[1]唐阳芳,张少华,栾丽霞,等.高危型人乳头瘤病毒阳性、细胞学检查阴性患者感染不同类型高危型人乳头瘤病毒与宫颈高级别鳞状上皮内病变相关性研究[J].陕西医学杂志,2022,51(8):978-981,1012.[doi:DOI:10.3969/j.issn.1000-7377.2022.08.017]
　TANG Yangfang,ZHANG Shaohua,LUAN Lixia,et al.Correlation between different types of high-risk human papillomavirus infection,negative cervical cytology and occurrence of high-grade squamous intraepithelial lesions of the cervix[J].,2022,51(8):978-981,1012.[doi:DOI:10.3969/j.issn.1000-7377.2022.08.017]
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高危型人乳头瘤病毒阳性、细胞学检查阴性患者感染不同类型高危型人乳头瘤病毒与宫颈高级别鳞状上皮内病变相关性研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年8期
页码:
978-981,1012
栏目:
临床研究
出版日期:
2022-08-05

文章信息/Info

Title:
Correlation between different types of high-risk human papillomavirus infection,negative cervical cytology and occurrence of high-grade squamous intraepithelial lesions of the cervix
作者:
唐阳芳; 张少华; 栾丽霞; 魏 琳; 郑 文; 陈国平; 邓亚楠; 陈 蕊
(西安医学院第一附属医院,陕西 西安 710077)
Author(s):
TANG Yangfang; ZHANG Shaohua; LUAN Lixia; WEI Lin; ZHENG Wen; CHEN Guoping; DENG Yanan; CHEN Rui
(First Affiliated Hospital of Xi'an Medical University,Xi'an 710077,China)
关键词:
不同类型;  高危型人乳头瘤病毒感染;  宫颈细胞学;  阴性;  宫颈高级别鳞状上皮内病变;  相关性
Keywords:
Different types;  High-risk human papillomavirus infection;  Cervical cytology;  Negative;  Cervical high-grade squamous intraepithelial lesion;  Correlation
分类号:
R 737.33
DOI:
DOI:10.3969/j.issn.1000-7377.2022.08.017
文献标志码:
A
摘要:
目的:探讨高危型人乳头瘤病毒(HPV)阳性、细胞学检查阴性的患者感染不同类型高危型HPV与宫颈高级别鳞状上皮内病变(HSIL)发生的相关性。方法:选择因高危型HPV阳性,薄层液基细胞学检测未见上皮内病变或恶性细胞,进一步在阴道镜下取病理组织检查的女性2193例为研究对象。将患者依据宫颈病变级别分为A组(宫颈低级别病变组)1897例和B组(宫颈高级别病变组)296例。分析两组间HPV感染类型,采用多因素回归分析探讨不同类型高危型HPV感染与宫颈高级别病变发生的相关性。 结果:该研究人群宫颈高级别病变的发生率为13.50%,在年龄范围30～39岁人群中,宫颈高级别病变的发生率(44.59%)较宫颈低级别病变(32.95%)显著升高(P<0.05)。HPV16、HPV18、HPV52、HPV58、HPV53是该人群高危型HPV感染的主要类型,分别占比为24.98%、13.35%、22.32%、11.96%、10.73%。其中,宫颈高级别病变组HPV16、HPV31、HPV33的发生概率分别为61.5%、10.04%、9.61%,相比较宫颈低级别病变组(HPV16:24.98%; HPV31:4.38%; HPV33:3.45%)的发生概率显著上升(P<0.05)。进一步调整基线资料进行多因素分析显示,HPV16阳性、HPV31阳性、HPV33阳性时宫颈高级别病变发生风险较宫颈低级别病变组高3.73倍(OR=4.73,95%CI:3.53～6.35)、1.53倍(OR=2.53,95% CI:1.53～4.20)、2.02倍(OR=3.02,95% CI:1.53～4.20),以上差异均具有统计学意义(均P<0.05)。结论:宫颈高级别病变有年轻化趋势,应加强年轻女性,尤其是年龄范围在30～39岁之间妇女的筛查及随访。当筛查结果显示细胞学阴性,HPV16、HPV31或HPV33呈阳性时,建议积极转诊阴道镜检查。
Abstract:
Objective:To investigate the correlation between different types of high-risk human papillomavirus(HPV)infection,negative cervical cytology and occurrence of high-grade squamous intraepithelial lesions(HSIL)of the cervix.Methods:A total of 2193 women with negative cervical cytology and positive HPV were referred to colposcopy and histopathological examination.Patients were divided into group A(low-grade cervical lesion group,1897 cases)and group B(high-grade cervical lesion group,296 cases)according to the grade of cervical lesions.The HPV infection types between the two groups were analyzed,and the multivariate regression analysis was used to explore the correlation between different types of high-risk HPV infection and the occurrence of cervical high-grade lesions.Results:The incidence of high-grade cervical lesions in the study was 13.50%,and the incidence of high-grade cervical lesions(44.59%)was significantly higher than that of low-grade cervical lesions(32.95%)in the population aged 30 to 39 years(P<0.05).HPV16,HPV18,HPV52,HPV58 and HPV53 were the main types of high-risk HPV infection in this population,accounting for 24.98%,13.35%,22.32%,11.96% and 10.73%,respectively.The incidence of HPV16,HPV31 and HPV33 in the high-grade cervical lesion group was 61.5%,10.04% and 9.61%,respectively.Compared with those in the low-grade cervical lesion group(HPV16:24.98%; HPV31:4.38%; HPV33:3.45%),the probability of occurrence increased significantly(P<0.05).Multivariate analysis showed that when HPV16,HPV31 and HPV33 were positive,the risk of high-grade cervical lesion group was 3.73 times higher(OR=4.73,95%CI:3.53 to 6.35),1.53 times higher(OR=2.53,95%CI:1.53 to 4.20)and 2.02 times higher(OR=3.02,95%CI:1.53 to 4.20)than those in the low-grade cervical lesion group,all of which were statistically significant(all P<0.05).Conclusion:High grade cervical lesions tend to be younger,so the screening and follow-up of young women,especially those between 30 and 39 years old,should be strengthened.When screening results are cytologically negative and positive for HPV16,HPV31 or HPV33,an active referral to colposcopy is recommended.

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备注/Memo

备注/Memo:
基金项目:陕西省科技计划项目(2022SF-553)
更新日期/Last Update: 2022-08-04