关键词: 宫颈肿瘤, 筛查, 高危人乳头瘤病毒, 薄层液基细胞学检查, 阴道镜检查

Abstract: Background　Cervical cancer is a highly prevalent malignancy in women，which can be effectively prevented through standardized screening based on its clarified etiology. However，cytology-based cervical cancer screening programs are unfeasible in Xinjiang Uyghur Autonomous Region，where medical resources are inadequate. So it would be meaningful to understand the status of high-risk human papilloma virus（hrHPV）infection in Shihezi region for optimizing the primary hrHPV screening. Objective　To investigate the hrHPV infection status in cervical cancer screening participants aged 30-65 years from urban areas，Shihezi，Xinjiang Uygur Autonomous Region. Methods　The cervical cancer screening data （results of hrHPV DNA testing，ThinPrep cytologic test，colposcopy and histopathology）of 18 378 women，who underwent primary hrHPV screening at First Affiliated Hospital，School of Medicine，Shihezi University，Shihezi People's Hospital，and Shihezi Maternal and Child Health Hospital during December 2018—May 2019，were retrospectively collected. The prevalence of hrHPV subtypes（hrHPV16 and/or 18 positive versus other hrHPV positive）were comparatively analyzed. The prevalence of hrHPV was compared between four age groups（30-39，40-49，50-59，and 60-65）. Results　Among the participants，the hrHPV prevalence was 15.32%（2 816/18 378），with single infections accounting for 11.38%（2 092/18 378）and multiple infections for 3.94%（724/18 378）. The five most common hrHPV subtypes of single infections were hrHPV52（2.37%），hrHPV16（1.65%），hrHPV53（0.97%），hrHPV51（0.90%），and hrHPV39/68（0.87%），hrHPV18 was ranked 11th（0.36%）. Participants infected with both hrHPV16 and hrHPV18 had higher prevalence of cervical lesions than those infected with only hrHPV18（35.71% vs 8.95%），and so did those infected with hrHPV16（30.86% vs 8.95%）（P<0.05）. Although the hrHPV52 was the most frequent subtype，no precancerous cervical lesion or cervical cancer was detected in the cohort with hrHPV52 infection. Among the people with infections of other hrHPV subtypes and histology ≥LSIL revealed by colposcopic cervical biopsies，hrHPV58，hrHPV56，hrHPV51，hrHPV33，and hrHPV39 were more common than other subtypes. In addition，there was a statistically significant difference in hrHPV infection rates between different age groups（χ2=7.866，P=0.049）. Conclusion　The prevalence of hrHPV infection among women in urban areas，Shihezi is high，and infections with single hrHPV are predominant，where infections of hrHPV16 need to be given special attention.

Key words: Uterine cervical neoplasms, Screening, High risk human papillomavirus, Thin layer liquid-based cytology, Colposcopy