人乳头瘤状病毒基因型在宫颈疾病中的分布特点  

Preliminary analysis of human Papillomavirus genotype distribution in cervical diseases

作　　者：史娅萍 朱宇宁[2] 周丽琴[2] 崔卫东 

机构地区：[1]浙江省富阳市妇幼保健院,311400 [2]浙江大学医学院附属妇产科医院

出　　处：《中华检验医学杂志》2007年第9期1009-1012,共4页Chinese Journal of Laboratory Medicine

摘　　要：目的通过分析人乳头瘤状病毒(HPV)基因型在宫颈疾病中的分布特点,探讨 HPV基因型别与宫颈癌发生的相关问题。方法收集宫颈疾病筛查者中感染有高危型 HPV(杂交捕获法,HC-Ⅱ)、又具有同期宫颈病理切片结果的患者318例,按病理结果分成4组:宫颈癌组、高度鳞状上皮内病变(HSIL)组、低度鳞状上皮内病变(LSIL)组和慢性炎症组。采用凯普医用核酸分子快速杂交基因分型试剂盒(HybriMax)对这些患者感染的 HPV 进行分型检测,对 HPV 基因型在各组疾病中的分布数据作统计学分析。结果所有病例标本中共检测到21种基因型中的19种,未发现44、56型。各亚型在不同病变中的分布不同,宫颈癌组中主要感染基因型为16(80.8%)、33(15.4%)、31(11.5%)、58(7.7%)、18(7.7%)。16型感染在所有病例组中均居首位,并在宫颈癌组、HSIL 组的发生率显著高于 LSIL 组和慢性炎症组(P<0.01);68型在 HSIL 组、LSIL 组均为主要感染基因型,但未在宫颈癌组中出现;低危基因型6型以多重感染形式也出现在宫颈癌组和 HSIL 组。在各种病变中都存在一定比例的 HPV 混合感染,单一感染率随疾病的严重程度增加而递增,在宫颈癌标本中作为单一感染原的 HPV 型别有限。结论宫颈癌组织中主要感染的 HPV 基因型存在地理差异;16型感染仍是宫颈癌的最大威胁;多重感染可能并不增加宫颈癌的发生率;对高危基因型别需要进一步的以识。Objective To investigate the distribution of Human Papillomavirus （HPV） genotype in cervical diseases and explore the risk of cervical cancer associated with HPV genotype. Methods 318 patients infected with high-risk HPV （ HC- Ⅱ ） were classified into 4 groups according to their pathologic examination： cancer group, HSIL group, LSIL group, and chronic eervieitis group. HybriMax were used to detect HPV genotype in cervical tissues previously detected by HC-Ⅱ from these patients. The distribution data of HPV genotype were statistically analysed. Results Nineteen genotypes were found by HybriMax in total 21 HPV genotype, except HPV44 and HPV56. The HPV genotype is differently distributed in various histologie-grade diseases. In cancer group, the most common genotypes were HPV16 （80. 8% ）, HPV33 （ 15.4% ） ,HPV31 （ 11.5% ） ,HPV58 （7.7%） ,HPV18 （7.7%）. HPV16 is the most popular genotype in all specimens, and more prevalent in cancer group and HSIL group compared with LSIL group and chronic eervieitis（P 〈0. 01 ）. HPV68 wasn＇t detected in cancer group although it is main type in HSIL group and LSIL group. Low-risk genotype HPV6 was present in cancer group and HSIL group combined with other types of virus. Multiple-genotype infections were found in all cervical diseases, but single-type infection rate was increased with severity of the disease. Few HPV genotypes could be found solely existing in cancer group. Conclusions There exist geographical differences in the prevalence of HPV genotypes in cervical cancer. HPV16 remain the most common genotype in cervical cancer. Muhiple-genotype infection can not increase the occurrence of cervical cancer. More studies are warranted to identify high-risk HPV genotypes.

关 键 词：宫颈肿瘤 乳头瘤病毒 人 基因型 核酸杂交 

分 类 号：R737.33[医药卫生—肿瘤]