人乳头瘤病毒基因分型及其与子宫颈细胞学异常相关性研究  

Studies on genotyping for human papillomavirus and its association with cervical cytology abnormality

作　　者：何进才[1,2] 李瑞[1,2] 周丹[1,2] 黄涛[1,2] 邵牧民[1,2] 

机构地区：[1]广州中医药大学深圳附属医院 [2]深圳市中医院,广东深圳518033

出　　处：《重庆医学》2011年第33期3331-3334,共4页Chongqing medicine

摘　　要：目的了解人乳头瘤病毒(HPV)感染状况及其型别,探讨HPV及其不同型别感染与年龄和子宫颈病变的相关性,评价聚合酶链反应(PCR)-反向点杂交法检测HPV的方法学性能和临床诊断性能。方法采用PCR-反向点杂交法对2009年6月至2010年9月在该院就诊或健康检查的2 994例女性子宫颈脱落细胞标本进行HPV DNA及其基因分型检测,其中131例进行HPV DNA序列测定,1 511例同步进行HPV基因分型和液基薄层细胞(TCT)检测。结果 2 994例受检女性HPV感染率为25.1%,排名前5位的HPV型别分别为HPV52(15.6%)、16(14.1%)、58(12.0%)、56(6.6%)和33(5.2%)。25岁以下女性HPV16、58感染率最高;HPV52感染率在55岁以上女性最高,25岁以下女性次之;高危型HPV在非典型鳞状细胞(ASCUS)、低度鳞状上皮内病变(LSIL)及高度鳞状上皮内病变(HSIL)中感染率分别为44.2%、91.7%和93.3%;HPV58、16、56和31与子宫颈病变程度相关(回归系数分别为0.493、1.744、―0.819和1.566),HPV52则无明显相关性;分别以测序法和TCT结果大于或等于LSIL作为金标准,PCR-反向点杂交法检测HPV及其对子宫颈病变诊断的敏感度、特异度和准确度分别为96.4%和92.2%、93.4%和84.2%、94.7%和84.5%。结论女性感染HPV比例较高,年轻女性更易受感染,感染型别以HPV 52、16、58、56和33为主,HPV感染与子宫颈病变程度高度相关,PCR-反向点杂交法检测HPV在方法学性能和对子宫颈病变的临床诊断性能上均能满足要求。Objective To study the prevalence of human papillomavirus（HPV） infection and distribution of genotypes. Discuss association of infection of HPV and HPV genotypes with age and cervical lesions. Assessment the methodology performance and clinical diagnostic performance of PCR-Reverse Dot Blot（PCR-RDB）. Methods Detect HPV DNA and its genotypes of cervical cy- tological specimens with PCR-RDB. The subjects were 2 994 women from outpatients and the health physical examination individu- als during June 2009 to September 2010 in our hospital. In 2 994 cases,including 131 cases for DNA sequencing,1 511 cases for de- tection of HPV genotypes and TCT synchronously. Results HPV infection rates in 2 994 females were 25.1%. The first fifth HPV genotypes infection were HPV52 （15.6%） ,16（14.1%） ,58（12.0%） ,56（6.6%） and 33（5.2%）. The highest HPV infection was the group of females aged below 25, HPV16 and HPV58 included. The women who infect HPV52 most were the group aged above 55,the group aged below 25 was next. The positive rates of HR-HPV were 44.2% in ASCUS,91.7% in LSIL,and 93. 3% in H SIL, respectively, the genotypes of HPV58,16,56 and 31 had correlations with the degree of cervical lesions（The regression coefficients were 0. 493,1. 744,-- 0. 819 and 1. 566,respectively）. HPV52 was not significant correlation with the degree of cervical le sions. With sequencing and the result of TCT≥LSIL as gold standard, for PCR-RDB in HPV and diagnosis of cervical lesions, the sensitivity,specificity,accuracy were 96.4%and 92.2% ,93.4%and 84.2% ,94.7%and 84.5% ,respectively. Conclusion The pro- portion of HPV infection in female is quite high and young women are more susceptible to infections. The major pathogenic types are HPV52,16,58,56 and 33. HPV infection is highly correlated with cervical lesions level. Detecting HPV with PCR-RDB can fully satisfy the need of clinical testing on the methodology performance and clinical diagnostic performance in diagnosing cervical lesions.

关 键 词：人乳头瘤病毒 基因分型 子宫颈细胞学 

分 类 号：R737.33[医药卫生—肿瘤]