| Objective: To analyze the infection status of human papilloma virus(HPV)in Hunan women in central China,and provide scientific evidence for the prevention and treatment of cervical cancer in Hunan.Methods: Using computer to search the Chinese and English databases,as PubMed,The Cochrane Library,EMbase,CNKI,CBM,WanFang Data and VIP Data,supplemented by manual search to collect published studies concerning the infection of female cervical human papillomavirus in Hunan.The search time limit is from the time of building the library to December 31,2018.Two of our independent researchers(Postgraduate)independently screened the retrieved studies according to inclusion and exclusion criteria.The Newcastle-Ottawa Scale(NOS)scale was used for quality evaluation in the cohort study literature included in the study,The cross-sectional study literature included in the study was evaluated using the cross-sectional study bias risk assessment criteria recommended by the Agency for Healthcare Research and Quality(AHRQ).We extracted the data of the subjects,age,study area,source of DNA,detection method,number of samples,number ofHPV positive cases,number of HPV positive cases of each type,number of positive cases of each type and publication year.Stata 14.0 software was used to calculate the co-infection rate and 95% confidence interval(CI),and using the Review Manager 5.3 software M-H method to analyze the Odds Radio(OR)and 95% confidence interval(CI)of the six high-risk HPV subtypes in the cervical intraepithelial neoplasia group and cervical cancer group.The count data were analyzed by chi-square test using SPSS 23.0 statistical software,and p<0.05 indicated that the difference was statistically significant.Results: According to the inclusion and exclusion criteria formulated in this article,a total of 18 documents,16 Chinese sources and 2 English sources were included.(1)The top nine HPV infection rates of the cervix of the subjects in Hunan were HPV 16,52,58,81,6,53,33,11 and 18.The top nine HPV infection rates in the physical examination population were HPV 52,58,16,53,33,68,39,18 and 31.High-risk HPV infection was predominant in cervical intraepithelial neoplasia and invasive cervical cancer.The top nine infection rates in cervical intraepithelial neoplasia were HPV 16,58,52,33,31,18,53,39 and 51.The top nine HPV types in invasive cervical cancer women were HPV 16,58,18,52,53,31,39,81 and 6,and low-risk HPV11 is also carcinogenic.The infection rate of HPV16 and 18 in cervical cancer group was higher than that in cervical intraepithelial neoplasia group,suggesting that type 16 and 18 were more carcinogenic.HPV35 and 56 infections were not detected in cervical cancer group.(2)Vaccine coverage of cervical intraepithelial neoplasia in the region:bivalent vaccine: 35.68%,tetravalent vaccine: 37.05%,nine-valent vaccine:76.59%.Vaccine coverage for cervical cancer in the region: bivalent vaccine:67.43%,tetravalent vaccine: 70.03%,nine-valent vaccine: 88.92%.(3)The HPV infection rate of the subjects was 22.1%,and the HPV infection rate of the physical examination population was 11.11%.The incidence of cervical lesions in the population was 6.61%,mainly with low-grade cervical intraepithelial neoplasia(3.17%)and high-grade cervical intraepithelial neoplasia(2.77%),while the incidence of cervical cancer(0.66%)was relatively low.The HPV infection rate of cervical lesions was75.29%.As the degree of cervical lesions worsened,the HPV infection rate increased.The low-grade cervical intraepithelial neoplasia,high-grade cervical intraepithelial neoplasia and cervical cancer HPV infection rates were59.79%,81.06% and 87.63%,respectively.The HPV infection rate of cervical lesions was 75.29%.As the degree of cervical lesions worsened,the HPV infection rate increased.The HPV infection rates of low-grade cervical intraepithelial neoplasia,high-grade cervical intraepithelial neoplasia and cervical cancer were 59.79%,81.06% and 87.63%,respectively.(4)Group by age,the HPV infection rate of different age groups showed a "U" distribution,the HPV infection rates of people aged ?30 years,31-40 years old,41-50 years old,and >50 years old were: 25.19%,19.47%,19.87%,21.62%,respectively.The incidence of cervical lesions of different age groupsshowed a "V" distribution.The incidence of cervical lesions in people aged?30 years,31-40 years,41-50 years,and >50 years old were 6.01%,5.73%,6.68%,and 9.17%,respectively.(5)The incidence of low-grade,high-grade cervical intraepithelial neoplasia and cervical cancer in the population of ?30 years old were 4.14%,1.85% and 0.02%,respectively.The incidence of low-grade,high-grade cervical intraepithelial neoplasia and cervical cancer in the 31-40 year old population were 3.12%,2.41%,and 0.19%,respectively.The incidence of low-grade,high-grade cervical intraepithelial neoplasia and cervical cancer in the 41-50 year old population were 3.16%,3.18% and 0.34%,respectively.The incidence of low-grade,high-grade cervical intraepithelial neoplasia and cervical cancer in people older than 50 years were 2.01%,4.08%,and 3.28%,respectively.It is suggested that the incidence of cervical cancer increases with increasing age.Conclusion: 1.The cervical HPV dominant types of the subjects in Hunan were HPV16,52,58,81,6,53,33,11,18.The HPV dominant types of physical examination population were HPV52,58,16,53,33,68,39,18,31.The main types of cervical intraepithelial neoplasia were HPV 16,58,52,33,31,18,53,39,51.High-risk HPV 16,58,18,52,53,31,39 and low-risk types 81 and 6 were the main types of invasive cervical cancer.The low-risk HPV 11 is also carcinogenic.2.HPV81,6,11 in this region should be the sub-high risk type of cervicalcancer.3.Vaccine coverage of cervical intraepithelial neoplasia in the region:bivalent vaccine: 35.68%,tetravalent vaccine: 37.05%,nine-valent vaccine:76.59%.Vaccine coverage for cervical cancer in the region: bivalent vaccine:67.43%,tetravalent vaccine: 70.03%,nine-valent vaccine: 88.92%.4.Although the HPV infection rate of the subjects was higher,the incidence of cervical lesions was lower,and mainly in the precancerous stage,a small number of cervical cancers occur.The prevention of cervical cancer is mainly based on screening,and the health economic benefits of vaccination for the appropriate age group are debatable.5.According to China's national conditions,it is more hygienic and economical for women over 30 years of age to start cervical cancer screening. |
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