张家口市门诊女性HPV感染与宫颈病变筛查的临床资料分析

摘要

目的:了解张家口地区妇产科门诊女性生殖道高危型HPV感染现状及子宫颈上皮瘤样病变(CIN)的发生情况.方法:回顾性收集2010年11月～2011年6月,在河北北方学院附属第一医院妇产科就诊的19 ～70岁女性筛查资料和临床病理资料.所有调查对象均行子宫颈醋酸肉眼观察、电子阴道镜检查、液基细胞薄层涂片技术子宫颈脱落细胞学检查(LCT)及第二代杂交捕获技术(HC-Ⅱ)检测高危型HPV.对于HPV阳性、未明确诊断意义的不典型鳞状上皮细胞(ASCUS)、LSIL及以上病变者,行电子阴道镜检查,并取活检,进行病理诊断.结果:共调查了2 397例妇女,分为15 ～24岁、25～29岁、30～ 34岁、35 ～39岁、40～44岁、45 ～49岁和50 ～70岁年龄组,高危HPV检出率分别为19.5％、21.7％、12.6％、10.8％、11.2％、19.3％和21.0％,组间存在差异(P ＜0.05)；25 ～29岁组与50 ～59岁组HPV感染率较高,但两组间HPV感染率无差异(P＞0.05).CIN Ⅰ、CINⅡ和CINⅢ现患率分别为4.2％、1.8％和0.4％,CIN Ⅰ现患率高于CINⅡ和CINⅢ(P＜0.05).HPV感染率随子宫颈病变级别升高呈趋势性增加,无CIN病变的子宫颈HPV感染率为8.7％.结论:张家口地区门诊妇女生殖道HPV高危型感染率较高,且子宫颈病变多处于CIN的早期阶段.%Objective: To explore the status of high risk human papillomavirus (HPV) infection and the prevalence rate of cervical intra - epithelial neoplasia (CIN) among female outpatients of Zhangjiakou Cityby. Methods: Women aged 19 -70 who conducted visual inspection of cervix with acetic acid ( VIA) , electronic colposcopy, liquid - based cervicalcytology ( LCT) and Hybrid Capture II ( HC - II) between Nov. 2010 and June 2011 were recruited. Biopsy under colposcopy pathology was conducted in HPV - positive women and those with atypical squamous cells undetermined significance (ASCUS) , lower - grade squamous intraepithelial lesions ( LSIL) LSIL and more serious. Results: A total of 2 397 women recruited were divided into seven groups according to their ages; 15-24 years old, 25 -29 years old, 30-34 years old, 35 - 39 years old, 40-44 years old, 45 -49 years old and 50 - 70 years old. The detection rates of high risk HPV were 19. 5% , 21. 7% , 12. 6% , 10. 8% , 11.2%, 19.3% and 21.0% , showing statistically significant differences ( P < 0.05). The infection rates of high risk HPV in women aged 25-29 and 50 -59 were higher, but there was no significant difference between these two groups (P > 0.05). The prevalence rates of CIN I, CIN II and CIN III were 4.2% , 1.8% and 0.4%. That of CIN I was higher those of CIN II and CIN III ( P < 0.05 ). The infection rate of HPV was increased with the grade of cervical lesions. And the infection rate of HPV was 8. 7% in women without CIN. Conclusion; The infection rate of the high risk HPV is higher and themajority of cervical lesions are the low grade of CIN in ZhangJiakou.