沈阳市某收容所女性HPV感染率和宫颈癌前病变现患率调查

摘要

目的：调查沈阳市某收容所女性高危型HPV（ Human papillomavirus ）感染率和宫颈上皮内瘤病变（ Cervical intraep-ithelial neoplasisa ， CIN）的现患率，及HPV感染的高危因素分析。方法：对沈阳市某收容所309名曾在娱乐场所工作的女性进行流行病学问卷调查，行TCT（Thin－Cytologic Test）及HPV检测，肉眼醋酸及碘实验，对HPV阳性或HPV阴性但TCT为ASCUS及以上者，进行阴道镜检查。结果：高危型HPV阳性率为46．9％，TCT阳性率为37．2％；宫颈CIN现患率为17．99％；高危型HPV感染率在各年龄组之间差异无统计学意义（P＞0．05），50岁以上及20岁以下年龄组HPV感染率较高（85．71％，61．90％），31－40岁年龄组HPV感染率最低（41．07％）。HPV感染危险单因素分析，初次性生活年龄21－24岁OR值为0．40，95％CI为0．24－0．67，是HPV感染的保护因素；多因素分析，初次性生活年龄和绝经与HPV感染有关，初次性生活年龄OR值为0．699，95％CI为0．492－0．992，是HPV感染的保护因素；绝经OR值为2．93，95％CI为1．10－7．80，是HPV感染的危险因素。HPV感染与婚姻状况、性病史、吸烟、流产、口服避孕药、使用避孕套、定期体检、月经初潮年龄及从事性工作的时间无关。结论：沈阳市某收容所女性高危型HPV感染率和CIN的现患率均明显高于普通人群，说明该人群是HPV感染和患宫颈癌前病变的高危人群。%Objective:To investigate the positive rate of high risk type HPV and incidence rates of CIN on women in penitentiary in Sheny-ang.Methods:309 female workers enrolled in this study, they received a personal standard risk factor interview and gynecological physical exam-ination including TCT and HPV sampling, and VIA examination, colostomy was conducted for those who were HPV-positive or HPV-negative but TCT≥ ASCUS, and biopsy would be provided later if any abnormal lesion existed.Results:High-risk HPV positive rate in the study group was 46.93%.The incidence rate of CIN was 17.99%.There were no significant differences among different age groups.HPV infection rate in two age groups (older than 50 and younger than 20) was higher and the value was 85.71%and 61.90%.Rate in the group of 31-40 year-old was the lowest and the value was 41.7%.Conclusion:The infection rates of High risk type HPV and incidence rates of CIN on these women are higher, which showed such population are in high risk for HPV infection and cervical intraepithelial neoplasisa.