广州地区8925例女性感染HPV基因亚型状况分析

目的调查广州地区女性人群人乳头状瘤病毒(Human papillomavirus,HPV)感染状况和基因型分布情况。方法采用HPV基因分型技术对2011年10月至2014年10月在本院妇科体检和就诊的8 925例不同年龄的女性患者进行HPV基因检查,分析HPV-DNA亚型感染状况。结果 8 925例受检者中共检出HPV阳性者3 153例,阳性率为35.33%,其中高危型HPV感染阳性率为26.35%(2352/8925)。在被测的21个HPV基因亚型中,最常见类型依次为16型(8.13%,726/8925),52型(5.14%,459/8925),53型(2.69%,240/8925)。HPV阳性者中多重感染率为5.18%(462/8925),以二重感染最常见(4.20%,375/8925)。不同年龄段人群HPV阳性率有差异,41~50岁人群HPV阳性率最高(29.40%,927/3153)。结论广州地区最常见的亚型是HPV16、HPV52和HPV53,对HPV基因亚型分析是临床宫颈病变诊断和早期筛查的理想方法。     

河北地区26385例女性宫颈细胞HPV基因分型分析

目的 分析河北地区女性人乳头瘤病毒（HPV）感染率及感染亚型情况。方法 回顾性分析2014年4月到2017年8月来河北省人民医院妇科门诊就诊的26 385例患者,采用荧光定量PCR法对患者宫颈脱落细胞样本进行21种HPV亚型的检测,不同年龄组HPV感染率比较采用卡方检验。结果 26 385例受检者中,HPV感染率为33.05%（8 719/26 385）,其中高危型HPV感染率为26.50%（6 992/26 385）,阳性患者中占比80.19%（6992/8719）;共计检出21种HPV亚型,12 901例次HPV感染,其中高危型HPV感染11 059例次,占比91.46%,感染前三位依次为HPV16、HPV58、HPV52,均为高危亚型;15~25岁和≥56岁年龄组HPV感染率较高,分别与其他三组比较差异均有统计学意义（χ2=203.281,P＜0.01;χ2=42.033,P＜0.01）。结论 妇科门诊患者HPV感染率较高,以高危型HPV感染为主,主要感染型别为HPV16、HPV58、HPV52。15~25岁和≥56岁年龄组HPV感染率相对较高。     

中国大陆女性HPV感染危险因素的Meta分析

了解评价中国大陆女性HPV感染的相关危险因素, 为预防和控制提供参考依据。

采用系统评价法综合评价1995年1月1日至2020年12月31日在PubMed、CNKI、VIP和WanFang数据库收录的所有关于中国女性人群中发表的有关HPV感染相关危险因素的相关研究。由2位研究者独立筛选文献、提取数据资料和评价纳入研究的文献质量后, 采用Stata 12.0软件进行分析。

共有48篇文献纳入研究, 总人数为210 009人, HPV感染病例26 653例, 分析模型结果显示: 孕次 > 1次为1.14(1.07~1.20), 产次 > 1次为1.35(1.06~1.74), 流产次数 > 1次为1.30(0.97~1.74), 避孕药为1.11(0.91~1.34), 避孕套为0.56(0.35~0.89), 宫内节育器避孕为1.02(0.91~1.13), 滴虫性阴道炎为1.33(1.04~1.69), 宫颈糜烂为2.2(1.03~4.70), 吸烟为1.28(1.09~1.51), 饮酒为1.15(1.07~1.24), 文化程度初中及以下为1.03(0.74~1.44), 无工作为0.94(0.73~1.21), 已婚为0.60(0.47~0.78), 结婚次数 > 1次为1.47(1.25~1.73), 性伴侣数 > 1个为1.96(1.46~2.62), 丈夫婚外性行为1.68(1.35~2.09), 丈夫性伴侣数 > 1个为2.14(1.45~3.15), 性生活频率 > 2次/周为1.37(0.79~2.37), 绝经为1.65(1.11~2.46), 初次性生活年龄≤20岁为1.48(1.23~1.78)。

