导流杂交基因芯片技术在人乳头状瘤病毒检测中应用的研究  

Application research on the flow-through hybridization and gene chip in human papillomavirus detection

作　　者：陶萍萍[1] 卞美璐[1] 欧华[1] 陈庆云[1] 李敏[1] 刘军[1] 

机构地区：[1]中日友好医院妇产科,北京100029

出　　处：《中华妇产科杂志》2006年第1期43-47,共5页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的评价导流杂交基因芯片技术,即凯普导流杂交HPV DNA检测法(简称HybriMax)在女性生殖道人乳头状瘤病毒(HPV)感染检测中的临床效用。初步探讨女性生殖道感染最常见的HPV基因型。方法从2004年6月—2005年5月在中日友好医院妇科行宫颈癌筛查的患者7520例中选取591例,包括宫颈细胞学检查正常者138例,异常者453例,并对异常者按组织病理学分为炎症组、宫颈上皮内瘤变(CIN)Ⅰ组、CINⅡ组、CINⅢ组、宫颈癌组和湿疣组。采用HybriMax方法对591名患者进行宫颈细胞21种HPV基因型分型检测,并对其中的413例同时采用第二代杂交捕获(HC-Ⅱ)试验行13种高危型HPV检测。另选取453例细胞学异常者中的101例患者的组织切片进行原位杂交HPV16、18检测。比较不同方法检测结果的一致性,计算用HybriMax法检测的各组患者不同HPV基因型的阳性率。结果HybriMax与HC-Ⅱ两种方法检测13种高危型HPV的总符合率92·5%(382/413),总Kappa指数(KI)0·814,宫颈癌组符合率100·0%;与原位杂交检测结果符合率89·1%(90/101),KI为0·776。10种最常见的HPV基因型依次(按阳性率递减)为:细胞学正常者16、68、18、52、58、11、53、31、39、33;细胞学异常者16、52、58、18、33、31、81、53、68、66,宫颈癌组16、18、52、58、33、66、68、31、51、53。结论HybriMax与HC-Ⅱ、原位杂交检测结果一致性良好,且能对更多基因型确切分型。宫颈病变患者最常见的6种HPV基因型为16、18、52、58、33、31。Objective To evaluate the clinical efficacy of flow-through hybridization and gene chip （HybriMax） on female low genital human papillomavirus （HPV） detection and to identify the most common HPV genotypes. Methods Five hundred and ninety-one of 7520 women who received cervical cancer screening in China-Japan Friendship Hospital during Jun 2004 to May 2005 were selected for 21 genotypes HPV detecting by HybriMax, including 138 women with normal cytological diagnosis and 453 women with abnormal cytological diagnosis. The abnormal patients were classified into groups according to their histological diagnosis as chronic cervicitis, cervical intraepithelial neoplasia （CIN） Ⅰ , Ⅱ , Ⅲ, cervical cancer and condyloma acuminata. Among them 413 women were tested with HC- Ⅱ for 13 types of high-risk HPV, and 101 paraffin-embedded specimens from these 453 patients were detected for HPV16, 18 with in situ hybridization （ISH）. The accordance of the results was compared. The infection rates of each HPV type for each group were calculated. Results The total accordant rate of HybriMax and HC- Ⅱ on 13 types of high-risk HPV detecting was 92. 5% （382/413） and was 100. 0% in group of cancer. The accordance was good, and the Kappa index （KI） was as below： overall 0. 814, in normal group 0. 750, in chronic cervicitis 0. 781, in CIN Ⅰ 0. 755, in CIN Ⅱ 0. 619, in CINⅢ 0. 548, in condyloma acuminata 0. 800. The accordant rate of HybriMax and ISH was 89. 1% （90/101）, and KI was 0.766. The 10 most common genotypes were （in descending sequences） ： in normal group 16, 68, 18, 52, 58, 11, 53, 31,39, 33; in abnormal group 16, 52, 58, 18, 33, 31,81,53, 68, 66, in cervical cancer 16, 18, 52, 58, 33, 66, 68,31, 51, 53. Conclusions HybriMax has good accordance to HC-Ⅱ and ISH for HPV detection. It provides useful information on viral genotype and is more suitable for clinical use. The 6 most common genotypes in abnormal cytological group are 16, 18, 52, 58, 33, 31.

关 键 词：乳头状瘤病毒 人 基因型 寡核苷酸序列分析 原位杂交 宫颈肿瘤 宫颈上皮内瘤样病变 

分 类 号：R450[医药卫生—治疗学]