[深圳成年女性高危型人乳头瘤病毒及宫颈癌患病率调查]

DU Hui, Wu Rui-fang, Tang Hui-ru, Wu Lan-na, Zhang Li-jie, Liu Zhi-hong, Li Juan, Li Rui-zhen, Wang Guo-ping, Zhou Yan-qiu, Wang Chun, Weng Lei-ming

Gynecology and Obstetric Department of Beijing University Shenzhen Hospital, Shenzhen 518036, China.

Zhonghua Liu Xing Bing Xue Za Zhi. 2012 Aug;33(8):799-802.

OBJECTIVE

To investigate the prevalence of high risk human papillomavirus (HPV) genital infection and cervical cancer in adult women from Shenzhen.

METHODS

Cluster sampling was used to investigate the prevalence of HPV infection and cervical cancer from women aged 20 - 59 years old living in Luohu, Futian, Nanshan, Longgang and Baoan districts in Shenzhen from April 2006 to April 2010. All women were detected for liquid-based cytology test (LCT) or Thinprep cytologic test (TCT) and high-risk HPV-DNA test with hybrid capture II (HC-II). All women with ≥ ASC-US by cytology and/or a positive HC-II test were asked to return for colposcopy and four-quadrant biopsy. Endocervical curettage was performed. Pathological finding were used as the gold standard of the diagnosis of cervical intraepithelial neoplasia.

RESULTS

10 210 women were involved in the study and 10 017 of them having completed data. The overall positive rate of high-risk HPV-DNA was 16.29%. HPV positive rates in 20-, 30-, 35-, 40-, 45-, 50-59 age groups were 17.37%, 15.59%, 16.33%, 14.74%, 17.16% and 17.98%, respectively. The curve of HPV infection rates in different age groups appeared a 'W' shape. HPV infection rates in the 25-years-olds and 50-59 year-olds groups were significantly higher than the other age groups (χ(2) = 4.50, P = 0.03). The overall prevalence rate of cervical intraepithelial lesions (CIN) was 7.52%, of which the prevalence rates of low-grade cervical intraepithelial lesions (CIN I) was 5.32% high-grade cervical intraepithelial lesions (CIN II/III) was 2.21%, cervical cancer was 0.12%. The prevalence of CIN I was significantly higher than the CIN II/III (χ(2) = 134.15, P < 0.001). The prevalence of cervical cancer in 45-age group was 0.12%, the highest. HPV infection rates increased with the grades of cervical lesions including women without CIN as 44.31%, in CINI as 70.73%, in CINII as 86.73%, and in CIN III as 96.75% and in cancer as 100.00%. The HPV infection rates were different in districts (χ(2) = 17.81, P = 0.03), with Futian and Luohu higher than those of Nanshan, Longgang and Baoan district. The prevalence rate of CIN in Baoan was lower than other districts. The CIN prevalence rates were not significantly different among the other districts of Shenzhen (χ(2) = 4.84, P = 0.18).

CONCLUSION

The prevalence of cervical cancer was low in adult women living in Shenzhen, with cervical lesions still in the early stage. Prevention of HPV infection and treatment of CIN were the key points for the prevention of cervical cancer.

目的

调查深圳成年女性高危型人乳头瘤病毒（HPV）生殖道感染及宫颈癌的患病率。

方法

采用整群抽样法，对2006年4月至2010年4月居住在深圳罗湖、福田、南山、龙岗和宝安区的20 - 59岁女性进行HPV感染及宫颈癌患病率调查。所有女性均接受液基细胞学检测（LCT）或薄层液基细胞学检测（TCT）以及采用杂交捕获二代技术（HC-II）进行的高危型HPV-DNA检测。所有细胞学检查结果为≥非典型鳞状上皮细胞不能明确意义（ASC-US）及/或HC-II检测呈阳性的女性均被要求返回进行阴道镜检查及四点活检。同时进行宫颈管搔刮术。病理检查结果作为宫颈上皮内瘤变诊断的金标准。

结果

10210名女性参与本研究，其中10017名女性有完整数据。高危型HPV-DNA总体阳性率为16.29%。20、30、35、40、45、50 - 59岁年龄组的HPV阳性率分别为17.37%、15.59%、16.33%、14.74%、17.16%和17.98%。不同年龄组的HPV感染率曲线呈“W”形。25岁组和50 - 59岁组的HPV感染率显著高于其他年龄组（χ(2)=4.50，P = 0.03）。宫颈上皮内病变（CIN）的总体患病率为7.52%，其中低级别宫颈上皮内病变（CIN I）的患病率为5.32%，高级别宫颈上皮内病变（CIN II/III）的患病率为2.21%，宫颈癌的患病率为0.12%。CIN I的患病率显著高于CIN II/III（χ(2)=134.15，P < 0.001）。45岁年龄组的宫颈癌患病率最高，为0.12%。HPV感染率随宫颈病变级别升高而增加，未患CIN的女性为44.31%，CIN I为70.73%，CIN II为86.73%，CIN III为96.75%，宫颈癌为100.00%。不同区的HPV感染率存在差异（χ(2)=17.81，P = 0.03），福田和罗湖高于南山、龙岗和宝安区。宝安区的CIN患病率低于其他区。深圳其他区的CIN患病率差异无统计学意义（χ(2)=4.84，P = 0.18）。