HPV检测在农村宫颈癌筛查中的作用
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摘要
[目的]了解HPV检测在辽宁省沈阳市苏家屯地区农村妇女宫颈癌筛查过程中的作用,为宫颈癌筛查提供科学依据。[方法]对2014~2015年间自愿接受宫颈癌筛查的35~64岁农村常住妇女,进行调查、取样和HPV检测。[结果]对10 000名35~64岁妇女进行宫颈癌筛查,发现宫颈癌癌前病变80人(其中CIN1为36人,CIN2为30人,CIN3为14人),宫颈癌3人。高危型HPV阳性共1209人,高危型HPV阳性感染率随年龄的升高而升高。HPV的感染率随着病变程度加重而升高;宫颈上皮内瘤变和宫颈癌组HPV 16型的比例显著性高于其他组。[结论]HPV检测在宫颈癌的筛查过程中对提高早诊率具有重要的意义。
[Purpose] To investigate the role of HPV in cervical cancer screening in rural areas of Sujiatun,Shenyang city,Liaoning province,and to provide scientific basis for the prevention screening of cervical cancer. [Methods] From 2014 to 2015,rural women aged 35~64 volunteered for the screening of cervical cancer were investigated,sampled and performed HPV detection test.[Results] After the screening for cervical cancer in 10000 rural women,cervical precancerous lesions were found in 80 cases(CIN1 36 cases,CIN2 30 cases,CIN3 14 cases),and 3 cases with cervical cancer. There were 1209 cases with positive HPV,and the HPV positive rate increased by age increasing. The HPV infection rate increased with the severity of cervical cancer. HPV 16 positive rate in cervical precancerous lesions and cervical cancer group was significantly higher than that in other cervix lessions. [Conclusion] The HPV detection in the screening of cervical cancer have an important significance to increase the early diagnosis rate and improve health con-dition. The screening of cervical cancer in rural areas is necessary and feasible.
[Purpose] To investigate the role of HPV in cervical cancer screening in rural areas of Sujiatun,Shenyang city,Liaoning province,and to provide scientific basis for the prevention screening of cervical cancer. [Methods] From 2014 to 2015,rural women aged 35~64 volunteered for the screening of cervical cancer were investigated,sampled and performed HPV detection test.[Results] After the screening for cervical cancer in 10000 rural women,cervical precancerous lesions were found in 80 cases(CIN1 36 cases,CIN2 30 cases,CIN3 14 cases),and 3 cases with cervical cancer. There were 1209 cases with positive HPV,and the HPV positive rate increased by age increasing. The HPV infection rate increased with the severity of cervical cancer. HPV 16 positive rate in cervical precancerous lesions and cervical cancer group was significantly higher than that in other cervix lessions. [Conclusion] The HPV detection in the screening of cervical cancer have an important significance to increase the early diagnosis rate and improve health con-dition. The screening of cervical cancer in rural areas is necessary and feasible.
引文
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[16]Hamzi ARS,Isa NM,Zailani HA,et al.Distribution of HPV genotypes in cervical cancer in multi-ethnic Malaysia[J].Asian Pac J Cancer Prev,2014,15(2):651-656.
[2]Arbyn M,CastellsaguéX,SanjoséS D,et al.Worldwid burden of cervical cancer in 2008[J].Ann Oncol,2011,22(12):2675-2686.
[3]Chen WQ,Zheng SW,Zheng RS,et al.Report of cance incidence and mortality in China,2009[J].China Cancer2013,22(1):2-12.[陈万青,张思维,郑荣寿,等.中国2009年恶性肿瘤发病和死亡分析[J].中国肿瘤,2013,22(1):2-12.]
[4]Zhao CQ,Yang M.The introduction on the new guideline for cervical cancer screening in the United States[J].Chines Journal of Obstetrics and Gynecology,2013,48(5):394-396[赵澄泉,杨敏.美国最新子宫颈癌筛查指南的介绍[J]中华妇产科杂志,2013,48(5):394-396.]
[5]He CH,He D,Wu FY,et al.Analysis on results of cervi cal carcinoma screening among rural women in high risk areas of Sichuan[J].Maternal and Child Health Care o China,2010,25(31):4508-4509.[何朝华,何丹,吴方银,等.四川省宫颈癌高发地区农村妇女宫颈癌普查结果分析[J].中国妇幼保健,2010,25(31):4508-4509.]
[6]Mu LF,Qi SY.Analysis on results of cervical cancer screening in rural women in eastern of Qinghai province[J].Maternal and Child Health Care of China,2012,27(27):4212-4214.[穆兰芳,祁淑英.青海省东部农村妇女宫颈癌普查结果分析[J].中国妇幼保健,2012,27(27):4212-4214.]
[7]Hu MN,Xu W,Zhou Y,et al.Analysis of two gynecological cancer screening among women in Haidian district of Beijing[J].Chinese Journal of Woman and Child Health Research,2011,22(3):322-324.[胡美娜,徐文,周钰,等.北京市海淀区妇女两癌筛查情况分析[J].中国妇幼健康研究,2011,22(3):322-324.]
[8]Cai JF,Yang YY.The results analysis of uterine cervical cancer screening in 753310 cases[J].China Medical Herald,2012,9(13):134-136.[蔡静芬,杨幼易.宫颈癌筛查753310例结果分析[J].中国医药导报,2012,9(13):134-136.]
[9]Wang ZW,Tan J,Wang GQ,et al.Analysis of the main gynecologic malignant tumors detected through mass screening in Shanghai from 2000 to 2009[J].Chinese Journal of Woman and Child Health Research,2013,24(1):98-100.[王哲蔚,谭晶,王国琴,等.2000至2009年上海市妇科普查主要恶性肿瘤情况分析[J].中国妇幼健康研究,2013,24(1):98-100.]
[10]Zhou YQ,Zhang LJ,Wu LN,et al.Analysis on cervical screening in 3567 females in Shenzhen[J].Journal of Clinical and Experimental Medicine,2007,6(4):46-47.[周艳秋,张礼婕,乌兰娜,等.深圳市3567例体检妇女筛查宫颈癌结果分析[J].临床和实验医学杂志,2007,6(4):46-47.]
[11]Molano M,Brule AVD,Plummer M,et al.Determinants of clearance of human papillomavirus infections in Colombian women with normal cytology:a population-based,5-year follow-up study[J].Am J Epidemiol,2003,158(5):486-494.
[12]Illades-Aguiar B,Cortés-Malagón EM,Antonio-Véjar V,et al.Cervical carcinoma in Southern Mexico:human papillomavirus and cofactors[J].Cancer Detect Prev,2008,32(4):300-307.
[13]Marlow L,Waller JJ.Public awareness that HPV is a risk factor for cervical cancer[J].Br J Cancer,2007,97(5):691-694.
[14]Kepka D,Ding Q,Hawkins AJ,et al.Factors associated with early adoption of the HPV vaccine in US male adolescents include Hispanic ethnicity and receipt of other vaccines[J].Prev Med Rep,2016,4:98-102.
[15]Wangu Z,Hsu KK.Impact of HPV vaccination on anogenital warts and respiratory papillomatosis[J].Hum Vaccin Immunother,2016,12(6):1357-1362.
[16]Hamzi ARS,Isa NM,Zailani HA,et al.Distribution of HPV genotypes in cervical cancer in multi-ethnic Malaysia[J].Asian Pac J Cancer Prev,2014,15(2):651-656.