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[2010年黑龙江省大庆市人乳头瘤病毒流行情况及其危险因素分析]

[Prevalence of human papilloma virus and analysis of its risk factors in Daqing city, Heilongjiang province in 2010].

作者信息

Yang Lin, Li Ni, Guo Lan-wei, Li Qian, Cui Hong, Dai Min

机构信息

Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2013 Feb;47(2):118-23.

Abstract

OBJECTIVE

The aim of the study was to investigate the positivity of human papillomavirus (HPV) and the possible related risk factors for HPV infection in certain district government in Daqing city, Heilongjiang province.

METHODS

A total of 2015 female staffs who participated cervical cancer screening were selected as subjects, in certain district government in Daqing city, Heilongjiang province, from June to October, 2010. First of all, a standardized questionnaire was used for collection of subject's demographic information and possible risk factors. Afterwards, cervical cytological and HPV DNA testing were applied to all participants. Subjects with suspected cervical intraepithelial neoplasia (CIN) or cervical cancer were recalled for taking biopsy under colposcopy for further histopathological diagnosis. Standardized HPV positivity by Segi's world population and compared the difference of HPV positivity of different types. The positivity of HPV between women with and without cervical abnormalities were compared by unconditional logistic regression. And the possible risk factors for HPV infection were also investigated.

RESULTS

A total of 1759 out of 2015 subjects had gynecological examination, among which 152 subjects were HPV positive. The positivity of HPV was 8.64% (95%CI: 7.37% - 10.05%), and it was 8.47% (95%CI: 7.93% - 9.03%) after age standardization. Finally, 57 (3.24%) and 1702 (96.76%) subjects had abnormal (≥ CIN1 or low-grade squamous intraepithelial lesion (LSIL)) and normal cervix, respectively. The HPV positivity between women with and without cervical abnormalities were 73.68% (42/57) and 6.46% (110/1702), respectively. There was a significant difference (χ(2) = 307.23, P < 0.05) in HPV positivity between women with and without cervical abnormalities. The risk of cervical abnormalities for women with HPV positivity was 40.52 times (95%CI: 21.79 - 75.36) higher than that for women with HPV negativity. Among women with cervical abnormalities, the most three common HPV types, in descending order, were HPV16 (28.07% (16/57)), HPV52 (14.04% (8/57)) and HPV58 (12.28% (7/57)). While among women with normal cervix, the most three common HPV types were HPV52 (1.23% (21/1702)), HPV16 (1.00% (17/1702)) and HPV58 (0.71% (12/1702)). The positivity of HPV clade A9 among women with and without cervical abnormalities were 59.65% (34/57) and 3.23% (55/1702), which were higher than that of other clades. Analysis for risk factors of HPV infection showed that smoking (OR = 2.71, 95%CI: 1.00 - 7.33), late age (≥ 15 years old) of menarche (OR = 1.44, 95%CI: 1.00 - 2.05), early age (≤ 20 years old) of marriage (OR = 3.09, 95%CI: 1.30 - 7.35), multiple (≥ 2) sexual partners (OR = 2.69, 95%CI: 1.46 - 4.95), husband's extramarital sexual behaviors (OR = 2.77, 95%CI: 1.25 - 6.12) and multiple (≥ 2 times) parity (OR = 1.77, 95%CI: 1.03 - 3.03) would increase the risk of HPV positivity.

CONCLUSION

HPV positivity among women with cervical abnormalities was significantly higher than that among women with normal cervix. HPV16, 52, 58 were the major genotypes among the study population. Smoking, late age of menarche, early age of marriage, multiple sexual partners, husband extramarital sexual behaviors and multiple parity increase the risk of HPV infection.

摘要

目的

本研究旨在调查黑龙江省大庆市某区政府女性工作人员人乳头瘤病毒(HPV)感染阳性率及其相关危险因素。

方法

选取2010年6月至10月在黑龙江省大庆市某区政府参加宫颈癌筛查的2015名女性工作人员为研究对象。首先,采用标准化问卷收集研究对象的人口学信息及可能的危险因素。然后,对所有研究对象进行宫颈细胞学检查和HPV DNA检测。对疑似宫颈上皮内瘤变(CIN)或宫颈癌的研究对象进行阴道镜下活检,以进一步行组织病理学诊断。按Segi世界人口标准计算HPV感染阳性率,并比较不同型别HPV感染阳性率的差异。采用非条件logistic回归分析比较宫颈异常与宫颈正常女性的HPV感染阳性率,并分析HPV感染的可能危险因素。

结果

2015名研究对象中,1759名接受了妇科检查,其中152名HPV检测阳性。HPV感染阳性率为8.64%(95%CI:7.37% - 10.05%),年龄标准化后为8.47%(95%CI:7.93% - 9.03%)。最终,57名(3.24%)和1702名(96.76%)研究对象分别存在宫颈异常(≥CIN1或低度鳞状上皮内病变(LSIL))和宫颈正常。宫颈异常与宫颈正常女性的HPV感染阳性率分别为73.68%(42/57)和6.46%(110/1702),两者差异有统计学意义(χ(2)=307.23,P<0.05)。HPV感染阳性女性发生宫颈异常的风险是HPV感染阴性女性的40.52倍(95%CI:21.79 - 75.36)。宫颈异常女性中,HPV感染最常见的3种型别依次为HPV16(28.07%(16/57))、HPV52(14.04%(8/57))和HPV58(12.28%(7/57))。宫颈正常女性中,HPV感染最常见的3种型别依次为HPV52(1.23%(21/1702))、HPV16(1.00%(17/1702))和HPV58(0.71%(12/1702))。宫颈异常与宫颈正常女性中HPV A9分支感染阳性率分别为59.65%(34/57)和3.23%(55/1702),高于其他分支。HPV感染危险因素分析显示,吸烟(OR=2.71,95%CI:1.00 - 7.33)、初潮年龄晚(≥15岁)(OR=1.44,95%CI:1.00 - 2.05)、结婚年龄早(≤20岁)(OR=3.09,95%CI:1.30 - 7.35)、性伴侣数多(≥2个)(OR=2.69,95%CI:1.46 - 4.95)、丈夫有婚外性行为(OR=2.77,95%CI:1.25 - 6.12)及孕产次多(≥2次)(OR=1.77,95%CI:1.03 - 3.03)可增加HPV感染阳性风险。

结论

宫颈异常女性的HPV感染阳性率显著高于宫颈正常女性。HPV16、52、58型是本研究人群中的主要基因型。吸烟、初潮年龄晚、结婚年龄早、性伴侣数多、丈夫有婚外性行为及孕产次多可增加HPV感染风险。

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