| Objective:High risk human papillomavirus(HR-HPV) infection is a major risk factor for cervical cancer and precancerous lesions. It is very significant to discover HR-HPV infection, finding and treating the cervical precancerous lesions as early as possible to prevent the occurrence of cervical cancer and to reduce the incidence of cervical cancer. This paper studies characteristics and influencing factors of HR-HPV infection of female workers in the coal mine through investigating high-risk human papillomavirus detection and related factors of female workers in Jincheng Coal Industry Group. It will provide scientific basis to prevent high-risk human papillomavirus infection.Methods:The objects of this study include 6325 female workers in Jincheng Coal Industry Group, who accepted screening of cervical cancer from September 2011 to October2012. We collected the demographic characteristics of the respondents, the level of education, the work characteristics, female reproductive factors, the previous gynecological history, the family history of cancer, social pressure and other factors related to HPV. In order to get the infection status of high risk human papillomavirus(HR-HPV) in the population of high risk human papillomavirus, we adopted HC-II method to do DNA HR-HPV detection. Furthermore, influence factors of HR-HPV infection were analyzed by comparing between HR-HPV positive cases(case group)and the HR-HPV negative group(control group). Then we researched on the correlation between HPV DNA load of infected patients and liquid based cytology and cervical lesions. Chi-square test and multivariate non-conditional logisticregression analysis, variance analysis and spearman rank test for correlation are all processed in statistical software SPSS17.0. When the difference P<0.05, it is statistically significant.Results:1. Infection status of female workers in the coal mines: The HR-HPV infection rate of female workers in Jincheng Coal Mining Group is 22.2%.2. Infection characteristics of female workers in the coal mine: The HR-HPV infection rate of 30-50 years of age is higher than other ages, which 30-39 years’ infection rate was 26.3%, 40-49 years’ infection rate was 26.7%; The infection rate of education degree of junior high school and below was the highest(25.9%) and undergraduate and above is the lowest(17.5%). The HR-HPV infection rate of underground female workers(25.9%) is higher compared with well female workers(18.8%).3. Single factor analysis: The HR-HPV infection is related to age(χ2=145.666,P<0.001,OR95%CI:0.487-0.717),education(χ2=38.016,P<0.001,OR95%CI:0.501-0.728),underground operation(χ2=45.989, P<0.001, OR95%CI:1.340-1.701), menopause(χ2=28.989, P<0.001, OR95%CI:0.487-0.717), contraception(χ2=28.989,P<0.001,OR95%CI:0.487-0.717), the use of the contraceptive Pill(χ2=6.682, P=0.035,OR95%CI:1.046-1.413), pregnant more than 3 times(χ2=56.599, P<0.001,OR95%CI:1.845-2.892), birth equal to or more than 2 times(χ2=7.015,P=0.008,OR95%CI:1.061-1.492), abortion(χ2=29.631, P<0.001, OR95%CI:1.237-1.573),artificial abortion(χ2=4.494,P=0.034,OR95%CI:1.010-1.285), abortion more than 3times(χ2=36.378,P<0.001,OR95%CI:1.373-2.749), with a history of gynecologic history(χ2=17.692, P<0.001, OR95%CI:1.275-1.961) secretion abnormalities(χ2=11.229,P=0.001,OR95%CI:1.128-1.586), vaginal abnormalities(χ2=7.562,P=0.006, OR95%CI:1.105-1.829), cervical abnormalities(χ2=14.268, P<0.001,OR95%CI:1.118-1.421).4. Multivariate logistic regression analysis: Menopause is the protective factor of HR-HPV infection(OR=0.466, OR95%CI: 0.376-0.577). Taking contraceptive measures(OR=1.169, OR95%CI: 1.015-1.347), birth equal to or more than to 2 times(OR=1.620, OR95%CI: 1.338-1.961), abortion(OR=1.496, OR95%CI: 1.138-1.968),abortion more than 3 times(OR=1.609, OR95%CI: 1.004-2.770), having gynecological history previous(or = 1.209. OR95%CI: 1.001-1.563) and examination of vaginal secretions abnormity(OR=2.550, OR95%CI: 2.082-3.122) and examination of cervical abnormity(OR=1.257, OR95%CI: 1.110-1.423 are HR-HPV infection risk factors.5. Analysis of the relationship between DNA HR-HPV load and cytology: The detection rate of HR-HPV DNA load less than or equal to 100 RLU/CO and more than 100 RLU/CO in non-epithelial cells within the lesion or malignant lesion(NILM)were 77.5% and 22.5%, in Atypical squamous cells of undetermined significance(ASC-US) were 58% and 42%, in low-grade squamous intraepithelial lesions(LSIL)were 45.5% and 54.5%, in high-grade squamous intraepithelial squamous cell and carcinoma(HSIL/ SCC) were 41.5% and 59.5%. With aggravation of cells lesions, the proportion of. HR-HPV DNA load more than 100 RLU/CO increases. The highest level in different liquid based cytology level of lesion load is HSIL/SCC group(565.23±73.557), followed by LSIL(465.17±56.192), ASC-US(336.78±51.961),NILM(163.85±30.170). With the increase of the cytological lesions grade, HR-HPV DNA load increases.6. Analysis of the relationship between HR-HPV DNA load and cervical lesions:The detection rate of HR-HPV DNA load less than or equal to 100 RLU/CO and more than 100 RLU/CO in cervical squamous epithelial hyperplasia or inflammation were65.3% and 34.7%, in neoplasia CIN I(mild dysplasia) of cervical intraepithelial were 45.2% and 54.8%, in neoplasia CIN II(moderate dysplasia) of the grade of cervical intraepithelial were 36.4% and 63.6%, in neoplasia grade CIN III(severe dysplasia and carcinoma in situ) of cervical intraepithelial were 10.2% and 89.8%, in squamous cell carcinoma(SCC) were 10% and 90.0%. With the severity of cervical lesions, the ratio of HR-HPV DNA load more than 100 RLU/CO increases. The highest in different load levels of cervical lesions group is SCC(859.32±65.596),followed by CINIII(769.51±56.680), CIN II(513.12±64.587), CINI(417.88±61.102),cervicitis(284.60±52.108). With the increase of the degree of cervical lesions,HR-HPV DNA load increases.Conclusions:1. The HR-HPV infection rate of female workers in Jincheng Coal Industry Group is 22.2%. The HR-HPV infection rate of 30-50 years old female workers is higher, as well as that of the underground operation female workers. With the improvement of the level of education, HR-HPV infection rate is gradually decreasing.So the main objects to Prevent and control HPV infection are underground operation groups, 30-50 years old age groups and low educational level groups.2. Menopause is the Protective factor of HR-HPV infection. Taking contraceptive measures, equal or more than to 2 times birth, abortion, many miscarriages, having gynecological history previous, examination of vaginal secretions abnormity and examination of cervical abnormity are risk factors of HR-HPV infection. putting forward corresponding prevention and control measures according to these risk factors is significant to reduce the female HR-HPV infection rate and the related diseases.3. The higher the grade of cytology, the more severe the lesion of cervical biopsy, the higher the DNA HR-HPV load and the higher the DNA HR-HPV load, the greater the risk of cervical precancerous lesions and cervical cancer. HR-HPV DNA load can be warning indicators of cervical cells and cervical lesions. |
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