目的:調查澳門婦女宮頸人類乳頭狀瘤病毒(HPV)感染的基因型,爲制訂預防宮頸癌策略提供依據。方法:對澳門411例女性進行宮頸細胞學檢查和HPV分型檢測。宮頸細胞學採用SurePathTM塗片檢查和顯微鏡下觀察,而HPV分型採用HPV基因陣列檢測。將獲得的HPV基因分型和細胞學改變結果進行相關分析。結果:年齡-HPV感染頻率呈雙峰形,第1高峰在25歲~30歲(21.3%),第2高峰期在35歲~40歲(14.4%)。25.6%HPV陽性病例為多種HPV類型的混合感染。在陽性病例中,大多數(82.3%)感染高/可能高風險的HPV病毒類型。HPV52是感染最常見的類型,佔陽性檢出率的18.5%,其次感染高/可能高風險的HPV病毒類型為HPV16(12.0%)、HPV58(10.2%)、HPV53(9.3%)、HPV31(8.8%)、HPV66(4.6%)、HPV18(3.7%)、HPV39、HPV42和HPV51(均為2.8%)、HPV56和HPV59(均為2.3%)、HPV35、HPV45和HPV68(均為1.4%)、HPV33(0.9%)。感染HPV52患者的細胞學改變與感染HPV16和HPV18的患者比較在統計學上無顯著性差異。結論:由於HPV感染累及青年婦女,在澳門應儘早開展預防感染教育和疫苗接種。HPV52是最常檢出的類型,建議在HPV疫苗增加HPV52型,以提高HPV疫苗對澳門人群接種的成本效益。
Objective: To investigate the genotype of HPV infection in Macanese women and to formulate strategies in prevention of cervical cancer. Methods: Cervical cytology and HPV genotyping were undertaken in 411 Macanese women. Cervical cytology was done by SurePath TM smear and observed under microscopy, HPV genotyping was performed by HPV gene array analysis. The relationship between the HPV genotyping and its cytological change were analyzed. Results: The age-specific prevalence HPV infection rate showed the bimodal distribution, the first peak were of age 25-30years old (21.3%) and the second peak were of 35-40 years old (14.4%), coinfection with multiple types of HPV infection were detected in 25.6% of positive cases. Majority (82.3%) of positive samples harbored showed high or probable high risk types. HPV 52 was the most common type found 18.5% of positive samples, followed by HPV 16(12.0%), HPV58(10.2%), HPV53 (9.3%), HPV31 (8.8%), HPV66(4.6%), HPV18(3.7%),HPV3 and HPV51 (2.8%)each., HPV56 and HPV59(2.3%) each, HPV35 HPV45 and HPV68(1.4%)each respectively, HPV33 (0.9%). There was no statistical difference in cervical cytological change between the patients with HPV 52 and HPV16 or HPV 18 infection. Conclusion: Because young women are involved in HPV infection, education and vaccination campaigns should initiate early in Macao. To achieve the most cost-effective implementation of HPV vaccination, it is suggested that the vaccine should contain HPV 52 as it's the most common type of HPV infection in Macanese women.