作　　者： (田欣欣）; (姜玲波）; (张丽冉）; (赵俊艳）; (王新国）; (谢风祥）; (邢萌）; (彭德志）; (毕春蕊）; (李欣）; (祁德波）;

机构地区： 济南金域医学检验中心,250101

出　　处： 《中华临床实验室管理电子杂志》 2017年第3期176-182,共7页

摘　　要： 目的探讨山东省门诊女性就诊者人乳头状瘤病毒(human papillomavirus,HPV)感染及其亚型分布状况。方法收集2014年3月至2015年6月期间,山东省171家医院和社区卫生服务站妇科门诊4161例女性门诊就诊者宫颈拭子标本,送济南金域医学检验中心用导流杂交与基因芯片结合技术进行21种HPV基因型检测后,分析6个年龄组(≤20岁组101例、21~30岁组953例、31~40岁组1368例、41~50岁组1262例、51~60岁组330例、>61岁组56例)的阳性率和亚型分布。结果 4161例女性中,检出HPV阳性1325例,总阳性率31.8%,其中:高危型HPV(high-risk HPV,hr HPV)和低危型HPV(low-risk HPV,lr HPV)阳性检出率分别为27.3%和10.4%。hr HPV(46.5%)和lr HPV(45.5%)阳性率均以≤20岁年龄组阳性率最高,后随年龄增加而逐渐下降,而hr HPV阳性率在51~60岁组略有升高(26.1%)。此外,随着年龄的增加,各年龄组单一性感染构成比(依次为37.1%、55.9%、67.2%、67.4%、72.3%、73.4%)和单一性hr HPV感染构成比(依次为25.8%、57.2%、72.9%、76.8%、78.7%、73.3%)所占比例逐渐增加,而各年龄组多重感染构成比(依次为63.9%、44.1%、32.8%、32.6%、27.7%、26.7%)、单一性lr HPV感染构成比(依次为24.2%、16.9%、13.0%、12.2%、8.5%、20.0%)和高低危HPV混合感染构成比(依次为50.0%、25.9%、14.1%、11.0%、12.8%、6.7%)所占比例逐渐减少。21种HPV亚型均有检出(范围为0.1%~18.3%),hr HPV前5位的分别为HPV16(13.6%)、HPV52(11.1%)、HPV58(7.7%)、HPV53(6.9%)和HPV51(4.7%);lr HPV前3位分别为HPV6(6.8%)、HPV11(5.5%)和HPV81(5.4%)。多重感染中HPV16所占比率明显低于单重感染(10.7%比18.3%),而HPV53(8.1%比4.9%)和HPV33(4.0%比2.3%)则相反。在多重感染病例中,随着感染不同亚型HPV数量的增多,高低危混合感染例数所占比例明显增加(287例二重感染中检出高低危HPV亚型混合感染病例占35.9%、125例三重感染中占61.6%、80例四重及以上感染中占78.7%)。结论山东省门诊女 Objective To investigate the prevalence and genotype distribution of human papillomavirus （HPV） infection among female outpatients in Shandong Province. Methods Cervical swabs of 4161 females from 171 local community hospitals and health stations from March 2014 to June 2015 were referred to Jinan KingMed Diagnostics and tested by a HPV genotyping chip, which can detect 21 HPV types using flow-through hybridization. The prevalence and genotype distribution in six age groups （101 cases in ≤ 20 age group, 953 cases in 21-30 age group, 1368 cases in 31-40 age group, 1262 cases in 41-50 age group, 330 cases in 51-60 age group and 56 cases in 〉 61 age group） were documented and analyzed. Results A total of 1325 cases were HPV-positive and the positive rate was 31.8%. The positive rates of high-risk HPV （hrHPV） and low-risk HPV （lrHPV） were 27.3% and 10.4% respectively. Both the prevalence of hrHPV （46.5%） and IrHPV （45.5%） was highest in ≤ 20-year age group, and gradually declined as age increased. The hrHPV-positive rate slightly increased in 50-60-year age group （26.1%）. Similar age-specific prevalence was observed in multiple HPV infection（double or more subtype, the age-specific constituent rates were 63.9%, 44.1%, 32.8%, 32.6%, 27.7% and 26.7%, respectively）, pure lrHPV infection（the age-specific constituent rates were 24.2%, 16.9%, 13.0%, 12.2%, 8.5% and 20.0%, respectively）, hrHPV and lrHPV mixed infections（the age-specific constituent rates were 50.0%, 25.9%, 14.1%, 11.0%, 12.8% and 6.7%, respectively）. In contrast, the percentages of single HPV（the age-specific constituent rates were 37.1%, 55.9%, 67.2%, 67.4%, 72.3% and 73.4%, respectively）and pure hrHPV infections（the age-specific constituent rates were 25.8%, 57.2%, 72.9%, 76.8%, 78.7% and 73.3%, respectively）showed an upward trend as age increased. All 21 HPV genotypes were detected （ranging from 0.1% to 18.3%）. HPV16 （13.6%）, HPV52 （11.1%）, HPV58 （7.7%）, HPV53 （6.9%） and HPV51 （4

关 键 词： 人乳头状瘤病毒 基因型 宫颈癌