. Methods A retrospective analysis of 2013 cervical cancer screening using time of flight mass spectrometry detection of cervical brushing HPV typing (14 kinds of high-risk, two kinds of low-risk type) data. Results A total of 191 829 patients were screened, accounting for 0.41% of the total number of unsuccessful patients. 191 034 cases were successful, of which 24 234 were positive and the infection rate was 12.68%. The single gene subtype infection was the most common (18 921 cases, accounting for 78.08% ), The top 10 were all high-risk genotypes. The top five were HPV 52 (3 789 cases, 15.64%), HPV 16 (2 849 cases, 11.76%), HPV 58 HPV 68 (1 368 cases, 5.64%), HPV 18 (1 279 cases, 5.28%), 2 low risk HPV 6 (13th, 493 cases, 2.03%), HPV 11 , 0.92%). The most common infection was multiple infection (4 189 cases, accounting for 78.84%). The infection rates of multiple genotypes of HPV genotypes were similar to those of single genotypes. The two low-risk genotypes In the age group of 5 years old, the infection rate of HPV in the low age group to the high age group showed an upward trend (χ2 = 72.47, P <0.01), and the age group with obvious change was 35-39 years old ~ 49 years old and 50-65 years old (compared with 8.91 and 34.21, respectively, P <0.01). The overall prevalence of single-gene subtypes was the highest (13.97%) between the ages of 40 and 59 years %, 12.40%, respectively, the difference was statistically significant, χ2 values were 17.06 and 28.77, all P <0.01), of which the infection rate increased with age Increased with HPV 58, HPV 66, with reduced HPV 52, HPV 39, HPV 6, HPV 45, HPV 11, multiple infections were first decreased and then increased asymmetric U-shaped trend (bottom 40 to 49 years old, 14.60%). Conclusion HPV infection in Wuxi is most common in single-gene high-risk subtypes 52, 16, 58, 68, and 18, single-gene subtypes in the high-risk population are in the 40- to 59-year-old age range, 60 ~ 65 years old two age groups.