桂西地区HPV感染与宫颈病变关系探讨  

To study the relation of HPV infection and cervix lesion in Guixi region

作　　者：常正义[1] 吴惠珍[2] 黄燕[1] 蒋柳艳[2] 卢冬[1] 陈碧艳[3] 黄永秩[4] 

机构地区：[1]右江民族医学院附属医院检验科,广西百色533000 [2]右江民族医学院附属医院妇产科 [3]百色市妇幼保健院检验科 [4]右江民族医学院病理学教研室

出　　处：《中国妇幼保健》2007年第22期3053-3056,共4页Maternal and Child Health Care of China

基　　金：广西壮族自治区卫生课题(Z2005234)

摘　　要：目的:探讨人乳头瘤病毒(HPV)感染与宫颈病变的关系。方法:以桂西地区育龄妇女为研究对象,对疑为HPV感染或宫颈病变的1228病例进行HPV分型检测和液基细胞学检查,对细胞学诊断≥ASCUS及HPV检测为阳性的病例进行阴道镜活检。结果:①HPV检测阳性率为25.30%(311/1228);液基细胞学诊断≥ASCUS为26.3%(324/1228)。在ASCUS、LSIL、HSIL、SCC中HPV的检出率分别为50.6%、66.2%、89.3%、100%。②细胞学诊断阳性≥LSIL19.6%(241/1228)与组织学诊断阳性≥CINI21.7%(266/1228)比较差异无显著性(χ2=1.55,P>0.05),细胞学与组织学诊断符合率为100%的SCC、92.8%的HSIL、88.4%的LSIL。组织学诊断CINⅠ、CINⅡ、CINⅢ、SCC病变中HPV检出率以65.3%、81.5%、89.1%、100%依次递增。③桂西地区育龄妇女HPV感染共检出16种亚型,低危型占17.1%、高危型占82.9%,单一亚型检出率为80.1%,双重或多重亚型感染率19.9%;低危型以HPV6、11为最多见,高危型以HPV16检出率30.1%为最高,其次是HPV58检出率为16.4%,HPV18和31是并列第3常见的高危感染类型。结论:HPV分型检测因其准确性高并能明确基因类型,联合液基细胞学和组织学更能有效地筛查宫颈病变细胞,为临床防治宫颈癌提供更可靠的科学依据。Objective： To discuss the relation of HPV infection and cervix lesion. Methods： 1 228 reproductive life women in Guixi region who were suspected by HPV infection or cervix lesion were carried through HPV typing and liquid medium cytology examination, the patients who had cytology diagnosis ≥ASCUS and HPV positive were put up colposcope biopsy. Results： ① Positive rate of HPV was 25.3% （311/1 228）. Liquid medium cytology diagnosis ≥ASCUS was 26. 3% （324/1 228） . Positive rate of HPV in ASCUS, LSIL, HSIL, SCC parted to 50. 6%, 66. 2% , 89. 3% , 100%. ②There was no significant difference between positive of cytology diagnosis≥ LSIL19. 6% （241/1 228） and histology diagnosis≥CINI 21.7% （266/1 228） （χ^2 = 1.55, P 〉0.05） , coincidence rate of cytology preventive histology diagnosis, SCC 100% , HSIL92. 8%, LSIL88.4%. Positive rate of HPV in histology diagnosis CIN Ⅰ , CIN Ⅱ , CINⅢ, SCC parted to 65.3% , 81.5% , 89.1% , 100% , which to increase progressively in turn. ③ 16 isoforms were checked out in reproductive life women in the Guixi region who had infected HPV, low risk form 17. 1% , high risk form 82. 9% , single isoforms 80. 1% , double or multi -isoforms 19. 9%. HPV6, 11 were seen mostly in low risk form, HPV16 was checked out the highest in high risk form to 30. 1% , then HPV58 16. 4% , HPV18 and 31 were to stand side by side the third high risk infected type. Conclusion： Because of high accuracy and definited gene type, HPV typing determination united liquid medium cytology and histology can screen cervix lesion cell more effectively, offer reliable cience bases for clinical prevention and cure cervix cancer.

关 键 词：宫颈病变 HPV分型 液基细胞学 组织学 

分 类 号：R711.74[医药卫生—妇产科学]