Zhang Qian, Cao Di, Ma Qian, Li Na, Cui Xu-qin, Yang Xiao-feng
Department of Obstetrics and Gynecology,the First Affiliated Hospital of Xi'anJiaotong University,Xi'an 710061,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2015 Oct;37(5):534-40. doi: 10.3881/j.issn.1000-503X.2015.05.008.
To investigate the natural outcome of genital tract high risk human papillomavirus (HR-HPV) infection and associated factors among women in Xi'an region.
Totally 760 women with primary genital tract HR-HPV infection were enrolled and followed up by HPV-DNA genotyping technology. The cervical cytological techniques and/or colposcopy were used when necessary.
Among these subjects,the natural clearance rate of HR-HPV infection was 71.58%,with the median time of 8.10 months. The rate of HPV persistent infection was 22.63%, with the median time of 17.23 months. The rate of progression to cervical intraepithelial neoplasia (CIN)/cervical cancer (CC) was 5.79%, with the median time of 29.34 months. The natural clearance rate (P=0.000), persistent infection rate (P=0.000) and progression rate (P=0.040) in women older than 50 years were statistically difference from other age groups. The persistent infection rate in multiple infections group was significantly lower than that in single infection group (P=0.010), with the median time statistically longer than that in single infection group (P=0.018). The most easily progressive genotypes were HPV-16,HPV-33, HPV-58,HPV-18,HPV-52, and HPV-68, among which HPV-16 was the most common genotype in CIN 3/CC cases, accounting for 85.00%.
Most of HR-HPV infections are naturally cleared within 2 years, and only a few cases progresses to CIN/CC. Women older than 50 years have a lower natural clearance rate and higher persistent and progressive rates. Multiple infections can affect the persistent infection. HPV-16 is the most common carcinogenic genotype in Xi'an region.
探讨西安地区女性生殖道高危型人乳头瘤病毒(HR-HPV)感染的自然转归及相关因素。
纳入760例原发性生殖道HR-HPV感染女性,采用HPV-DNA基因分型技术进行随访,必要时采用宫颈细胞学技术和/或阴道镜检查。
在这些研究对象中,HR-HPV感染的自然清除率为71.58%,中位时间为8.10个月。HPV持续感染率为22.63%,中位时间为17.23个月。进展为宫颈上皮内瘤变(CIN)/宫颈癌(CC)的比例为5.79%,中位时间为29.34个月。50岁以上女性的自然清除率(P=0.000)、持续感染率(P=0.000)和进展率(P=0.040)与其他年龄组相比有统计学差异。多重感染组的持续感染率显著低于单一感染组(P=0.010),中位时间在统计学上长于单一感染组(P=0.018)。最易进展的基因型为HPV-16、HPV-33、HPV-58、HPV-18、HPV-52和HPV-68,其中HPV-16是CIN 3/CC病例中最常见的基因型,占85.00%。
大多数HR-HPV感染在2年内自然清除,只有少数病例进展为CIN/CC。50岁以上女性的自然清除率较低,持续和进展率较高。多重感染会影响持续感染。HPV-16是西安地区最常见的致癌基因型。