1 郑州市妇幼保健院病理科，郑州 450012
目的：对比分析门诊和体检患者感染人乳头瘤病毒(human papillomavirus，HPV)的差异，探讨检测HPV的重要性。方法：采用PCR-反向点杂交法对门诊14 426例患者和体检9 081例妇女进行HPV检测并分型。结果：患者年龄15~85(36.0±9.9)岁。总HPV检出率16.7%(3 939/23 507)，其中高危型16.1%(3 790/23 507)，低危型1.2%(273/23 507)；单一亚型感染占83.1%(3 272/3 939)，多亚型混合感染占16.9%(667/3 939)；30岁以下、40~49岁以及60岁以上患者以感染高危型HPV52亚型为主，30~39岁和50~59岁患者以感染高危型HPV16亚型为主。门诊患者与体检患者在检出率、感染类型和年龄相关性方面均存在差异。两组患者高危型HPV检出率存在显著性差异(P<0.001)，门诊患者中高危型HPV51亚型感染低于体检患者(χ2=9.055，P=0.003)；而低危型HPV检出率也存在显著性差异(P<0.001)。低危型HPV6亚型和HPV11亚型感染均明显高于体检患者(χ2=53.306，P<0.001和χ2=10.539，P=0.001)。结论：门诊患者检测HPV重要，体检患者HPV的检测也要重视。关键词： 子宫颈；宫颈癌；癌前病变；人乳头瘤病毒；聚合酶链式反应
A comparative analysis of human papillomavirus infection between outpatient and physical examination patients in Zhengzhou
CorrespondingAuthor:LI Xinmin Email: email@example.com
Foundation: This work was supported by the Henan Medical Science and Technology Project, China (201503211).
Objective: To compare and analyze the difference of human papillomavirus (HPV) infection between outpatient and physical examination patients, and to explore the importance of HPV detection. Methods: HPV was detected and typed by PCR-reverse dot hybridization in 14 426 outpatients and 9 081 women in physical examination. Results: The age of the patients ranged from 15 to 85 years, and the median age was 36.0±9.9 years. The total detection rate of HPV was 16.7% (3 939/23 507), of which 16.1% (3 790/23 507) was high-risk type, 1.2% (273/23 507) was low-risk type. Single subtype infection accounted for 83.1% (3 272/3 939) and multi-subtype mixed infection accounted for 16.9% (667/3 939). Furthermore, high-risk HPV52 subtype infection was the main type in patients under 30, 40–49 and over 60 years old. And high-risk HPV16 subtype infection was the main type in patients aged 30–39 and 50–59 years. There were differences in detection rate, infection type and age correlation between outpatient and physical examination patients. There was a significant difference in the detection rate of high-risk HPV between the two groups (P<0.001). The infection rate of high-risk HPV51 subtype in outpatient patients was lower than that in physical examination patients (χ2=9.055, P=0.003), and the detection rate of low-risk HPV also had a significant difference (P<0.001). The infection rates of low-risk HPV6 and 11 subtypes were significantly higher than those of physical examination patients (χ2=53.306, P<0.001 and χ2=10.539, P=0.001). Conclusion: It is important not only to detect HPV in outpatients, but also in patients undergoing physical examination.Keywords： cervix; cervical cancer; precancerous lesions; human papillomavirus; PCR