HPV感染主要危险因素为多孕, 多产, 滴虫性阴道炎, 宫颈糜烂, 吸烟, 饮酒, 结婚次数过多, 多个性伴侣, 丈夫婚外性行为, 丈夫有多个性伴侣, 绝经, 初次性生活年龄过早, 而避孕套和已婚是其保护因素。

     

基于阴道微生态对比研究宫颈HPV16与HPV52单一亚型感染特征

目的 对比分析宫颈人乳头瘤病毒（HPV）16与52单一亚型感染阴道微生态特征,探讨HPV16与52单一亚型阳性患者阴道微生态差异的临床意义,探求治疗不同亚型HPV感染的方法。方法 将2020年2月至2023年1月在遂宁市第一人民医院妇产科门诊常规宫颈癌筛查的女性（20～65岁）作为研究对象,纳入符合标准的HPV16型、HPV52型、HPV阴性研究对象各165例作为参试者,HPV16、52型均为单一亚型感染,HPV阴性组作为对照组,3组参试者一般资料对比差异无统计学意义（P<0.05）。3组研究对象均行HPV分型、液基薄层细胞学（TCT）、阴道微生态检测,对比分析3组参试者阴道微生态相关指标（pH、过氧化氢、唾液酸苷酶、白细胞酯酶、葡萄糖醛酸酶、乙酰氨基葡萄糖苷酶、白细胞、杆菌、球菌、线索细胞、滴虫、清洁度）以及TCT情况。结果 （1）3组参试者的阴道内pH情况,HPV16型组（5.01±0.31）显著高于HPV52型组（4.71±0.42）(F=56.26,P<0.05),也较对照组（4.68±0.43）明显异常（F=47.10,P<0.05）;而HPV52型组阴道内...     

兰州地区女性感染HPV及其基因类型分析

目的:了解兰州地区成年女性感染人乳头瘤病毒(humanpapillomavirus,HPV)及其基因类型分布状况,为本地区HPV分子流行病学研究提供理论依据。方法:利用PCR技术分别对100例妇科门诊就诊者进行HPV基因亚型检测。结果:100例样品中,HPV DNA检出率为19%(19/100),其中HPV16 DNA感染率15%(15/100),HPV58 DNA感染率3%(3/100),HPV18 DNA感染率2%(2/100),HPV 16与HPV18双重感染1例。结论:本地区成年女性HPV感染主要以HPV16多见,而HPV16与恶性肿瘤密切相关,因此对HPVDNA阳性者定期随访,有利于宫颈癌的防治。     

兰州地区女性感染HPV及其基因类型分析

目的：了解兰州地区成年女性感染人乳头瘤病毒（human pap illoma virus,HPV）TL其基因类型分布状况,为本地区HPv分子流行病学研究提供理论依据。方法：利用PCR技术分别对100例妇科门诊就诊者进行HPV基因亚型检测。结果：100例样品中,HPVDNA检出率为19％（19／100）,其中HPVl6DNA感染率15％（15／100）,HPV58DNA感染率3％（3／100）,HPV18DNA感染率2％（2／100）,HPV16与HPVl8双重感染1例。结论：本地区成年女性HPV感染主要以HPV16多见,而HPV16与恶性肿瘤密切相关,因此对HPVDNA阳性者定期随访,有利于宫颈癌的防治。     

553 例女性宫颈高危型HPV 感染与宫颈病变的相关性研究

目的:研究女性生殖道高危型人乳头瘤病毒(high risk human papilloma virus,hrHPV)感染现状及子宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CI N)的现患率,并分析该人群年龄与HPV感染及宫颈癌前病变的相关性以及hrHPV病毒载量与宫颈病变之间剂量-效应关系。方法:对553例30岁-78岁有性生活史的女性进行以人群为基础的横断面调查。对所有接受筛查的妇女均行宫颈HPV检测及电子阴道镜下病理活检,并以病理结果作为诊断子宫颈病变的金标准。资料采用EXCEL整理,利用x2检验和非条件Logistic回归分析危险因素和CI N的关系。结果:553例受检对象总体阳性检出率为18.0%。hrHPV感染情况在不同年龄段分布有显著差异,hrHPV病毒载量越高宫颈病变的程度越重。结论:不同年龄段hrHPV感染情况不同,hrHPV病毒载量与宫颈病变之间存在剂量-效应关系。     

