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目的探讨北京市社区妇女中高危型人乳头瘤病毒(HPV)感染及子宫颈上皮内瘤变(CIN)状况。方法2006年6月至2007年6月对北京市展览路社区的795名20～54岁有性生活妇女进行筛查。筛查对象接受妇科检查时,依次留取超柏氏薄层液基细胞学(LCT)和高危型HPV (hc2)检测标本,并对宫颈细胞学异常者行阴道镜检查及活检。结果795名社区妇女中高危型HPV感染阳性112例,占14.1%;阴性683例,占85.9%。高危型HPV感染率随宫颈病变加重,阳性率升高:正常宫颈及慢性宫颈炎人群为0.8%(6/751);CIN1为83.3%(10/12),CIN2及以上为100%(8/8);宫颈细胞学阳性并行阴道镜活检的40例中,发现11例慢性宫颈炎、14例宫颈湿疣、5例CIN1、3例CIN2、4例CIN3及1例早期浸润癌;细胞学阴性的750人中,发现2例宫颈湿疣、5例CIN1及1例宫颈低级别腺上皮内病变(CGIN)。750人中HPV阴性为669人,其中发现3例CINI及1例CGIN;HPV阳性为81例,其中2例CIN1及2例宫颈湿疣。在细胞学阳性(≥ASCUS)的40例中,HPV阴性为13例,其中发现10例慢性宫颈炎及3例宫颈湿疣;HPV阳性为27例,发现1例慢性宫颈炎、11例宫颈湿疣、7例CIN1、3例CIN2、4例CIN3及1例早期浸润癌,对宫颈病变的检出率后两者相比差异有统计学意义(P<0.001)。结论北京市社区妇女中高危型HPV感染率随子宫颈上皮内瘤变加重,阳性率升高。
Objective To investigate the prevalence of high-risk human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) in community women in Beijing. Methods From June 2006 to June 2007, 795 women with sexual life from 20 to 54 years old in Zhanqianlu community in Beijing were screened. Screening subjects to receive gynecological examination, followed by the collection of ultra-thin layer liquid-based cytology (LCT) and high-risk HPV (hc2) test specimens, and cervical cytology abnormal colposcopy and biopsy. Results Among 795 community women, 112 were high-risk HPV infection, accounting for 14.1%; 683 were negative, accounting for 85.9%. The prevalence of high-risk HPV infection increased with cervical lesions, the positive rate increased: normal cervical and chronic cervicitis population was 0.8% (6/751); CIN1 was 83.3% (10/12), CIN2 and above was 100% (8 / 8); Cervical cytology positive parallel colposcopy biopsy in 40 cases, found in 11 cases of chronic cervicitis, 14 cases of cervical condyloma, 5 cases of CIN1, 3 cases of CIN2, 4 cases of CIN3 and 1 case of early invasive carcinoma; cytology negative Among 750 people, 2 cases of cervical condyloma, 5 cases of CIN1 and 1 case of low-grade cervical intraepithelial lesion (CGIN) were found. Among 750 people, HPV negative was 669, of which 3 were CINI and 1 CGIN. HPV positive was 81, of which 2 were CIN1 and 2 were cervical condyloma. Among the 40 cases with positive cytology (≥ASCUS), HPV negative was 13 cases, of which 10 cases were found chronic cervicitis and 3 cases of cervical condyloma; HPV positive was 27 cases, 1 case of chronic cervicitis, 11 cases of cervical condyloma, 7 cases of CIN1, 3 cases of CIN2, 4 cases of CIN3 and 1 case of early invasive cancer, the detection rate of cervical lesions after the difference was statistically significant (P <0.001). Conclusion The prevalence of high-risk HPV infection in community-based women in Beijing increased with the incidence of cervical intraepithelial neoplasia, and the positive rate increased.