人乳头状瘤病毒不同亚型感染与宫颈病变的相关性  

The association between human papillomavirus (HPV) types infection and the cervical lesions

作　　者：杨英捷[1] 赵健[1] 李雪倩[1] 廖秦平[1] 

机构地区：[1]北京大学第一医院妇产科,100034

出　　处：《中国妇产科临床杂志》2006年第4期253-256,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：国家"十五"攻关科研基金资助项目(2004BA720A05-01)资助

摘　　要：目的了解门诊高危人群和宫颈病变患者的人乳头状瘤病毒(HPV)感染的型别分布,探讨不同HPV亚型感染的致癌性。方法采用导流杂交技术,对门诊就诊的1715名有性生活史妇女,进行下生殖道HPV感染分型筛查。其中463例经阴道镜下定点宫颈活检,病理确诊分为宫颈炎症234例、CINⅠ96例、CINⅡ80例和CINⅢ53例。分析人群HPV感染的型别分布、与宫颈病变相关性。结果21种HPV亚型均被检出,1715名门诊妇女中HPV阳性率57.1%(9781715),宫颈病变中为76.9%(356463),而在CINⅢ中达98.1%(5253)。常见的5种亚型分布:高危人群为HPV16、58、52、33和6型;宫颈病变为HPV16、58、52、33和31型;CINⅢ中为HPV16、33、58、31和52型。HPV16、33和31型与宫颈病变程度相关(P<0.05),Logistic回归分析,高级别鳞状上皮内瘤变(HSIL,CINⅡ+CINⅢ)的主要风险也是感染HPV16、33和31型(OR9.59、2.99和2.52,95%CI4.805～11.989、1.231～7.296和1.174～5.429)。结论本地区宫颈病变的常见型别是HPV16、58、52、33和31型,HPV16、33和31型是HSIL的主要致病型。Objective To investigate the human papillomaviras （HPV） types detected in outpatient women and patients with cervical lesions, and to analyze the oncogenesis of the various HPV types. Methods A total of 1715 outpatient women were checked for 21 HPV DNA types by DNA flow- through hybridization genotyping technique, 463 women who undergo colposeopy and cervical biopsy were collected. According to the pathological diagnosis, the patients were divided into four groups： 234 in inflammatory group, 96 in CIN Ⅰ group, 80 CINⅡ and 53 CINⅢ. The association between HPV types and different cervical lesions was analyzed. Results All of 21 types HPV were detected, the infection rates of outpatient women, women with cervical lesions and patients with CINⅢ, were 57.1% （978/1715）, 76.9% （356/463） and 98.1% （52/53） respectively. HPV 16 was the most common type, the other common types （in descending order of frequency） ： in outpatient women 58, 52, 33 and 6, in patients with cervical lesions 58, 52, 33 and 31, in CINm 33, 58, 31 and 52. By logistic regression, the high- grade squamous intraepithelial lesions （HSIL, CINⅡ ＋ CINⅢ） was associated with detection of HPV 16, 33 and 31 （OR 9.59, 2.99 and 2.52, 95%CI 4.805 ～ 11.989, 1.231～ 7.296 and 1.174 ～ 5.429）. Conclusions HPV types 16, 58, 52, 33 and 31 are more common in cervical lesions, the major pathogenic types were HPV 16, 33 and 31.

关 键 词：人乳头状瘤病毒 基因亚型 宫颈病变 

分 类 号：R737.33[医药卫生—肿瘤]