常州地区妇女HPV 感染状况调查

目的:研究常州地区普通妇女人群中HPV感染状况,为宫颈癌的预防及治疗提供理论依据。方法:采用PCR与基因芯片技术,对常州地区参加妇科体检的744名妇女进行HPV分型检查,并对不同分型感染情况进行统计学分析。结果:744名妇女中共检出HPV阳性者157例,感染率为21.10%。在高危型HPV感染妇女中,共计83.64%的妇女感染了以下六种亚型,依次是16型46例,58型28例,33型24例,18型18例,31型11例以及52型11例。结论:鉴于高危型HPV与宫颈癌发生的密切关系,对普通妇女人群展开HPV检测具有预防与治疗意义。     

HPV感染与宫颈癌预防的研究进展

宫颈癌在全球范围内依然是严重威胁妇女健康的常见恶性肿瘤之一。流行病学调查显示,高危型HPV持续感染是导致宫颈癌发病的主要原因,并且HPV感染具有显著的特点,因此,预防HPV感染是防治宫颈癌的主要途径。已明确性行为是促进HPV感染最重要的辅助因子,个体免疫力低下及年龄因素亦是促进HPV感染的重要因素。研究显示,在全球逐渐开展的预防措施包括对常见的高风险HPV类型进行预防性疫苗接种及包括HPV检测在内的宫颈癌筛查项目的实施已经在降低宫颈癌的发病率方面起到了很重要的作用。近些年来,人们越来越重视HPV检测在宫颈癌筛查程序中的应用。由于HPV的感染率具有显著的地域性差异,我们需要针对各地区的特点以完善相应的宫颈癌筛查程序,从而为宫颈癌防治工作的开展提供重要依据。     

553例女性宫颈高危型HPV感染与宫颈病变的相关性研究

目的：研究女性生殖道高危型人乳头瘤病毒（high risk human papilloma virus,hrHPV）感染现状及子宫颈上皮内瘤样病变（cervical intraepithelial neoplasia,CI N）的现患率,并分析该人群年龄与HPV感染及宫颈癌前病变的相关性以及hrHPV病毒载量与宫颈病变之间剂量-效应关系。方法：对553例30岁-78岁有性生活史的女性进行以人群为基础的横断面调查。对所有接受筛查的妇女均行宫颈HPV检测及电子阴道镜下病理活检,并以病理结果作为诊断子宫颈病变的金标准。资料采用EXCEL整理,利用x2检验和非条件Logistic回归分析危险因素和CI N的关系。结果：553例受检对象总体阳性检出率为18.0%。hrHPV感染情况在不同年龄段分布有显著差异,hrHPV病毒载量越高宫颈病变的程度越重。结论：不同年龄段hrHPV感染情况不同,hrHPV病毒载量与宫颈病变之间存在剂量-效应关系。     

宫颈癌患者人乳头瘤病毒(HPV)主要型别及其感染研究

本文探讨了江西省和广东省宫颈癌患者人乳头瘤病毒(Human papillomavirus,HPV)感染及其型别分布,分析了高危型HPV对各种宫颈病变的感染情况,为宫颈癌的早期发现和临床诊治提供科学依据。首先采用细胞学、HPV DNA检测(第二代杂交捕获法,HC2)、电子阴道镜和宫颈化学着色方法筛查宫颈癌患者,经病理镜检确诊,然后用GP PCR-SBT法对宫颈癌患者进行HPV基因分型。江西省溪口镇、古市镇及修水县城宫颈癌癌前病变发生率为5．7‰。HC2方法发现宫颈癌患者13种高危型HPV DNA阳性率为89．9％,宫颈上皮内瘤样病变的为84．8％,对照组为24．5％。采用GP PCR-SBT方法进行基因分型发现,江西省宫颈癌患者存在HPV16、58、31、33、18、66、6、11、56和81十种型别,其中HPV81型在国内外鲜有报道。据此提出生殖道高危型HPV感染是妇女宫颈癌发病的重要因素。并发现江西省宫颈癌高发区妇女高危型HPV感染率为24．5％。建立了HPV基因分型的方法,对HPV致宫颈病变的分子机制进行了分析。     

