本文關(guān)鍵詞： 人乳頭瘤病毒 宮頸上皮內(nèi)瘤變 宮頸癌 基因型　出處：《山東大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的： 研究濟南市正常人群、宮頸癌前病變及宮頸癌患者中HPV感染型別的分布,探討濟南市高危人群高危型HPV感染在不同年齡組的分布差異和HPV感染的常見亞型與宮頸病變級別的相關(guān)性。 方法： 收集2009年3月至2013年3月在濟南市中心醫(yī)院婦科門診行HPV檢查的健康查體人群資料共9976例,HPV感染陽性者1618例。采用HPV分型檢測方法對HPV陽性者進行分型,同時進行液基細胞學檢查。對HPV陽性,細胞學結(jié)果為意義不明確的非典型鱗狀細胞及以上者進行陰道鏡檢查及組織病理學活檢,對診斷為宮頸上皮內(nèi)瘤變及以上的患者,回顧分析其HPV分型及與疾病相關(guān)性。 結(jié)果： 1.濟南市HPV感染陽性率為16.22%,其中高危型HPV的陽性率為11.73%,低危型HPV陽性率為7.96%。常見高危型HPV由高到低為HPV16、18、33型,常見低危型HPV由高到低為HPV11、6型。 2.HPV感染率以25-34歲女性最高(17.6%),之后隨年齡的增長HPV感染率呈下降趨勢。高危型HPV感染陽性率有兩個年齡高峰,第一個在25-34歲(13.8%),第二個在45-54歲(13.2%),低危型HPV感染陽性率有一個年齡高峰,在25歲以下(9.4%),之后隨年齡的增長逐漸下降。 3.高危型HPV陽性率隨著宮頸病變級別的升高而升高,宮頸病變的程度與年齡無明顯相關(guān)性。 4.不同級別宮頸病變中HPV亞型分布由高到低排列：宮頸癌中依次為：HPV16、18、33型,CINIII中依次為：HPV16、18、58、33、56型；CIN II中依次為：HPV16、18、31、58、52、56、66型；CIN I中依次為：HPV16、18、59型。 5.各年齡組HPV單一感染人數(shù)均多于多重感染人數(shù)。單一感染及多重感染均在25-34歲年齡組呈現(xiàn)最高峰,然后逐漸下降,在≥55歲年齡組降到最低點。在各級別宮頸病變之間多重感染率差別無統(tǒng)計學意義(P0.05)。 結(jié)論： 1.濟南市常見的高危型HPV亞型為HPV16、18、33型,低危型HPV亞型為HPV11、6型。首次檢測出濟南地區(qū)不同級別宮頸病變中高危型HPV亞型分布,根據(jù)檢出率由高到低如下：宮頸癌中為：HPV16、18、33型,CINIII中為：HPV16、18、58、33、56型；CINⅡ中為：HPV16、18、31、58、52、56、66型；CIN I中為：HPV16、18、59型。目前第一代HPV預防性疫苗適用于濟南地區(qū)女性接種以預防宮頸癌。 2.HPV感染與年齡相關(guān),在25-34歲達到最高峰,之后隨年齡的增長HPV的感染率呈下降趨勢。高危型HPV感染率有兩個年齡高峰,25-34歲為第一個高峰,45-54歲為第二個高峰；低危型HPV感染率在25歲以下就達到高峰,之后隨著年齡的增長逐漸下降。 3.隨著宮頸病變程度的加重高危型HPV的感染率增加。宮頸癌及癌前病變的發(fā)病與高危型HPV感染密切相關(guān)。 4.HPV感染以單一感染為主,多重感染與宮頸癌及癌前病變的發(fā)生率無直接關(guān)系。
[Abstract]:Objective: To study the distribution of HPV infection type in normal population, precancerous lesion and cervical cancer patients in Jinan. To investigate the distribution of high risk HPV infection in different age groups and the correlation between the common subtypes of HPV infection and the grade of cervical lesions in high risk population in Jinan. Methods: From March 2009 to March 2013, we collected data of 9 976 health examiners who were examined by HPV in gynecological outpatient department of Jinan central hospital from March 2009 to March 2013. 1618 cases were positive for HPV infection. HPV positive cases were classified by HPV typing method, and liquid-based cytology was performed. HPV was positive. Cytological results showed that atypical squamous cells with unclear significance were examined by colposcopy and histopathological biopsy. The patients with cervical intraepithelial neoplasia or above were diagnosed as cervical intraepithelial neoplasia or above. HPV classification and its correlation with disease were analyzed retrospectively. Results: 1. The positive rate of HPV infection was 16.22 in Jinan, and the positive rate of high-risk type HPV was 11.73%. The positive rate of low risk type HPV was 7.96. The common high risk type HPV from high to low was HPV16 / 1833, and the common low risk type HPV from high to low was HPV11 / 6 type. 2. The infection rate of HPV was the highest in women aged 25 to 34 years, and then decreased with the increase of age. The positive rate of high risk HPV infection had two age peaks. The first was aged 25-34 and the second was 13.22.The positive rate of low-risk HPV infection had a peak at an age of 9.4% under the age of 25). After that, it gradually declined with the increase of age. 3. The positive rate of high risk HPV increased with the increase of cervical lesion grade, and there was no significant correlation between the degree of cervical lesion and age. 4. The distribution of HPV subtypes in cervical lesions of different grades ranged from high to low. In cervical cancer, the order was: 1: HPV16, 1833, CINIII, 1: HPV16, 1858, respectively. Type 33C56; In CIN II, the order was: type 1: HPV16, 1831, 582, 562, 6N66; In CIN I, the order is: HPV16 / 1859. 5. The number of HPV single infection was higher than that of multiple infection in all age groups. Both single infection and multiple infection showed the highest peak in the age group of 25-34 years, and then decreased gradually. In the age group of 鈮，

本文編號：1474287