上海地区女性宫颈人乳头状瘤病毒型别分布的 Meta分析

摘要

Objective To analyze infection situation and type distribution of human papilloma virus ( HPV) in Shanghai women so as to provide basic data for local prevention of cervical cancer .Methods Databases including Cochrane Library ( Issue 3, 2016), PubMed, Ovid, EMbase, CBM, WanFang Data and CNKI were searched to collect studies concerning female cervical HPV infection in Shanghai . Document retrieval time was from January 2000 to December 2015.According to inclusion and exclusion criteria , related studies were screened, data were extracted, and the quality of included studies was evaluated by two reviewers independently .Then meta-analysis was conducted using Stata 12.0 software.Results Altogether 165 432 cases were studied, among which overall HPV infection rate was 32.5%(95%CI:0.289-0.361).The top six high-risk types of HPV were HPV16, 52, 58, 53, 33, 18 and the infection rates were 9.0%, 4.5%, 4.0%, 2.1%, 2.0%, 1.7%respectively.The top three low-risk types of HPV were HPV81, 11, 6 and the infection rates were 2.0%, 1.8%, 1.5% respectively.There were 21 587 cases with definite cervical histopathological results .Overall HPV infection rate was 41.9%(95%CI:0.276-0.562).The top five were HPV 16, 58, 52, 18, 33 in the low-grade cervical lesion group and the top five were HPV 16, 58, 33, 18, 52 in the high-grade cervical lesion group .The HPV prevalence of HPV16, 18, 31, 33, 58 in the high-grade cervical lesion group was higher than that in the low-grade cervical lesion group .Conclusion HPV16, 52, 58, 53, 33,18 are dominant types in Shanghai area for cervical HPV infection .The distribution of HPV types has differences in different grade cervical lesion groups .%目的：分析人乳头状瘤病毒（ HPV）在我国上海地区女性中的感染情况及型别分布，为地区宫颈癌防治提供依据。方法检索The Cochrane Library（2016年第3期）、PubMed、Ovid、EMbase、中国生物医学文献数据库、万方数据库和中国知网，查找有关上海地区女性宫颈HPV感染的文献，检索时限为2000年1月至2015年12月。由两位评价者根据纳入与排除标准独立筛选文献、提取资料和评价纳入研究后，采用Stata 12．0软件进行Meta分析。结果纳入的研究对象共165432例，总HPV感染率为32．5％（95％CI：0．289～0．361）。高危HPV感染中居前六位的是HPV 16、52、58、53、33、18，感染率分别为9．0％、4．5％、4．0％、2．1％、2．0％、1．7％；低危型HPV感染中居前三位的是HPV81、11、6，感染率分别为2．0％、1．8％、1．5％。有明确宫颈组织病理学结果的研究对象共21587例，总HPV感染率为41．9％（95％CI：0．276～0．562），宫颈HPV的感染率在低级别宫颈病变组居前五位的是HPV16、58、52、18、33；在高级别宫颈病变组感染率居前五位的是HPV16、58、33、18、52。其中HPV16、18、31、33、58在高级别宫颈病变组的感染率高于低级别宫颈病变组。结论 HPV16、52、58、53、33、18是上海地区女性宫颈HPV感染的优势型别，HPV型别分布在不同级别宫颈病变组之间存在差异。