高危型人乳头瘤病毒多重感染与宫颈癌及癌前期病变关系的研究  

Association of multiple high-risk human papillomavirus infection and cervical carcinoma and precancerous lesion

作　　者：吴冬梅[1] 郭慈仁[2] 余江[1] 刘倩[1] 缪海燕[1] 黄瑞仙[1] 郑怡真[1] 

机构地区：[1]福建中医药大学附属福建省第二人民医院妇产科,福州350003 [2]福建省肿瘤医院妇科

出　　处：《中国医药》2011年第5期604-606,共3页China Medicine

基　　金：陈可冀中西医结合发展基金资助项目（CKJ2009010）

摘　　要：目的探讨高危型人乳头瘤病毒（HR-HPV）多重感染是否能增加宫颈癌及癌前期病变发生的风险。方法对病理检查确诊为宫颈癌、癌前期病变和慢性宫颈炎的641例妇女的宫颈细胞标本行HPV基因分型检测，分析HR．HPV多重感染与宫颈癌及癌前期病变的关系。结果与慢性炎症组比较，低度宫颈上皮内瘤变（CINI）组、高度宫颈上皮内瘤变（CINⅡ～Ⅲ）组、宫颈癌组HR-HPV阳性率明显增高，与CINI组比较，CINⅡ—Ⅲ组、宫颈癌组HR—HPV阳性率明显增高，差异有统计学意义（均P〈0．01）。与慢性炎症组比较，CINⅡ～Ⅲ组的多重感染率增高，差异有统计学意义（P〈0．01）。宫颈癌发生危险性较高的为HPV-16、-18、-31、-33、-45．,-53、-58和一59（HPV-16：OR=0．75，95％C10．16—3．43；HPV-18：OR=2．67，95％c，0．26—26．92：HPV．31：OR=15．00，95％C10．22—85．20：HPV-33：OR=0．87，95％C10．25—1．98；HPV-53：OR=0．80，95％C10．04—14．64；HPV-58：OR=0．53，95％C10．11～2．62；HPV-59：OR=4．00，95％C10．43～37．11）；CINⅡ～Ⅲ发生危险性较高的为HPV-52；CINI发生危险性较高的为HPV-66、-68、-CP8304。与单独感染比较，未发现HR-HPV多重感染增加宫颈癌发生的风险。结论HR-HPV多重感染无明显增加宫颈癌及癌前期病变发生的风险。Objective To investigate whether the presence of multiple high-risk human papillomavirus （HR-HPV） can increase the risk of having cervical carcinoma and precancerous lesion. Methods The cervical samples of 641 women who had histologically verified cervical carcinoma , precancerous lesion or chronic cervicitis were taken for HPV genotype testing. The correlation of multiple HR-HPV and cervical carcinoma or precancerous lesion was amalyzed. Results Compared with chronic cervicitis group, the positivity of HR-HPV in CINⅠ , CINⅡ-Ⅲ or carcinoma group was higher, and there was a statistically significant difference（P 〈0. 01 ）. Compared with CIN I group, the positivity of HR-HPV in CIN II ~ 11I or carcinoma group was higher, and there was a statistically significant difference（P 〈0.01 ）. Compared with chronic cervicitis group, multiple infection of HR-HPV in CIN II -HI was higher （P〈0.01）. HPV-16, -18, -31, -33, -45, -53, -58, and-59 were associated with carcinoma. HPV-52 was CIN Ⅱ-Ⅲassociated type and HPV-66, -68, and -ep8304 were associated with CIN Ⅰ. Compared with single HR-HPV infection, multiple HR-HPV infection cannot increase risk of cervical carcinoma or precancerous lesion. Conclusion The presence of multiple HR-HPV has no increased risk of cervical carcinoma or precancerous lesion.

关 键 词：子宫肿瘤 多重感染 人乳头瘤病毒 

分 类 号：R737.33[医药卫生—肿瘤]