宫颈人乳头瘤病毒感染的药物治疗

宫颈癌是妇科三大恶性肿瘤之一。根据GLOBOCAN 2008数据统计,在中国女性所有恶性肿瘤中,发病比占6.3%,死亡比占4.6%。宫颈癌的发生与宫颈HPV感染存在密切关系。2012年NCCN指南提出30岁的女性推荐HPV DNA检查与细胞学检查结合用于宫颈癌的筛查。单纯HPV检测阳性时,患者可以选择继续观察随访。但事实上,妇科医生在临床诊疗过程中发现很多病人心理上无法接受对疾病不进行任何处理。而一些过度治疗方案包括LEEP,冷刀锥切,宫颈局部激光治疗等又有可能会造成宫颈机能不全,继发宫颈管狭窄,早产及低体重出生儿等不良结果。若积极处理的话有多种治疗方案可供选择。但是对于有生育要求的女性在治疗方案的选择上应该尤为慎重。本文对目前相关治疗方案的治疗效果及其能否阻止宫颈病变的进展等方面进行总结。旨在解决临床医生和患者共同关注的问题。     

Human Papillomavirus Type-Specific Prevalence in the Cervical Cancer Screening Population of Czech Women

Background

Infection with high-risk human papillomavirus (HPV)types has been recognized as a causal factor for the development of cervical cancer and a number of other malignancies. Today, vaccines against HPV, highly effective in the prevention of persistent infection and precancerous lesions, are available for the routine clinical practice.

Objectives

The data on the prevalence and type-specific HPV distribution in the population of each country are crucial for the surveillance of HPV type-specific prevalence at the onset of vaccination against HPV.

Methods

Women attending a preventive gynecological examination who had no history of abnormal cytological finding and/or surgery for cervical lesions were enrolled. All samples were tested for the presence of HPV by High-Risk Hybrid Capture 2 (HR HC2) and by a modified PCR-reverse line blot assay with broad spectrum primers (BS-RLB).

Results

Cervical smears of 1393 women were analyzed. In 6.5% of women, atypical cytological findings were detected. Altogether, 28.3% (394/1393) of women were positive for any HPV type by BS-RLB, 18.2% (254/1393) by HR HC2, and 22.3% (310/1393) by BS-RLB for HR HPV types. In women with atypical findings the prevalence for HR and any HPV types were significantly higher than in women with normal cytological findings. Overall, 36 different HPV types were detected, with HPV 16 being the most prevalent (4.8%). HPV positivity decreased with age; the highest prevalence was 31.5% in the age group 21-25 years.

Conclusions

Our study subjects represent the real screening population. HPV prevalence in this population in the Czech Republic is higher than in other countries of Eastern Europe. Also the spectrum of the most prevalent HPV types differs from those reported by others but HPV 16 is, concordantly, the most prevalent type. Country-specific HPV type-specific prevalences provide baseline information which will enable to measure the impact of HPV vaccination in the future.     

宫颈人乳头瘤病毒感染治疗方法研究进展

人乳头瘤病毒(Human papillomavirus,HPV)感染所致宫颈疾病是常见的性传播疾病之一,也是导致宫颈癌发生的重要危险因素.目前尚无特异有效的临床治疗手段,针对HPV感染所致宫颈疾病治疗策略的研究和应用是世界范围内迫切需要解决的重要问题.本文针对宫颈HPV感染治疗策略从手术治疗、物理治疗、药物治疗(包括西药和中药)和免疫治疗四方面的研究进展进行综述.     

