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目的了解河北省承德市女性宫颈人乳头瘤病毒(HPV)感染情况,分析HPV感染的危险因素,为HPV感染及宫颈癌防治提供理论依据。方法于2013年1月—2016年1月在承德市8县3区选取4 250名女性进行问卷调查、液基薄层细胞学检查(TCT)及宫颈HPV DNA检测,对HPV16/18型和细胞学提示不能明确意义的非典型鳞状上皮细胞(ASCUS)、非典型腺上皮细胞(AGC)及以上患者进行阴道镜检查、组织活检及病理检查,分析不同宫颈病变及年龄组HPV感染情况,采用多因素logistic回归模型分析HPV感染危险因素。结果承德地区4 250名妇女HPV感染819例,感染率为19.27%,最常见的5种HPV高危型别依次为16、58、52、39、51型。伴随宫颈上皮内瘤变(CIN)级别升高,HPV感染率升高,宫颈癌HPV感染率为100%。<20岁组HPV感染率最高,为21.74%;30~49岁及≥60岁组为HPV感染高峰。吸烟、首次性生活年龄过早、受教育程度低(高中以下)、接触性出血和宫颈柱状上皮异位为HPV感染的危险因素,避孕套避孕和了解宫颈癌及HPV为HPV感染的保护因素。结论HPV感染与CIN及宫颈癌密切相关,加强对具有HPV感染危险因素人群的筛查及管理可有效预防宫颈癌的发生。
Objective To understand the status of HPV infection among women in Chengde City of Hebei Province and analyze the risk factors of HPV infection so as to provide a theoretical basis for HPV infection and prevention and treatment of cervical cancer. Methods From January 2013 to January 2016, 4 250 women from 8 districts, 8 counties, Chengde City were selected for questionnaire survey, liquid-based TLCT and HPV DNA test, HPV16 / 18 and cell Colposcopy, biopsy and pathological examination of atypical squamous cell (ASCUS), atypical glandular epithelial cells (AGC) and above patients who were not suggestive of definite significance were analyzed. HPV infection in different cervical lesions and age groups was analyzed. Multivariate logistic regression model was used to analyze the risk factors of HPV infection. Results There were 819 cases of HPV infection in 4 250 women in Chengde district, the infection rate was 19.27%. The most common types of high-risk HPV were 16,58,52,39,51. Accompanied by cervical intraepithelial neoplasia (CIN) level increased, HPV infection increased, HPV infection in cervical cancer was 100%. The highest HPV infection rate was 21.74% in <20 years old group and HPV infection peak in 30-49 years old group and 60 years old group. Smoking, premature first sex life, low education (below high school), contact bleeding and cervical columnar epithelial ectopic HPV infection risk factors, condom contraception and understanding of cervical cancer and HPV as a protective factor of HPV infection. Conclusion HPV infection is closely related to CIN and cervical cancer. To strengthen the screening and management of people with risk factors for HPV infection can effectively prevent the occurrence of cervical cancer.