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目的了解5个县农村女性人乳头瘤病毒(HPV)感染与宫颈病变分布特征,探讨宫颈癌防治对策。方法 2014年在安徽省5个县抽取21 078名35~64岁农村妇女,进行高危亚型/高危分型HPV初筛,并根据HPV初筛结果进行宫颈细胞学、阴道镜、病理等进一步检查,分析HPV感染状况和型别以及病理检查结果。结果21 078名妇女HPV初筛阳性检出率为8.01%,其中检出率最高的16型占18.41%;5个县中HPV初筛阳性检出率为6.06%~9.43%,且各县6种常见型别HPV检出率排序不同,差异均有统计学意义;35~39岁HPV初筛阳性检出率最低,为6.90%,55~65岁最高,为8.94%,随着年龄增加检出率呈现上升趋势(P<0.05);HPV检测对于识别宫颈病变具有较高的灵敏度和阳性预测值,分别为98.44%和89.74%;HPV检测对于识别宫颈癌及癌前病变灵敏度和阴性预测值均为100.00%;宫颈癌和癌前病变检出率为488.66/10万,HPV初筛结果阳性者中宫颈癌和癌前病变检出率为9.18%。结论安徽省5县HPV检出率存在地区差异,HPV检出率随年龄增长而增加,HPV初筛有助于宫颈早期病变的早发现和早干预。
Objective To investigate the distribution of human papillomavirus (HPV) infection and cervical lesions in rural women in five counties and to explore the strategies for prevention and treatment of cervical cancer. Methods A total of 21 078 rural women aged 35-64 years were collected from 5 counties in Anhui province in 2014 for screening of high-risk subtypes / high-risk HPVs. Further screening of cervical cytology, colposcopy and pathology was performed according to the results of HPV screening , Analysis of HPV infection and type and pathological examination results. Results The positive rate of HPV screening in 21 078 women was 8.01%, of which 16 was the highest, 18.41% of them were HPV positive. The positive rates of HPV screening in 5 counties were 6.06% ~ 9.43% The common types of HPV detection rate of different sorts, the differences were statistically significant; 35 to 39 years of age HPV screening positive detection rate was the lowest, 6.90%, 55 to 65 years old the highest, 8.94%, as the age increased seizure (P <0.05). HPV detection had higher sensitivity and positive predictive value for identifying cervical lesions, which were 98.44% and 89.74%, respectively. The sensitivity and negative predictive value of HPV test for identifying cervical cancer and precancerous lesions 100.00%. The detection rate of cervical cancer and precancerous lesions was 488.66 / 100000. The detection rate of cervical cancer and precancerous lesions was 9.18%. Conclusion The detection rate of HPV in 5 counties in Anhui Province is different. The detection rate of HPV increases with the increase of age. The screening of HPV is helpful for the early detection and early intervention of early cervical lesions.