背景:调查年轻和中年女性中常见性传播感染(STIs)的患病率以及STI/人乳头瘤病毒共感染与既往宫颈异常检查结果的相关性。
方法:719例宫颈拭子细胞刷标本取自年龄≤50岁的女性,因既往宫颈异常而在北京大学第一医院接受阴道镜检查。使用21HPVGenoArray诊断试剂盒(HBGA-21PKG;HybrioBio,Ltd.,潮州,中国)和核酸STI检测试剂盒(广州杂交生物有限公司,中国),之后进行阴道镜检查和多点定位活检。
结果:既往宫颈癌筛查结果异常的HPV阳性女性中,性传播感染的总体患病率为63.7%(458/719)。高危型HPV阳性患者中,细小脲原体3型,细小脲原体6型和单纯疱疹病毒2型的患病率明显较高(19.3%,X2=5.725,P=0.018;21.5%,X2=4.439,P=0.035;5.7%,X2=4.184,P=0.048)。在高危型人乳头瘤病毒阳性的患者中,人乳头瘤病毒16/18阳性患者淋病奈瑟菌感染率明显高于其他患者(2.5%,X2=4.675;P=0.043)。组织病理学,沙眼衣原体感染在低于或等于低度鳞状上皮内病变感染状态下更常见(13.0%,X2=3.368;P=0.041)。
结论:HPV与其他性传播病原体共同感染的患病率较高,特别是细小脲原体3型,细小脲原体6型和单纯疱疹病毒2型,要求对宫颈癌筛查结果异常的患者进行常规的性传播感染筛查和有效的性传播感染预防和管理.
To investigate the prevalence of common sexually transmitted infections (STIs) and the association of STI/human papillomavirus co-infection in young and middle-aged women with previous abnormal cervical findings referred for colposcopy.
719 cervical-swab cytobrush specimens were obtained from women aged ≤ 50 years who were referred for colposcopy at Peking University First Hospital due to previous abnormal cervical findings. HPV 21 typing and a panel of pathogenic STIs were tested for using the 21 HPV GenoArray Diagnostic Kit (HBGA-21PKG; HybriBio, Ltd., Chaozhou, China) and a nucleic acid STI detection kit (HybriBio Ltd. Guangzhou, China), after which colposcopy with multipoint positioning biopsy was performed.
The overall prevalence of STIs among HPV positive women with previous abnormal cervical cancer screening results was 63.7% (458/719), with Ureaplasma parvum serovar 3, Ureaplasma parvum serovar 6 and herpes simplex virus type 2 having significantly higher prevalence among high-risk HPV positive patients (19.3%, Χ2 = 5.725, P = 0.018; 21.5%, Χ2 = 4.439, P = 0.035; 5.7%, Χ2 = 4.184, P = 0.048). Among patients positive for the high-risk human papillomavirus, the prevalence of Neisseria gonorrhoeae infection in human papillomavirus 16/18 positive patients was significantly higher than that in other patients (2.5%, Χ2 = 4.675; P = 0.043). Histopathologically, Chlamydia trachomatis infection was more frequently detected in lower than or equal to low-grade squamous intraepithelial lesion infection status (13.0%, Χ2 = 3.368; P = 0.041).
The high prevalence of HPV coinfection with other sexually transmitted pathogens, particularly Ureaplasma parvum serovar 3, Ureaplasma parvum serovar 6, and herpes simplex virus type 2, calls for routine STI screening and effective STI prevention and management in patients with abnormal cervical cancer screening results.