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目的 了解我国宫颈癌高发区妇女生殖道人乳头状瘤病毒 (humanpapillomavirus ,HPV)感染状况 ,研究高危型HPV感染与宫颈癌的关系。方法 应用第二代杂交捕获试验对山西省襄垣县 1997名 35～ 45岁已婚妇女自己采集的阴道细胞和医生采集的宫颈细胞 ,检测 13种高危型HPV脱氧核糖核酸 (DNA)。采用多因素的非条件logistic回归模型分析HPV感染与宫颈癌及宫颈上皮内瘤变 (CIN)的关系。用卡帕 (kappa)系数衡量两种标本HPV检测的符合度。 结果 该人群的高危型HPVDNA总检出率为 2 0 .8%。HPVDNA检出率随病变程度加重呈趋势性增高 (χ2 =44 4.0 4,P =0 .0 0 0 )。两年龄组 (35～ 39岁和 40～ 45岁 )妇女的宫颈HPVDNA检出率几乎一样(2 0 .9%∶2 0 .6 %,χ2 =0 .0 3,P =0 .86 )。非条件logistic回归分析显示 ,HPV感染与宫颈上皮内高度病变及癌症 (≥CINⅡ )和低度病变 (CINⅠ )的发生高度相关 (OR =2 5 4.2和OR =2 6 .4) ,归因危险百分比 (ARP)分别为 98.1%和 83.6 %。自我取样HPV检测的灵敏度低于医生取样HPV检测 (84%∶98%,χ2 =5 .92 ,P =0 .0 15 ) ,特异度差异无显著性 (86 %∶85 %,χ2 =0 .0 0 ,P =0 .997) ,但两种标本HPV检测的符合度较好 (kappa =0 .74)。结论 女性生殖道高危型HPV感染是当地宫颈癌及CIN流?
Objective To understand the infection status of human reproductive tract human papillomavirus (HPV) in high incidence area of cervical cancer and to study the relationship between high-risk HPV infection and cervical cancer. Methods Using the second-generation hybridization capture test, vaginal cells collected by 1997 married women aged 35-45 years old in Xiangyuan County of Shanxi Province and the cervical cancer cells collected by doctors were used to detect 13 high-risk HPV DNA. The relationship between HPV infection and cervical cancer and cervical intraepithelial neoplasia (CIN) was analyzed with a multivariate non-conditional logistic regression model. The kappa coefficient was used to measure the coincidence of HPV testing of two specimens. Results The total prevalence of high-risk HPVDNA in this population was 20.8%. The detection rate of HPVDNA increased with the severity of the disease increased (χ2 = 44 4.04, P = 0.000). Women in both age groups (35-39 and 40-45 years) had similar rates of cervical HPVDNA (20.9%: 2.06%, χ2 = 0.330, P = .86). Non-conditional logistic regression analysis showed that HPV infection was highly correlated with the occurrence of cervical intraepithelial neoplasia and cancer (≥CINⅡ) and low grade (CINⅠ) (OR = 2.54 and OR = 26.4) Percentage (ARP) were 98.1% and 83.6% respectively. The sensitivity of self-sampling HPV testing was lower than that of doctors’ sampling HPV testing (84%: 98%, χ2 = 5.92, P = 0.015). There was no significant difference in specificity (86% vs 85%, χ2 = 0 0, P = 0 .997), but the coincidence of the two samples was better (kappa = 0.74). Conclusion Female genital tract high-risk HPV infection is a local cervical cancer and CIN flow?