14 962例体检女性HPV感染特征及联合TCT筛查宫颈病变的价值

李乐; 王瑞

doi:10.16016/j.1000-5404.202004176

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14 962例体检女性HPV感染特征及联合TCT筛查宫颈病变的价值

临床医学 | 更新时间：2026-01-09

- 14 962例体检女性HPV感染特征及联合TCT筛查宫颈病变的价值
- Characteristics of HPV infection and value of its combination with TCT in screening cervical lesions: report based on 14 962 women taking physical examination
- 第三军医大学学报 2020年42卷第15期页码：1548-1554
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院健康管理科
- 作者简介：
  
  [ 王瑞，E-mail:lovetcm1992@126.com WANG Rui, E-mail:lovetcm1992@126.com
- 基金信息：
- DOI：10.16016/j.1000-5404.202004176
  中图分类号： R181.32;R373.9;R737.33
- 收稿：2020-04-16，
  
  修回：2020-05-17，
  
  纸质出版：2020-08-15
- 稿件说明：
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李乐, 王瑞. 14 962例体检女性HPV感染特征及联合TCT筛查宫颈病变的价值[J]. 第三军医大学学报, 2020,42(15):1548-1554.

Le LI, Rui WANG. Characteristics of HPV infection and value of its combination with TCT in screening cervical lesions: report based on 14 962 women taking physical examination[J]. Journal of Third Military Medical University, 2020, 42(15): 1548-1554.
李乐, 王瑞. 14 962例体检女性HPV感染特征及联合TCT筛查宫颈病变的价值[J]. 第三军医大学学报, 2020,42(15):1548-1554. DOI： 10.16016/j.1000-5404.202004176.

Le LI, Rui WANG. Characteristics of HPV infection and value of its combination with TCT in screening cervical lesions: report based on 14 962 women taking physical examination[J]. Journal of Third Military Medical University, 2020, 42(15): 1548-1554. DOI： 10.16016/j.1000-5404.202004176.

摘要

目的

探讨联合高危型HPV和TCT筛查宫颈病变的应用价值。

方法

选取同时进行21种HPV基因分型检测及宫颈液基细胞学(TCT)检测的14 962例女性体检者，分别对HPV感染率、亚型分布、年龄段分布，及不同TCT结果中高危型HPV的感染率、高危型HPV和TCT联合检测等情况进行统计学分析。

结果

14 962例健康体检者中，共检出HPV阳性者1 482例，总感染阳性率9.91%，所有21种亚型，包括13种高危型，8种低危型均被检出。其中52型(17.61%)感染率最高，43型(0.06%)感染率最低。高危型HPV感染率前3位的分别是52型(17.61%)、58型(14.89%)、16型(11.88%)，低危型HPV感染率前3位的是53型(9.89%)、CP8304(低危型，6.48%)、66型(3.58%)。单一感染率最高，为78.34%(1 161/1 482)，二重感染率13.70%(203/1 482)，三重及以上感染率7.96%(118/1 482)。在

25岁、25~35岁、36~45岁、46~55岁、

55岁5个年龄组中，HPV感染率依次为12.72%(22/173)、10.70%(306/2 861)、9.07%(454/5 008)、9.75%(540/5 541)、11.60%(160/1 379)，其中

25岁年龄组感染率最高，各年龄组HPV感染率比较差异有统计学意义(

0.05)。随着宫颈病变程度加重，高危型HPV感染率增高，其中HISL最高，为83.90%(99/118)，各TCT组间的高危型HPV感染率差异有统计学意义(

0.05)。TCT阳性共537例(3.59%)，其中ASC-US 273例，LSIL 146例，HISL 118例。高危型HPV阳性共1 184例(7.91%)，二者共为阳性280例(1.87%)，二者联合检测阳性共1 441例(9.63%)，联合检测与单一检测阳性检出率相比，差异有统计学意义(

0.05)。

结论

体检女性高危型HPV亚型前3位为52、58、16型，HPV联合TCT筛查可提高宫颈病变检出率。

Abstract

Objective

To explore the application value of high-risk human papillomavirus (HPV) infection combined with and ThinPrep cytology test (TCT) in screening of cervical lesions.

Methods

A total of 14 962 women who undergoing 21 HPV genotyping and cervical fluid based TCT detection at the same time in our hospital from October 2018 to October 2019 were enrolled in this study. The HPV infection rate

subtype distribution

age distribution

and the high-risk HPV infection rates in different TCT results

and combined detection of high-risk HPV and TCT were observed and analyzed statistically.

Results

Among them

1 482 cases were positive to HPV

with a total positive rate of 9.91%. All 21 subtypes

including 13 high-risk types and 8 low-risk types

were detected. The highest infection rate was HPV 52 (17.61%)

and the lowest was HPV 43 (0.06%). The top 3 subtypes of high-risk HP

V infection were HPV 52 (17.61%)

58 (14.89%)

and 16 (11.88%)

and those of low-risk were HPV 53 (9.89%)

CP8304 (6.48%)

and 66 (3.58%). The highest single infection rate was 78.34% (1 161/1 482)

double infection rate 13.70% (203/1 482)

and triple and above infection rate 7.96% (118/1 482). For the 5 age groups (

25~35

36~45

46~55 and

55 years)

the infection rate of HPV was 12.72% (22/173)

10.70% (306/2 861)

9.07% (454/5 008)

9.75% (540/5 541) and 11.60% (160/1 379)

respectively. The highest infection rate was in the

25-year group

and statistical differences were seen among the different age groups (

0.05). With the increasing severity of cervical lesions

the infection rate of high-risk HPV was elevated

and high-grade intraepithelial lesion (HISL) was the most common lesion (83.90%

99/118). There were significant difference in the infection rate of high-risk HPV among different TCT groups (

0.05). There were 537 cases of TCT positive to HPV infection (3.59%)

including 273 cases of atypical squamous cells of undetermined significance (ASC-US)

146 cases of low-grade squamous intraepithelial lesion (LSIL) and 118 cases of HISL. There were 1 184 cases (7.91%) positive to high-risk HPV

280 cases (1.87%) were positive to both 2 detection

and 1 441 cases (9.63%) were positive to combined detection. The difference between the positive rate of combined detection and single detection was statistically significant (

0.05).

Conclusion

The top 3 high-risk HPV subtypes in female physical examiners are 52

58 and 16. Combined detection of HPV subtyping and TCT can improve the detection rate of cervical lesions.

关键词

Keywords

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