高危型人乳头瘤病毒载量与宫颈上皮内瘤变病变程度相关性  

Association between high-risk human papillomavirus viral load and cervical intraepithelial neoplasia

作　　者：杨烨[1] 谢毅[1] 孙廷慰[1] 祝亚平[1] 

机构地区：[1]上海交通大学附属第一人民医院妇产科,上海200080

出　　处：《现代妇产科进展》2011年第2期131-133,共3页Progress in Obstetrics and Gynecology

摘　　要：目的：探讨高危型人乳头瘤病毒（HR-HPV）载量与宫颈上皮内瘤变（cervi-cal intraepithelial neoplasia,CIN）病变程度相关性。方法：对2008年1月~2010年6月于上海市第一人民医院行阴道镜检查的1035例患者,用HCⅡ方法检测其HR-HPV病毒载量,分为阴性组（0.00~1.00）、低度载量组（1.0~10.00）、中度载量组（10.00~100.00）、高度载量组（100.00~1000.00）和极高度载量组（≥1000.00）;将病理结果按照宫颈病变程度分为阴性组（慢性黏膜炎和挖空细胞）、低级别病变组（CINⅠ）和高级别病变组（CINⅡ、CINⅢ）。多分类Logistic回归分析HPV病毒载量和CIN病变程度相关性。结果：病理诊断为慢性黏膜炎、挖空细胞、CINⅠ、Ⅱ、Ⅲ的HR-HPV病毒载量的中位数（感染率）分别是2.70（58.22%）、56.00（79.07%）、88.05（79.66%）、323.90（93.27%）和364.07（92.47%）,基本呈递增趋势。CIN的各级别病毒载量的分布差异显著（P均〈0.05）,低级别病变组和高级别病变组的各级别病毒载量组（低度载量组、中度载量组、高度载量组和极高度载量组）对于病理阴性组的危险度（OR值）依次递增：低级别病变组0.677、2.406、2.893和2.943;高级别病变组2.177、4.262、6.354和20.177。结论：CIN的发生与高危型人乳头瘤病毒载量有关,病毒载量越高,CIN发生危险度越高。Objective：To determine the association between viral load of high risk human papillomavirus（HR-HPV） and different histological grades of cervical intraepithelial neoplasia.Methods：A total of 1035 patients underwent colposcope in Shanghai NO.1 Hospital from January 2008 to June 2010 were observed,HR-HPV was detected by the Hybrid Capture Ⅱ（HCⅡ） system,viral load was categorized into five groups：negative（0,1.00）,low viral load（1.0,10.00）,moderate viral load（10.00,100.00）,high viral load（100.00,1000.00） and extreme high viral load（1000.00,∞）,cervical lesions were diagnosed as negative cervical pathology（chronic mucositis and koilocyte）,low-grade squamous intraepithelial lesions（cervical intraepithelial neoplasia grade I,CINI） and high-grade squamous intraepithelial lesions[cervical intraepithelial neoplasia grade Ⅱ（CINⅡ） and cervical intraepithelial neoplasia grade Ⅲ（CINⅢ）].Association between HR-HPV viral load and histological grades of CIN were evaluated by multinomial logistic regression.Results：（1）The median viral load and infection rate of HR-HPV in women with chronic mucositis,koilocyte,CINⅠ,CINⅡ and CINⅢ were 2.70（58.22%）,56.00（79.07%）,88.05（79.66 %）,323.90（93.27%） and 364.07（92.47%）,respectively,an increasing trend among them.There were significant differences among the distributions of viral loads in each grade of CIN（P0.05）.Compared with negative cervical pathology.The odds ratio of low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions in different distributions of viral loads（low,moderate,high and extreme high viral loads） were：low-grade squamous intraepithelial lesions 0.677,2.406,2.893 and 2.943;high-grade squamous intraepithelial lesions 2.177,4.262,6.354 and 20.177,increasingly.Conclusion：There were positive relationship between high-risk human papillomavirus viral load and CIN.The risks of CIN increased with the HR-HPV viral loads.

关 键 词：高危型人乳头瘤病毒载量 宫颈上皮内瘤变 相对危险度 

分 类 号：R737.33[医药卫生—肿瘤]