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目的探讨行为和生物学因素与藏族妇女宫颈癌发生的关系。方法采用病例对照研究,选取2014年1月-2015年9月在青海省人民医院、青海大学医学院确诊的100例藏族宫颈癌患者为宫颈癌组,另选取同期医院就诊的200例非宫颈癌患者为非宫颈癌组。采用非条件Logistic回归模型分析。结果 100例藏族宫颈癌患者HPV阳性84例,感染率84%;高危型HPV感染为主,其中HPV16型60例,占71.43%;HPV18型14例,占16.67%。200例非宫颈癌患者中HPV阳性感染者89例,阳性率44.50%;HPV高危型85例,占95.50%。单因素分析宫颈癌诱发与HPV感染、初潮年龄,月经持续时间、经期性行为、初次性行为年龄、初次生育年龄、生育次数、流产史、婚外性行为、避孕方式、外阴清洗和伴侣清洗与宫颈癌发生均有关联,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,HPV感染(OR=5.92,95%CI:2.17,16.14)、月经持续时间(OR=5.62,95%CI:1.06,29.70)、经期性行为(OR=11.24,95%CI:4.16,30.38)、初次生育年龄(OR=3.78,95%CI:2.27,6.30)、流产史(OR=3.74,95%CI:1.34,10.44)、婚外性行为(OR=1.69,95%CI:1.06,2.68)、初次性行为年龄(OR=0.10,95%CI:0.03,0.30)、避孕方式(OR=0.17,95%CI:0.06,0.48)、外阴清洗(OR=0.27,95%CI:0.13,0.58)和伴侣清洗(OR=0.36,95%CI:0.17,0.80)与宫颈癌发生有关。结论高危型HPV持续感染和不健康的行为方式是导致藏族妇女诱发宫颈癌的重要影响因素,早期筛查和行为学干预是经济有效的预防措施。
Objective To explore the relationship between behavior and biological factors and cervical cancer in Tibetan women. Methods A case-control study was conducted in which 100 cases of cervical cancer patients diagnosed in Qinghai Provincial People’s Hospital and Qinghai University School of Medicine from January 2014 to September 2015 were selected as cervical cancer patients. Another 200 cases of non-cervical cancer Patients were non-cervical cancer group. Non-conditional logistic regression model analysis. Results The positive rate of HPV in 84 cases of cervical cancer in 100 cases was 84%. High-risk HPV infection was the most common, of which 60 cases were HPV16, accounting for 71.43%. HPV18 14 cases, accounting for 16.67%. Among 200 non-cervical cancer patients, 89 were positive for HPV infection, the positive rate was 44.50%; 85 were HPV high-risk type, accounting for 95.50%. Univariate analysis of cervical cancer-induced and HPV infection, menarche age, menstrual duration, menstrual behavior, age at first sexual act, first-time childbearing age, number of births, miscarriage history, extramarital sex, contraceptive methods, vulvar cleansing and partner cleansing Cervical cancer were associated with the difference was statistically significant (P <0.05). Multivariate Logistic regression analysis showed that HPV infection (OR = 5.92, 95% CI: 2.17, 16.14), duration of menstruation (OR = 5.62, 95% CI: 1.06, 29.70) (OR = 3.78, 95% CI: 2.27, 6.30), miscarriage history (OR = 3.74, 95% CI: 1.34, 10.44) and extramarital sex (OR = 1.69, 95 (OR = 0.10, 95% CI: 0.03,0.30), contraceptive methods (OR = 0.17, 95% CI: 0.06,0.48) and vulvar cleansing (OR = 0.27, 95 % CI: 0.13, 0.58) and cleansing of the partner (OR = 0.36, 95% CI: 0.17, 0.80) were related to the occurrence of cervical cancer. Conclusions Continuous infection and unhealthy behaviors of high-risk HPV are the important factors that lead to cervical cancer in Tibetan women. Early screening and behavioral intervention are the effective and economical preventive measures.