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目的了解广州市白云区流动人口育龄妇女人乳头瘤病毒(human papillomavirus,HPV)感染现状和流行病学特征,探讨HPV感染与不同宫颈病变的相关性。方法采用原位杂交法对4288名育龄妇女进行HPV-DNA检测,对宫颈肉眼观异常者作阴道镜检查并在病变处行活组织检查,行病理检查确诊。结果 4288名受检对象中,HPV感染率为7.9%,4个不同年龄组HPV感染率分别为11.3%、7.8%、5.1%、6.0%,差异有统计学意义(P<0.05)。不同性生活年限HPV病毒的感染率分别为7.6%、7.7%、8.2%、7.9%、8.3%、8.0%、7.1%,差异无统计学意义(P>0.05)。宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)级别Ⅰ、Ⅱ、Ⅲ及宫颈癌中HPV检出率分别为60.1%、87.8%、93.0%、100.0%,与正常对照相比,其近似值差异率(odd ratio,OR)分别为7.1、43.6、52.6、75.1。不同年龄组CINⅠ的患病率分别为1.7%、2.0%、2.9%、4.7%,CINⅡ的患病率分别为0.8%、1.1%、3.2%、4.7%,CINⅢ的患病率分别为0.3%、0.4%、1.5%、2.7%,宫颈癌的患病率分别为0%、0.1%、0.5%、0.6%,差异均无统计学意义(P>0.05)。结论广州市白云区流动人口育龄妇女的HPV感染主要分布在19～29岁人群,性生活年限为21～25年的感染率较高,50～59岁年龄段的人群宫颈病变的患病率最高。HPV感染与宫颈癌的发生密切相关,HPV感染是宫颈癌发生的高危因素,宫颈病变越严重,HPV检出率越高。
Objective To understand the current status and epidemiological characteristics of human papillomavirus (HPV) infection in migrant women of migrant population in Baiyun District of Guangzhou City and to explore the correlation between HPV infection and different cervical lesions. Methods HPV DNA was detected in 4288 women of childbearing age by in situ hybridization. Colposcopy was performed on patients with cervical abnormalities and biopsy was performed in the lesions. Pathological examination was performed. Results The HPV infection rate was 7.9% in 4,288 subjects, and the HPV infection rates in 4 different age groups were 11.3%, 7.8%, 5.1% and 6.0%, respectively. The difference was statistically significant (P <0.05). The infection rates of HPV of different sex life years were 7.6%, 7.7%, 8.2%, 7.9%, 8.3%, 8.0% and 7.1%, respectively. The difference was not statistically significant (P> 0.05). The detection rates of HPV in cervical intraepithelial neoplasia (CIN) grade Ⅰ, Ⅱ, Ⅲ and cervical cancer were 60.1%, 87.8%, 93.0% and 100.0%, respectively. Compared with the normal control, (odd ratio, OR) were 7.1,43.6,52.6,75.1. The prevalence rates of CINⅠ in different age groups were 1.7%, 2.0%, 2.9% and 4.7% respectively. The prevalences of CINⅡ were 0.8%, 1.1%, 3.2% and 4.7%, respectively. The prevalences of CINⅢ were 0.3% , 0.4%, 1.5% and 2.7% respectively. The prevalence of cervical cancer was 0%, 0.1%, 0.5% and 0.6% respectively, with no significant difference (P> 0.05). Conclusion The prevalence of HPV infection among floating women of childbearing age in Baiyun District of Guangzhou City is mainly in the age group of 19 ~ 29 years. The infection rate of sexual life is 21 ~ 25 years, and the prevalence of cervical lesions is the highest in people aged 50 ~ 59 years . HPV infection is closely related to the occurrence of cervical cancer. HPV infection is a high risk factor for cervical cancer. The more severe cervical lesions, the higher the HPV detection rate.