High-Risk Cervical Human Papillomavirus Infections among Human Immunodeficiency Virus-Positive Women in the Bahamas

Background

High-risk (HR) HPV genotypes other than 16 and 18 have been detected in a significant proportion of immunocompromised females. We aim to evaluate the frequency of HR HPV genotypes in a population of HIV-positive Caribbean women.

Methods

One hundred sixty-seven consecutive, non-pregnant, HIV-positive females ≥18 years were recruited in this study. Each participant received a vaginal examination, PAP smear, and completed a questionnaire. DNA was extracted for HPV testing in 86 patients.

Results

Mean age was 39.1 years for women positive for HR HPV and 43.1 years for women negative for HR HPV (P value  = 0.040). 78% (130/167) of the women had HR HPV infections; the prevalence of abnormal cervical cytology was 38% among women who were HR HPV-positive compared to women who were HR HPV-negative (22%). Fifty-one percent of the 86 women with available genotype carried infections with HPV 16 and/or HPV 18; genotypes of unknown risk were also frequently observed. Women who had a CD4+ count of ≤200 had 7 times increased odds of carrying HR HPV infection in comparison to women with CD4+>200.

Conclusions

HR HPV infections in HIV infected females may consist of more than just HPV 16 and 18, but also HPV 52 and 58. Further studies are needed to determine whether HPV 52 and 58 play a significant role in the development of cervical cytological abnormalities in HIV+ women.     

MALDI-TOF-MS技术检测宫颈癌中HPV感染状态

目的:本研究拟评MALDI-TOF-MS技术在HPV分型中的实际应用效果.方法:采用MALDI-TOF-MS技术检测河南安阳地区94例宫颈癌样本中HPV感染状态,并与普通PCR方法得到的结果相比较.结果:94例宫颈癌组织中HPV感染率为92.6%,共检测到10种常见的高危型别,以16为主,其次是58和18型.样本单一HPV型别感染为主,其中16型单一型别感染占6I.7%,见多种型别和组合的多重感染.与普通PCR检测结果比较发现两种方法样本HPV(不分型)检测一致率为95.7,样本HPV16型检测一致率为93.6%.结论:MALDI-TOF-MS技术能够精确、快速、高通量的对宫颈癌中HPV进行检测和分型.     

Genital Human Papillomavirus Infection among Women in Bangladesh: Findings from a Population-Based Survey

Background

There has been no population-based study on human papillomavirus (HPV) prevalence or its genotypes in Bangladesh; a country eligible for GAVI funding for HPV vaccine.

Methods

We used baseline survey data of a prospective cohort study that was conducted in one urban and one rural area of Bangladesh. A total of 997 urban and 905 rural married women, aged 13 to 64 years, were enrolled in the baseline during July-December, 2011. Information was collected on socio-demographic characteristics and potential risk factors for HPV infection followed by gynecological examination and collection of endocervical samples using the cervical cytobrush (Digene cervical sampler). HPV DNA testing was done by Polymerase Chain Reaction (PCR) using a consensus primer set.

Results

Prevalence of any HPV infection was 7.7% with no significant difference between urban and rural women. Most common high-risk genotypes were HPV16, HPV66, HPV18, HPV45, HPV31 and HPV53. Urban women working as housemaids or garment workers were at higher risk of any HPV infection (OR = 2.15, 95% CI: 1.13–4.11) compared to housewives. Rural women whose husband lived overseas were almost two times more likely to have any HPV infection (OR = 1.93; 95% CI 1.05–3.55) compared to women whose husbands lived with them.

Conclusion

The prevalence of HPV infection among Bangladeshi women is similar to other regions of Asia. However, type-specific patterns are different. The study findings will inform the formulation of HPV vaccination policies in Bangladesh, monitoring the impact of vaccination programmes, and the identification of target populations for screening.     

