摘要
目的分析绝经后细菌性阴道炎、宫颈鳞状上皮内病变(SIL)及宫颈鳞状细胞癌(SCC)女性人乳头瘤病毒(HPV)感染特点。方法选取2022年1月—2023年12月就诊于呼和浩特市第一医院妇产科的绝经后女性,包括低度宫颈鳞状上皮内病变(LSIL)患者30例(LSIL组),高度鳞状上皮内病变(HSIL)患者18例(HSIL组),SCC患者60例(SCC组);选取同期绝经后细菌性阴道炎患者30例为对照组。4组患者均进行阴道微生态检测、HPV检测、液基薄层细胞学检查(TCT)及阴道镜检查。结果138例患者中,<60岁81例,60~69岁43例,≥70岁14例,4组患者的年龄比较差异有统计学意义(P<0.05)。SCC组、HSIL组、LSIL组、对照组既往有HPV感染的患者分别为58例,17例,15例,8例,差异有统计学意义(χ^(2)=41.779,P<0.05)。对照组中,HPV52感染比例最高,为33.33%。SCC组、HSIL组、LSIL组中,HPV16感染比例最高。4组HPV16感染率比较差异有统计学意义(χ^(2)=27.371,P<0.05)。SCC组高危型HPV亚型感染率为93.33%,高于其余3组,但差异无统计学意义(χ^(2)=6.588,P>0.05)。SCC组HPV单一感染率高于其余3组,但差异无统计学意义(χ^(2)=7.115,P>0.05)。4组HPV阴性共13例,HPV阳性共125例。4组HPV阳性率比较,差异有统计学意义(χ^(2)=9.042,P<0.05),其中SCC组没有HPV阴性患者,HSIL组仅有1例HPV阴性患者。结论绝经后女性宫颈病变患者以HPV16亚型感染为主,既往有HPV感染会促进绝经后女性宫颈病变发展,HPV多重感染似乎并未参与宫颈病变进展,绝经后细菌性阴道炎患者的HPV多重感染率较高。
Objective To analyze the characteristics of human papillomavirus(HPV)infection in postmenopausal patients with bacterial vaginitis,cervical squamous intraepithelial lesion(SIL),and cervical squamous cell carcinoma(SCC).Methods The postmenopausal patients enrolled in Department of Gynecology and Obstetrics,the First Hospital of Hohhot from January 2022 to December 2023 were selected,including 30 cases of low-grade cervical squamous intraepithelial lesion(LSIL),18 cases of high-grade cervical squamous intraepithelial lesion(HSIL),and 60 cases of SCC.Thirty patients with postmenopausal bacterial vaginitis were selected as control group.All the patients in the four groups underwent vaginal microecological test,HPV test,liquid-based thin layer cytological test(TCT),and colposcopy.Results Among 138 patients,81 patients were less than 60 years old,43 patients were 60-69 years old,and 14 patients were 70 or more than 70 years old.There was statistically significant difference in age among the four groups(P<0.05).There were 58,17,15,and 8 cases with previous HPV infection in SCC group,HSIL group,LSIL group,and control group,respectively,and the difference was statistically significant(χ^(2)=41.779,P<0.05).In control group,the infection rate of HPV52 was the highest(33.33%).The proportion of HPV16 infection was the highest in SCC group,HSIL group,and LSIL group.There was statistically significant difference in infection rate of HPV16 among the four groups(χ^(2)=27.371,P<0.05).The infection rate of high-risk HPV subtypes in SCC group was 93.33%,which was higher than those in the other three groups,but the difference was not statistically significant(χ^(2)=6.588,P>0.05).The single infection rate of HPV in SCC group was higher than those in the other three groups,but the difference was not statistically significant(χ^(2)=7.115,P>0.05).There were 13 HPV-negative cases and 125 HPV-positive cases in the four groups.There was statistically significant difference in HPV positive rate among the four groups(χ^(2)=9.042,P<0.05),there was no HPV-negative case in SCC group,and there was only one HPV negative case in HSIL group.Conclusion HPV16 subtype infection is predominant in postmenopausal women with cervical lesions.Previous HPV infection can promote the progression of cervical lesions in postmenopausal women,and HPV multiple infection does not appear to be involved in the progression of cervical lesions,and HPV multiple infection rate is high in postmenopausal women with bacterial vaginitis.
作者
刘君
杨琦芳
伊吉乐木仁
杨惠玉
但禹廷
肖慧英
LIU Jun;YANG Qi-fang;Yijilemuren;YANG Hui-yu;DAN Yu-ting;XIAO Hui-ying(Department of Gynecology and Obstetrics,the First Hospital of Hohhot,Hohhot,Inner Mongolia Autonomous Region 010030,China)
出处
《中国妇幼保健》
2025年第19期3493-3496,共4页
Maternal and Child Health Care of China
基金
内蒙古自治区卫生健康科技计划项目(202201478)。
关键词
绝经后女性
细菌性阴道炎
宫颈鳞状上皮内病变
宫颈鳞状细胞癌
人乳头瘤病毒
Postmenopausal woman
Bacterial vaginitis
Cervical squamous intraepithelial lesion
Cervical squamous cell carcinoma
Human papillomavirus
