摘要目的:了解北京部分地区女性宫颈液基细胞学检查(thinprep cytologic test，TCT)病理诊断为未发现上皮内病变及癌变、宫颈低级别鳞状上皮内病变(low grade squamous intraepithelial lesion，LSIL)及宫颈高级别鳞状上皮内病变(high grade squamous intraepithelial lesion，HSIL)3组人群高危型人乳头瘤病毒(human papillomavirus，HPV)亚型感染以及年龄分层的感染情况。方法:收集2019年1月至2019年12月就诊于首都医科大学附属北京安贞医院妇产科的女性宫颈脱落细胞标本，利用高危型HPV分型核酸测定试剂盒[荧光定量聚合酶链式反应(polymerase chain reaction，PCR)法]进行基因分型检测，对结果进行回顾性分析，筛选其中同时行TCT检测患者结果，按TCT病理学诊断分为3组，将诊断为未发现上皮内病变及癌变患者纳入对照组(以下简称对照组)，以及宫颈TCT-LSIL组和宫颈TCT-HSIL组，采用χ 2检验分析其分布特征。 结果:对照组(561例)中，至少有一个亚型感染的例数为68例，总阳性率为12.12%；TCT-LSIL组(385例)中，至少有一个亚型感染的例数为288例，总阳性率为74.81%；宫颈TCT-HSIL组(170例)中，至少有一个亚型感染的例数为128例，总阳性率为75.29%。对照组阳性率最高的是52型，宫颈TCT-LSIL组和宫颈TCT-HSIL组阳性率最高的是16型。16、18、31、33、39、45、51、52、56、58、68型的感染率在3组之间差异均有统计学意义( P均<0.05)。所有型别中只有16型在宫颈TCT-HSIL组的感染率与对照组和宫颈TCT-LSIL组两两比较差异有统计学意义( P′<0.017)。对所有纳入对象进行年龄分层后，仅16型在不同年龄段之间感染率差异均有统计学意义( P均<0.05)；对3组进行年龄分层后在<31岁年龄段内，16、18、31、33、39、45、51、52、56、58型的感染率在3组间差异均有统计学意义( P均<0.05)；在≥31～<41岁年龄段内，16、18、39、51、52、56、58型的感染率在3组间差异有统计学意义( P均<0.05)；在≥41～<51岁年龄段内，16、18、35、52、56、58型的感染率在3组间差异均有统计学意义( P均<0.05)；在≥51岁年龄段内，16、18、31、33、51、52、58型的感染率在3组间差异有统计学意义( P均<0.05)。TCT-LSIL组进行年龄分层后16型、45型在<31岁、≥31～<41岁、≥41～<51岁和≥51岁4个年龄段感染率差异均有统计学意义( P均<0.05)，而对照组和宫颈TCT-HSIL组各个年龄段之间各个亚型的感染率差异均无统计学意义( P均>0.05)。 结论:HPV分型中的16、18、51、52、58型在HSIL患者中感染率高，是引起宫颈病变的主要HPV类型，且在HSIL患者不同年龄段内HPV各个型别的感染率相当。

abstractsObjective:To investigate the infection status and the infection rate of age stratification of human papillomavirus (HPV) subtypes in women at some areas of Beijing, who were diagnosed with no intraepithelial lesions and canceration, low grade squamous intraepithelial lesions (LSIL) and high grade squamous intraepithelial lesions (HSIL), based on the diagnosis of women′s thinprep cytologic test(TCT).Methods:From January 2019 to December 2019, the cervical exfoliated cells of women who presented in Department of Gynaecology and Obstetrics of Beijing Anzhen Hospital Affiliated to Capital Medical University were collected, and the high-risk HPV typing nucleic acid test kit (fluorescence quantitative PCR) was used for genotyping.The results were retrospectively analyzed.Meanwhile, the patients who were tested by TCT at the same time were screened.According to the TCT pathological diagnosis, these patients were divided into three groups: no intraepithelial lesions and canceration (hereinafter referred to as the control group), low-grade squamous intraepithelial lesions (TCT-LSIL) and high-grade squamous intraepithelial lesions (TCT-HSIL). The chi square test was used for the statistical analysis.Results:In control group (561 cases), 68 cases were infected by at least one subtype of HPV, with a total positive rate of 12.12%.In TCT-LSIL group (385 cases), 288 cases were infected by at least one subtype of HPV, with a total positive rate of 74.81%.In TCT-HSIL group (170 cases), 128 cases were infected by at least one subtype of HPV, with a total positive rate of 75.29%.The highest positive rate was type 52 in the control group, while the highest positive rate was type 16 in the TCT-LSIL and TCT-HSIL groups.The infection rate of the three groups increased with the increase of cervical pathological grade.The infection rates of type 16, 18, 31, 33, 39, 45, 51, 52, 56, 58 and 68 were significantly different among the three groups (all P<0.05). The infection rate of HPV16 in the TCT-HSIL group was significantly higher than that in the control group and the TCT-LSIL group(P′<0.017). After all the subjects were stratified by age, only type 16 had statistical difference in infection rate among different age groups (all P<0.05). After age stratification of three groups, within the age<31 years old, the infection rates of 16, 18, 31, 33, 39, 45, 51, 52, 56 and 58 types were statistically different among the three groups (all P<0.05). In the age range of ≥31-<41 years old, the infection rates of 16, 18, 39, 51, 52, 56 and 58 types were statistically different among the three groups (all P<0.05). In the age range of ≥41-<51 years old, the infection rates of 16, 18, 35, 52, 56 and 58 types were statistically different among the three groups (all P<0.05). In the age≥51 years old, the infection rates of 16, 18, 31, 33, 51, 52 and 58 types were statistically different among the three groups (all P<0.05). After the age stratification of TCT-LSIL group, the infection rates of 16 and 45 types were statistically different among in the four groups of<31, ≥31-<41, ≥41-<51 and ≥51 years old (all P<0.05). However, there was no significant difference in the infection rate of each subtype in the control group and the TCT-HSIL group(all P>0.05). Conclusion:HPV subtypes 16, 18, 51, 52, and 58 are the main infection types in high grade squamous intraepithelial lesion patients, which are the main types of HPV caused cervical lesions.In addition, the infection rates of HPV in patients with cervical high-grade squamous intraepithelial lesionsare similar in different age groups.