人乳头瘤病毒在宫颈病变中的感染分型及其特点

目的:了解宫颈病变中人乳头瘤病毒(HPV)的感染分型及特点,为宫颈癌筛查诊治以及HPV疫苗研制提供基础。方法:采用导流杂交技术原理对2010年06月至2016年06月在广西医科大学附属肿瘤医院首诊的1021例患者的宫颈脱落细胞标本进行HPV检测,并按宫颈病变程度分为对照组(正常组)(217例)、CINⅡ-Ⅲ组(222例)和宫颈癌组(582例),分析三组的HPV感染特点和型别分布情况及其在不同年龄段(≤35岁、35岁)和民族(汉族、少数民族)中的感染特点。结果:(1)62.16%的CINⅡ-Ⅲ患者处于30-49岁,66.32%的宫颈癌患者处于40-59岁。(2)对照组、CINⅡ-Ⅲ组及宫颈癌组HPV感染率分别为20.7%、86.5%、90.5%(p0.001)。其中,多重感染率分别为11.1%、29.7%、18.0%(p0.05)。(3)CINⅡ-Ⅲ组和宫颈癌组的不同年龄段HPV感染率均高于对照组,宫颈癌组中不同年龄段的感染差异有统计学意义(p0.0001),CINⅡ-Ⅲ组差异无统计学意义(p0.05)。(4)三组HPV主要感染型别都是HPV16、58、18、52、33,但是排序先后有差异。其中,HPV33感染率在CINⅡ-Ⅲ组排第3位且主要参与多重感染,而在宫颈癌中感染率低。三组中汉族与少数民族HPV感染率差异均无统计学意义(p0.05),但宫颈癌组中少数民族患者58型感染率明显高于52型。(5)宫颈癌组病理类型与HPV感染相关,鳞癌患者的HPV感染率及多重感染率均高于非鳞癌患者,其中HPV感染差异有统计学意义(p0.05)。Logistic回归分析示:宫颈鳞癌组OR=1.966(p=0.042),95%CI值为1.023-3.775。结论:随着宫颈病变程度的增加,HPV感染增加,且多重感染与宫颈病变密切相关。HPV33可能是癌前病变特殊感染亚型,HPV58可能是少数民族特有的感染亚型。HPV感染使宫颈癌患者患鳞癌的风险增加。     

Human Papillomavirus Infection in HIV-1 Infected Women in Catalonia (Spain): Implications for Prevention of Cervical Cancer

Background

High-risk human Papillomavirus infection is a necessary factor for cervical squamous intraepithelial lesions and invasive cervical cancer. In HIV-1-infected women, HPV infection is more prevalent and a higher risk of cervical cancer has been identified. We aimed to calculate the prevalence of infection by HR-HPV, determine the factors associated with this infection and abnormal cytology findings and to describe the history of cervical cancer screening in HIV-1-infected women.

Methods

We enrolled 479 HIV-1–infected women from the PISCIS cohort. Each patient underwent a gynecological check-up, PAP smear, HPV AND Hybrid capture, HPV genotyping, and colposcopy and biopsy, if necessary. We applied questionnaires to obtain information on sociodemographic, behavioral, clinical, and cervical screening variables. We present a cross-sectional analysis.

Results

Median age was 42 years. The prevalence of HR-HPV infection was 33.2% and that of high-grade squamous intraepithelial lesions (HSIL) was 3.8%. The most common genotypes were 16(23%), 53(20.3%), and 52(16.2%). The factor associated with HR-HPV infection was age <30 years (odds ratio[OR],2.5; 95%confidence interval[CI],1.1–5.6). The factors associated with the presence of HSIL or low-grade squamous intraepithelial lesions (LSIL) were CD4T-lymphocyte count <200cells/mm³ versus >500cells/mm³ (OR,8.4; 95%CI,3.7–19.2), HIV-1 viral load >10,000copies/mL versus <400copies/mL (OR,2.1; 95%CI,1.0–4.4), and use of oral contraceptives (OR,2.0; 95%CI,1.0–3.9). Sixty percent of HIV-1–infected women had had one Pap smear within the last 2 years.

Conclusions

The high prevalence of HPV infection and cervical lesions in the HIV-1–infected population in Catalonia, as well as the low coverage and frequency of screening in this group, means that better preventive efforts are necessary and should include vaccination against HPV, better accessibility to screening programs, training of health care professionals, and specific health education for HIV-1–infected women.