中国青藏高原南部农村高海拔社区高危型人乳头瘤病毒（hr-HPV）感染率及宫颈细胞学异常情况：一项基于人群的横断面研究（2023 - 2024年）

High-risk human papillomavirus (hr-HPV) prevalence and abnormal cervical cytology in rural high-altitude communities: a population-based cross-sectional study in the Southern Tibetan Plateau, China (2023-2024).

作者信息

Chen Min, Lhamo Yeshi, Chödrön Kelsang, Chen Le

机构信息

Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.

Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.

出版信息

Virol J. 2025 Aug 13;22(1):279. doi: 10.1186/s12985-025-02909-1.

DOI:10.1186/s12985-025-02909-1

PMID:40804691

Abstract

BACKGROUND

Cervical cancer prevention remains challenging in resource-limited high-altitude regions. This study investigated the prevalence of high-risk human papillomavirus (hr-HPV) and cytological abnormalities in southern Tibet, China.

METHODS

A population-based cross-sectional study (2023-2024) enrolled 21,112 women from the Shannan Region (altitude: 3500-6000 m). The participants underwent hr-HPV genotyping (16/18 and 16 other types) and ThinPrep cytologic testing (TCT). Statistical analyses included χ² tests and quadratic regression.

RESULTS

The overall hr-HPV prevalence was 9.57% (2,021/21,112). Non-16/18 types predominated (83.37% of infections), with HPV16/18 accounting for 1.59% of infections. Age-stratified analysis revealed a U-shaped infection curve: peaks at 20-24 years (16.07%) and ≥ 65 years (11.84%), nadir at 45-49 years (8.94%; R²=0.89, p < 0.01). Cytological abnormalities occurred in 8.27% (1,746/21,112) of the patients, predominantly ASC-US (79.5%). The ≥ 65 years participants presented the highest abnormality rate (11.84% vs. other groups). Hr-HPV positivity correlated strongly with cytological severity (p < 0.001), increasing from NILM (7.84%) to HSIL (92.31%). HPV16/18 was more prevalent in high-grade lesions (HSIL: 38.46%; OR = 60.2 vs. NILM, 95% CI: 18.4-196.7).

CONCLUSION

Shannan has a distinct hr-HPV epidemiology characterized by a lower prevalence, U-shaped age distribution, and non-16/18 type dominance. The resurgence of infections/abnormalities in elderly women warrants age-tailored screening. These findings support prioritizing multivalent vaccines in this high-altitude population.

摘要

背景

在资源有限的高海拔地区，宫颈癌预防仍然具有挑战性。本研究调查了中国西藏南部高危型人乳头瘤病毒（hr-HPV）的流行情况和细胞学异常情况。

方法

一项基于人群的横断面研究（2023 - 2024年）纳入了来自山南地区（海拔：3500 - 6000米）的21112名女性。参与者接受了hr-HPV基因分型（16/18型和其他16种类型）和薄层液基细胞学检测（TCT）。统计分析包括χ²检验和二次回归。

结果

hr-HPV总体流行率为9.57%（2021/21112）。非16/18型占主导（感染的83.37%），HPV16/18占感染的1.59%。年龄分层分析显示感染曲线呈U形：在20 - 24岁（16.07%）和≥65岁（11.84%）出现峰值，在45 - 49岁出现最低点（8.94%；R² = 0.89，p < 0.01）。8.27%（1746/21112）的患者出现细胞学异常，主要为意义不明确的非典型鳞状细胞（ASC-US，79.5%）。≥65岁的参与者异常率最高（11.84%，与其他组相比）。hr-HPV阳性与细胞学严重程度密切相关（p < 0.001），从无上皮内病变或恶性病变（NILM，7.84%）到高级别鳞状上皮内病变（HSIL，92.31%）逐渐增加。HPV16/18在高级别病变中更常见（HSIL：38.46%；OR = 60.2，与NILM相比，95%CI：18.4 - 196.7）。