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目的:探讨高危型人乳头瘤病毒(High risk-human papilloma virus,HR-HPV)在中国农村宫颈癌前病变高危年龄妇女中的感染状况,为宫颈癌前病变的防治及宫颈癌筛查方案的制定提供客观依据。方法:对宫颈癌高发区江西修水县人桥乡2499例年龄为30~49岁农村已婚妇女进行以人群为基础的宫颈癌及癌前病变筛查的横断面研究。采用了目前被普遍认可的多种筛查技术的联合筛查:包括宫颈薄层液基细胞学检查(TCT)、宫颈脱落细胞HPV DNA检查、醋酸染色肉眼观察(VIA)、碘染色肉眼观察(VILI)以及阴道镜检查等方法。不同方法间遵循独立、双盲原则。对其中任何一项检查异常的妇女进行宫颈活组织病理检查,以宫颈活组织病理检查作为诊断金标准。HPV DNA检测采用第二代杂交捕获实验(Hybrid capture-2,HC-Ⅱ)对受检妇女宫颈脱落细胞行HPV DNA半定量检测。观察农村宫颈癌前病变高危年龄妇女病变程度与HR-HPV感染的关系以及HR-HPV在宫颈癌前病变高危年龄妇女人群中的感染状况。结果:2499例受检妇女中,352例妇女因HPV DNA缺失被排除,其余2147例妇女纳入本研究,共检出无宫颈病变1966例、宫颈鳞状细胞化生81例、慢性宫颈炎271例、CINⅠ82例,CINⅡ37例、CINⅢ59例、宫颈癌3例。HR-HPV在不同程度宫颈病变的感染率分别为5.1%、54.9%、66.9%、80.5%、94.1%、98.1%、100.0%。HR-HPV检出妇女中总阳性率为20.63%,在30~34岁、35~39岁、40~44岁、45~49岁各年龄组的阳性率分别为21.07%、19.66%、21.29%及20.54%。宫颈癌前病变妇女HR-HPV感染率与慢性宫颈炎妇女比较,差异有统计学意义(P<0.05)。宫颈癌前病变高危年龄妇女不同年龄组HPV感染率无统计学差异(P>0.05)。结论:HR-HPV感染与宫颈病变程度呈正相关,与年龄无明显相关性。
Objective: To investigate the infection status of high risk-human papilloma virus (HR-HPV) in women at risk of cervical precancerous lesions in rural China. To investigate the prevention and treatment of cervical precancerous lesions and cervical cancer screening programs Develop an objective basis. Methods: A cross-sectional study of population-based screening of cervical cancer and precancerous lesions in 2499 rural married women aged 30-49 years in Renheqiao Township, Xiushui County, Jiangxi Province, with high prevalence of cervical cancer. A combination of the currently widely accepted screening techniques is available: TCT, HPV DNA, VIA, and iodine staining VILI) and colposcopy and other methods. Different methods follow an independent, double-blind principle. Cervical biopsy was performed on any of the women who had abnormalities and cervical biopsy was used as the gold standard for diagnosis. HPV DNA test Hybridization test (Hybrid capture-2, HC-Ⅱ) was used to detect HPV DNA semiquantitatively in cervical exfoliated cells of women under test. To observe the relationship between the severity of cervical lesions and HR-HPV infection in rural women with precancerous lesions and the prevalence of HR-HPV in women at high risk of cervical precancerous lesions. Results: Out of 2499 women examined, 352 women were excluded due to HPV DNA deletion. The remaining 2147 women were enrolled in this study. There were 1966 cases of no cervical lesions, 81 cases of cervical squamous metaplasia and 271 cases of chronic cervicitis , CINⅠ82 cases, CINⅡ37 cases, CINⅢ59 cases, cervical cancer in 3 cases. The infection rates of HR-HPV in different degree of cervical lesions were 5.1%, 54.9%, 66.9%, 80.5%, 94.1%, 98.1%, 100.0% respectively. The positive rates of HR-HPV in women were 20.63%, 21.07%, 19.66%, 21.29% respectively in all age groups of 30-34, 35-39, 40-44 and 45-49 years old And 20.54%. Cervical precancerous women HR-HPV infection rate and chronic cervicitis women, the difference was statistically significant (P <0.05). There was no significant difference in the HPV infection rates among different age groups in women with high risk of cervical precancerous lesions (P> 0.05). Conclusion: There is a positive correlation between HR-HPV infection and cervical lesions, but no significant correlation with age.