摘要
目的:研究中国五个地区妇女HPV型别分布,了解中国生殖器疣低危HPV型别分布情况。估计HPV 6/11/16/18预防性疫苗对我国子宫颈高度病变及生殖器疣的预防效果,为下一代疫苗研制提供科学数据。
方法:2006年3月-2007年5月,对山西、北京、新疆、河南和上海的4,215名17-54岁有性生活妇女进行子宫颈癌筛查,对HPV DNA和抗HPV抗体进行检测。并检测655名14-36岁没有性行为女性的HPV抗体。对43篇2006年12月以前发表的中国大陆生殖器疣HPV型别分布文章进行meta分析。包括5,247份生殖器疣标本。用Logistic回归模型分析,对地理地区、病理类型、标本来源和PCR引物四个混杂因素进行调整。计算调整后的总HPV感染率和HPV 6、11、40、42、43和44的型特异性HPV感染率。
结果:我国汉族17-54岁妇女的高危型HPV感染率是13.81%,低危型HPV的感染率是3.15%。维吾尔族高危和低危型HPV感染率均是汉族的1/2。CIN2及以上病变中HPV 16/18的阳性率是74.6%。Meta分析显示,生殖器疣低危HPV型别总感染率是84.2%。HPV 6/11的阳性百分比是83.0%。
结论:HPV 16是我国子宫颈高度病变中最常见感染型别。HPV6和11是生殖器疣的最常见感染型别。HPV 6/11/16/18预防性疫苗预防中国子宫颈高度病变和生殖器疣的预防效果分别可达74.6%和83.0%。
Objective:To determine HPV type-distribution in women from five geographic regions of China,and to study low risk HPV type-distribution in mainland China.Estimate the potential impact of HPV 6/11/16/18 prophylactic vaccine in China and to provide evidence for next generation prophylactic HPV vaccines.
Methods:During March,2006 to May,2007,a population-based cervical cancer screening was conducted in Shanxi,Beijing,Xinjiagn,Henan and Shanghai.4,215 sex active women aged 17-54 took part in the screening.HPV DNA and HPV antibody were detected for the screening people.Six hundred and fifty-five sex naive women aged 14-36 were tested for HPV seropositivity.A meta-analysis of HPV types distribution in mainland China was conducted.Forty-three eligible papers published before December,2006 are included.Totally 5,247 CA cases were included.The variables of area,pathology type,specimen resource and PCR primers were introduced into the non-conditional logistic regression modules.The adjusted overall HPV prevalence was estimated based on the significant variables in the final model.The overall and type-specific HPV 6,11,40,42,43 and 44 prevalences were calculated.
Results:The overall high and low risk HPV prevalence in Han nationality was 13.81% and 3.15%,respectively.Both high and low risk HPV prevalence of Uygur minority women is 50%of Han.HPV 16 and/or 18 prevalence was 74.6%in CIN2 and more serious.In this recta-analysis,overall low-risk HPV prevalence was 84.2%of CA.HPV 6 and/or 11-positive fraction was 83.0%in mainland China.
Conclusion:HPV 16 was the most common HPV type in high-grade cervical lesion of China.HPV 6 and 11 was the most common types in CA.HPV 6/11/16/18 prophylactic vaccine are estimated to provide about 74.6%and 83.0%protection against CIN2 plus and CA in mainland China.
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