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西藏高海拔地区成年女性HPV阳性情况调查分析：单中心横断面研究

Investigation and Analysis of HPV Positivity Among Adult Women in High-altitude Regions of Xizang: A Single-center Cross-sectional Study

    摘要
  • 摘要:
    目的 探究西藏高海拔地区成年女性人群人乳头瘤病毒(human papillomavirus, HPV)检出现况。
    方法 对2019年3月—2023年7月西藏自治区人民医院门诊、住院患者及健康体检的成年女性人群HPV基因检测结果进行回顾性总结。比较不同民族、年龄组女性HPV阳性率，并分析HPV阳性率随时间的变化趋势。
    结果 共纳入行HPV检测的成年女性6498人，平均年龄(39.5±9.8)岁；藏族5440人，汉族1058人。整体HPV阳性率为19.58%(1272/6498)，且以单一阳性为主(14.99%)，双重阳性(3.71%)、三重及以上的多重阳性率(0.88%)较为少见。汉族女性HPV阳性率显著高于藏族女性29.30%(310/1058)比17.68%(962/5440)，P＜0.001。藏族女性中，高危型HPV阳性率居前5位的型别分别是HPV 52(3.27%)、HPV 16(2.68%)、HPV 58(2.35%)、HPV 53(1.64%)和HPV 31(1.18%)，汉族女性中分别为HPV 52(6.24%)、HPV 16(5.39%)、HPV 58(3.40%)、HPV 53(2.27%)、HPV 68(1.89%)。整体人群中，＜25岁和60~64岁年龄组HPV阳性率最高，分别为36.76%和32.41%；且随年龄升高，藏族女性HPV阳性率呈“U”形趋势，而汉族女性中无此种变化趋势。不论是整体人群，还是按藏、汉民族进行分别统计，2019—2023年西藏高海拔成年女性HPV阳性率整体均呈下降趋势，但2023年出现一定回升。
    结论 西藏高海拔地区成年女性HPV阳性率较高，且藏族女性与汉族女性在不同年龄组的HPV阳性率及高发型别存在显著差异。应重点加强西藏高海拔地区年轻女性HPV疫苗接种及年轻女性、绝经后女性人群的HPV筛查和诊治工作。

     

    Abstract:
    Objective To investigate the detection status of human papillomavirus (HPV) among adult women in high-altitude regions of Xizang.
    Methods A retrospective analysis was conducted on HPV genotyping results from outpatient, inpatient, and healthy adult female populations at Xizang Autonomous Region People's Hospital between March 2019 and July 2023. HPV positivity rates were compared across different ethnic groups and age strata, and temporal trends in HPV detection were analyzed.
    Results A total of 6498 adult women with HPV testing were included, with a mean age of (39.5±9.8) years, including 5440 Tibetan and 1058 Han women. The overall HPV positivity rate was 19.58%(1272/6498), predominantly single-type infections (14.99%), while double (3.71%) and triple-or-more infections (0.88%) were less common. Han women had a significantly higher HPV positivity rate than Tibetan women 29.30%(310/1058) vs. 17.68% (962/5440), P < 0.001. Among Tibetan women, the top five high-risk HPV types were HPV 52(3.27%), HPV 16(2.68%), HPV 58(2.35%), HPV 53(1.64%), and HPV 31(1.18%). In Han women, the most prevalent types were HPV 52(6.24%), HPV 16(5.39%), HPV 58(3.40%), HPV 53(2.27%), and HPV 68(1.89%). In the overall population, the highest HPV positivity rates were observed in the < 25 years(36.76%) and 60-64 years(32.41%) age groups. Tibetan women exhibited a U-shaped age-specific HPV prevalence trend, whereas no such pattern was observed in Han women. From 2019 to 2023, HPV positivity rates showed an overall declining trend in both ethnic groups, though a slight rebound occurred in 2023.
    Conclusions The HPV positivity rate among adult women in high-altitude Xizang is relatively high, with significant differences in age-specific prevalence and dominant genotypes between Tibetan and Han women. Targeted measures, including HPV vaccination for young women and enhanced screening and treatment for both young and postmenopausal women, should be prioritized in this region.

     

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