Wu Rui-fang, Liu Zhi-hua, Zhou Qing-zhi, Wulan Na, Wang Qian, Li Qing, Li Ni, Liu Zhi-hong, Shi Jü-fang, Li Rui-zhen, Zhang Chang-huai, Zhou Yan-qiu, Liu Bin, Weng Lei-ming, Qiao You-lin
Department of Gynecology & Obstetrics, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2010 Feb;32(1):90-5. doi: 10.3881/j.issn.1000-503X.2010.01.021.
To investigate the prevalence of high-risk human papillomavirus (HPV) and incidence of cervical intraepithelial neoplasia (CIN) in female populations in Shenzhen, Guangdong Province, China.
Totally 1137 women aged 15-59 from Shahe Community, Nanshan District, Shenzhen were investigated for cervical cancer during an population-based epidemiological screening from November 2004 to December 2004. Visual inspection with acetic acid (VIA), colposcopy, liquid-based cytology test (LCT), and hybrid capture 2 (HC-) were performed to detect the high-risk HPV types in cervical secretions. Biopsy under colposcope was performed in women who were HPV-positive with LCT >or= atypical squamous cells of undetermined sign (ASCUS) or HPV-negative with LCT >or= low grade squamous intraepithelial lesion (LSIL), with the pathological results as the golden standards.
The detection rate of high-risk HPV-DNA was 14.0%. HPV detection rates in 15-24, 25-29, 30-34, 35-39, 40-44, 45-49, and 50-59 age groups were 15.5%, 17.7%, 12.6%, 8.8%, 10.2%, 15.3%, and 21.0%, respectively (P < 0.05). HPV detection rates in 25-29 years group and 50-59 years group were significantly higher than those in other groups (P < 0.05) and 35-39 group had the lowest detection rate. The curve of HPV infection rates in all groups was 'V' type. The overall incidence of CIN was 4.4%. The incidences of CIN , CIN , and CIN were 3.2%, 1.0%, and 0.3%, respectively, in which the incidence of CIN was significantly higher than those of CIN and . HPV detection rates increased with cervical lesion grades, which in >or=CIN groups and normal group were 100.0% and 8.3%, respectively. No cervical cancer was identified in this research. The sensitivities of VIA, colposcopy, LCT, and HC-II for high-risk HPV screening were 35.7%, 50.0%, 92.9%,and 100%, respectively, in detecting high-grade squamous intraepithelial lesion (HSIL), the specificities of these four methods were 96.0%, 87.2%, 88.4%, and 86.9%, respectively. Satisfactory negative predictive values were obtained for all methods.
HPV infection is the main risk factor for CIN. Cervical cancer among female populations in Shenzhen is still in early stages. Prevention of HPV infection and treatment of CIN are key for the prevention of cervical cancer.
调查中国广东省深圳市女性人群中高危型人乳头瘤病毒(HPV)的感染率及宫颈上皮内瘤变(CIN)的发病率。
2004年11月至2004年12月,在深圳市南山区沙河社区对1137名年龄在15 - 59岁的女性进行宫颈癌的人群流行病学筛查。采用醋酸肉眼观察法(VIA)、阴道镜检查、液基细胞学检测(LCT)及杂交捕获二代(HC - II)检测宫颈分泌物中的高危型HPV。对LCT结果为≥意义不明确的非典型鳞状细胞(ASCUS)的HPV阳性女性或LCT结果为≥低度鳞状上皮内病变(LSIL)的HPV阴性女性进行阴道镜下活检,以病理结果作为金标准。
高危型HPV - DNA的检出率为1十四.0%。15 - 24、25 - 29、30 - 34、35 - 39、40 - 44、45 - 49及50 - 59岁年龄组的HPV检出率分别为15.5%、17.7%、12.6%、8.8%、10.2%、15.3%及21.0%(P <十四.05)。25 - 29岁组和50 - 59岁组的HPV检出率显著高于其他组(P <十四.05),35 - 39组的检出率最低。各组HPV感染率曲线呈“V”型。CIN的总发病率为4.4%。CINⅠ、CINⅡ及CINⅢ的发病率分别为3.2%、1.0%及0.3%,其中CINⅠ的发病率显著高于CINⅡ和CINⅢ。HPV检出率随宫颈病变级别升高而增加,≥CINⅠ组和正常组的HPV检出率分别为100.0%和8.3%。本研究未发现宫颈癌病例。VIA、阴道镜检查、LCT及HC - II对高危型HPV筛查的敏感度分别为35.7%、50.0%、92.9%及100%,在检测高级别鳞状上皮内病变(HSIL)时,这四种方法的特异度分别为96.0%、87.2%、88.4%及86.9%。所有方法均获得了满意的阴性预测值。
HPV感染是CIN的主要危险因素。深圳市女性人群宫颈癌仍处于早期阶段。预防HPV感染及治疗CIN是预防宫颈癌的关键。