人乳头状瘤病毒负荷量与宫颈癌及宫颈癌前病变的相关研究  

Study of the Relationship Between Loads of Human Papilloma Virus Incervical Carcinoma and Cervical Intraepithelial Neoplasia

作　　者：黄志宏[1] 钱德英[1] 王丁[1] 洪淡华[1] 岑坚敏[1] 舒焰红[1] 

机构地区：[1]广东省人民医院妇产科,510000

出　　处：《中国妇幼保健》2006年第11期1557-1559,共3页Maternal and Child Health Care of China

摘　　要：目的：探讨人乳头状瘤病毒（HPV）负荷量与子宫颈癌及其癌前病变的关系.方法：2003年3月～2003年12月在我院行宫颈癌筛查的2 651例患者为研究对象,采用杂交捕获2代（HCⅡ）方法定量检测宫颈HPV DNA的含量（以此表示宫颈HPV负荷量）.按HPV DNA含量分成5组,分别为：HPV＜1,1≤HPV≤100,101≤HPV≤500,501≤HPV≤1 000,HPV＞1 000.对其中HPV DNA阳性妇女,随后进行阴道镜检查、宫颈多点活检和颈管诊刮术.结果：794例阳性患者中的783例进行了阴道镜下多点活检和细胞学诊断,其中子宫颈炎650例（83.23%）,CIN 102例（13.47%）,宫颈癌26例（3.3%）.650例对照组、102例癌前病变组和26例宫颈癌组中,3组的HPV DNA定量总体分布有显著差别（P＜0.005）.在HPV-DNA定量＞100时,宫颈癌前病变的阳性率显著升高（P＜0.005）;当HPV-DNA的定量＞500时,宫颈癌的阳性率显著升高（P＜0.001）.CINⅡ、CINⅢ及宫颈癌在HPV DNA定量＞1时的诊断阳性率较显著＜1时显著高（P＜0.01）.结论：HCⅡ方法是检测宫颈HPV感染的有效手段,HPV DNA含量随宫颈病变的严重程度而增加,可作为宫颈癌前病变及宫颈癌的筛查及病情追踪监测的1项客观指标.Objective： To explore the relationship between loads of human papilloma virus in cervical carcinoma and cervical intraepithelial neoplasia. Methods： From March 2001 to October 2003, 2651 women who were screened high risk types of human papillomavirus （HPV） infection using hybrid capture （HC Ⅱ） . All patients were divided five groups according to the viral load of HPV -DNA , including： HPV 〈 1, 1 ≤ HPV ≤ 100, 101 ≤ HPV ≤500, 501≤ HPV≤1 000, HPV 〉 1 000. Results： Among 794 cases with positive human papilloma virus , 783 cases had been underwent colposcopy and multi - focal directed punch biopsies plus endoeervieal curettage. Of them , 650 （83. 23% ） cases who were normal or cervicitis as control group; 102 （ 13. 47% ） women diagnosed as cervical intraepithelial neoplasia （CIN） , and 26 （3. 3% ） women diagnosed as cervical squamous cell carcinoma （SCC）. Compared three groups, the collectivity distribution of HPV quantity were significantly different. When HPV DNA 〉 100, the rate of diagnosing cervical intraepithelial neoplasia was significantly higher than other groups ; and HPV DNA 〉 500, the masculine rate of diagnosing cervical squamous cell carcinoma was significantly higher （ P 〈 0.005 ） . When HPV DNA 〉 1, the the masculine rate of diagnosing CIN Ⅱ, CIN Ⅲ and SCC were significantly higher than HPV DNA 〈 1 （ P 〈 0.01 ） . Conclusion： The new technology using HC Ⅱ is an effective method to detect HPV infection in cervix. Viral loads of HPV - DNA increase with severity of cervical neoplasia. So it could be used for screening primary cervical carcinoma.

关 键 词：人乳头状瘤病毒 病毒载量 宫颈癌 癌前病变 

分 类 号：R737.3[医药卫生—肿瘤]