發(fā)布時間：2018-07-04 19:42

  本文選題：高危型人乳頭瘤病毒 + 流行病學(xué)��； 參考：《首都醫(yī)科大學(xué)學(xué)報》2015年02期

【摘要】：目的研究醫(yī)院機會性篩查人群高危型人乳頭瘤病毒(high risk-human papillomavirus,HR-HPV)感染的流行病學(xué)特征,探討HR-HPV感染與宮頸癌前病變的關(guān)系。方法收集2012年1月1日至2012年12月31日期間,就診于首都醫(yī)科大學(xué)附屬北京朝陽醫(yī)院婦科門診,同時接受HR-HPV和宮頸薄層液基細胞學(xué)檢查(thinprep cytologic test,TCT)符合納入標(biāo)準(zhǔn)的2 305例患者資料。采用二代雜交捕獲法(hybird capture II,HC-II)進行HR-HPV檢測。結(jié)果 1)醫(yī)院機會性篩查人群HR-HPV感染率為34.84%,年輕女性(20~24歲)感染率最高(50.0%),隨著年齡的增加,感染率逐漸下降,45~49歲女性感染率最低(24.18%),≥55歲者感染率升高(47.02%),感染率呈雙高現(xiàn)象。宮頸薄層液基細胞學(xué)異常率的年齡分布特點,與HR-HPV感染率的年齡分布特點一致。2)TCT結(jié)果為正�；蛘哐仔苑磻�(yīng)、不典型鱗狀上皮細胞(atypical squamous cells undetermined significance,ASCUS)、低度鱗狀上皮內(nèi)瘤樣病變(low squamous intraepithelial lesion,LSIL)、高度鱗狀上皮內(nèi)瘤樣病變(high squamous intraepithelial lesion,HSIL)、宮頸鱗狀細胞癌(squamous of cervical carcinoma,SCC)中,HR-HPV的感染率分別是23.98%、66.47%、87.21%、98.04%、100%。宮頸組織活檢病理為正�；蜓仔苑磻�(yīng)、宮頸上皮內(nèi)瘤樣病變1級(cervical intraepithelial lesions-Ⅰ,CIN-Ⅰ)、CIN-Ⅱ、CIN-Ⅲ、SCC患者HR-HPV的感染率分別為67.44%、86.96%、88.24%、94.57%、90.48%。3)在ASCUS患者中,宮頸高級別病變(≥CIN-Ⅱ)的發(fā)生率31.73%,HRHPV陽性組宮頸高級別病變(≥CIN-Ⅱ)的檢出率36.93%,HR-HPV陰性組宮頸高級別病變(≥CIN-Ⅱ)的檢出率21.43%,兩組間的差異具有統(tǒng)計學(xué)意義(χ2=4.13,P=0.042)。4)在LSIL患者中,宮頸高級別病變的發(fā)生率34.40%,HR-HPV陽性組宮頸高級別病變的檢出率37.37%,HR-HPV陰性組宮頸高級別病變的檢出率14.29%,兩組間的差異具有統(tǒng)計學(xué)意義(χ2=5.76,P=0.016)。結(jié)論不同年齡,HR-HPV感染率及TCT異常率不同,24歲和≥55歲為HR-HPV感染及異常宮頸薄層液基細胞學(xué)高峰年齡。HRHPV感染率和宮頸病變嚴(yán)重程度呈顯著正相關(guān)。HR-HPV檢測不能作為ASCUS和LSIL患者分流管理的唯一手段,HR-HPV陰性的ASCUS和LSIL不能排除≥CIN-Ⅱ級病變,仍然需要做陰道鏡檢查。
[Abstract]:Objective to study the epidemiological characteristics of high-risk human papillomavirus (high risk-human papillomavirus-HR-HPV) infection in hospital opportunistic screening population, and to explore the relationship between HR-HPV infection and cervical precancerous lesions. Methods from January 1, 2012 to December 31, 2012, data of 2 305 patients who were admitted to gynecological clinic of Beijing Chaoyang Hospital affiliated to Capital Medical University and received HR-HPV and (thinprep cytologic TCT were collected. HR-HPV was detected by (hybird capture II HC-II. Results 1) the infection rate of HR-HPV in hospital opportunistic screening population was 34.844.The infection rate of young women (20 ~ 24 years old) was the highest (50.0%). With the increase of age, the infection rate of women aged 45 to 49 years was the lowest (24.18%), and the infection rate of those over 55 years old was increased (47.02%). The age distribution of the abnormal rate of liquid-based cytology of the cervix and the age distribution of HR-HPV infection rate were consistent with the age distribution of HR-HPV infection rate. 2) the results of TCT showed normal or inflammatory reaction. The infection rates of HR-HPV in atypical squamous epithelial cells (atypical squamous cells undetermined), low-grade squamous intraepithelial neoplasia (low squamous intraepithelial lesion/ lsil), high squamous intraepithelial neoplasia (high squamous intraepithelial lesionlsil), and cervical squamous cell carcinoma (squamous of cervical carcinoma-SCC) were 23.9866.4787.217.21, 98.04 and 100, respectively. The infection rate of HR-HPV in patients with (cervical intraepithelial lesions- 鈪，

本文編號：2097147