库车市宫颈上皮内病变患者HPV感染亚型分布情况

Distribution of HPV Infection Subtypes in Patients with Cervical Intraepithelial Lesions in Kuche City

摘要: 目的：分析库车市宫颈上皮内病变患者人乳头瘤病毒(HPV)感染亚型分布情况。方法：收集2024年4至2025年9月在库车市医疗集团进行HPV分型检测、液基薄层细胞(TCT)检测、宫颈活检病理检查，免疫组化的患者的相关临床资料共3107例，其中筛选出200例宫颈TCT异常、HPV检测异常、同时阴道镜活检病理结果异常的数据病例共200例。对宫颈病变进行分类(包括宫颈炎、宫颈上皮内病变、宫颈癌)；分析不同类别宫颈病变患者HPV感染情况；分析HPV阳性患者HPV亚型分布情况。结果：200例患者中宫颈炎71例(35.50%)、低级病变54例(27.00%)、高级病变66例(33.00%)、宫颈癌9例(4.50%)；宫颈炎、低级病变、宫颈癌患者HPV单一感染率高于多重感染率，高级病变单一感染率低于多重感染率，统计计算分析，在癌前病变阶段，多重感染率随宫颈病变严重程度增加而升高，当病变进展至宫颈癌时，通常由单一优势高危型HPV驱动，多重感染率随之降低，差异有统计学意义(P_趋势 < 0.05)；HPV16型的感染人数较多，其次为HPV18型，女性感染多种高危亚型较为常见；宫颈炎和宫颈上皮病变主要集中于30~49岁年龄组，而宫颈癌在≥60岁年龄组中的比例最高；随着年龄增长，单一感染的比例呈上升趋势，而多重感染的比例相应下降。结论：库车市宫颈病变患者中HPV的优势亚型以16、18型为主，在癌前病变阶段，多重感染较为常见，但病变进展至宫颈癌时，通常由单一优势高危型HPV驱动，多重感染率随之降低，为当地宫颈癌的预防和精准筛查提供了重要的流行病学依据。

Abstract: Objective: To analyze the distribution of human papillomavirus (HPV) subtypes among patients with cervical intraepithelial neoplasia in Kuqa City. Methods: Clinical data from 3107 patients who underwent HPV genotyping, ThinPrep cytologic test (TCT), cervical biopsy pathology, and immunohistochemistry at the Kuqa Medical Group from April 2024 to September 2025 were collected. Among them, 200 cases with abnormal TCT results, abnormal HPV testing, and concurrent abnormal cervical biopsy pathology findings were selected. Cervical lesions were classified (including cervicitis, cervical intraepithelial neoplasia, and cervical cancer). The HPV infection status in different categories of cervical lesions was analyzed, and the distribution of HPV subtypes in HPV-positive patients was examined. Results: Among the 200 patients, 71 cases (35.50%) had cervicitis, 54 cases (27.00%) had low-grade lesions, 66 cases (33.00%) had high-grade lesions, and 9 cases (4.50%) had cervical cancer. The single-infection rate of HPV was higher than the multiple-infection rate in patients with cervicitis, low-grade lesions, and cervical cancer, while the single-infection rate was lower than the multiple-infection rate in patients with high-grade lesions. Statistical analysis revealed that during the precancerous stage, the multiple-infection rate increased with the severity of cervical lesions. When lesions progressed to cervical cancer, they were typically driven by a single dominant high-risk HPV type, leading to a subsequent decrease in the multiple-infection rate, with a statistically significant difference (P_trend < 0.05). HPV16 was the most common subtype, followed by HPV18, and multiple high-risk subtypes were frequently detected in women. Cervicitis and cervical intraepithelial neoplasia were predominantly observed in the 30~49 age group, while cervical cancer had the highest proportion in the ≥60 age group. As age increased, the proportion of single infections showed an upward trend, while the proportion of multiple infections correspondingly decreased. Conclusion: In Kuqa City, the dominant HPV subtypes in patients with cervical lesions were primarily HPV16 and HPV18. During the precancerous stage, multiple infections were relatively common, but as lesions progressed to cervical cancer, they were typically driven by a single dominant high-risk HPV type, resulting in a reduced multiple-infection rate. These findings provide important epidemiological evidence for the prevention and precise screening of cervical cancer in the region.