多种HPV亚型检测在宫颈病变诊治中的意义  

Significances of detections of multiple human papillomavirus subtypes in diagnosis and treatment of cervical lesions

作　　者：李娟[1] 尹格平[1] 陈铭[1] 朱彤宇[1] 崔晓宁[1] 提松梅[1] 

机构地区：[1]济南军区总医院妇科,山东济南250031

出　　处：《中国妇幼保健》2012年第2期195-198,共4页Maternal and Child Health Care of China

摘　　要：目的:通过研究不同HPV亚型与宫颈病变之间的关系,为宫颈病变的筛查和防治提供理论基础。方法:采用导流杂交基因芯片技术对1 430例宫颈病变患者进行21种HPV亚型检测,包括16种高危亚型(HR-HPV)和5种低危亚型(LR-HPV),对阳性患者行宫颈多点活体组织检查(活检),以组织病理学诊断作为宫颈病变确诊的金标准。结果:①1 430例宫颈病变患者中检测到HPV阳性患者210例,阳性率为14.68%,其中,感染HR-HPV 174例(82.86%),感染LR-HPV 36例(17.14%);居前6位的感染亚型是:HPV 16(43.81%)、52(15.71%)、11(10.00%)、58(8.57%)、31(7.62%)、33(7.14%)。其中单一感染176例(83.81%),多重感染34例(16.19%)。②HR-HPV感染致CIN和宫颈癌的发病率明显高于LR-HPV;HR-HPV的感染率随宫颈病变程度的加重而逐渐增高,其中,宫颈癌组HR-HPV感染率与对照组比较差异有统计学意义(P<0.05)。③宫颈癌组HPV多重感染率与对照组比较差异有统计学意义(P<0.05)。结论:不同HPV亚型感染可导致不同的宫颈病变,并且与宫颈病变的不同程度密切相关。HPV多重感染与宫颈癌的发病密切相关。多种HPV亚型检测在宫颈病变筛查和防治过程中具有重要意义。Objective： To provide theoretical basis for screening, prevention, and treatment of cervical lesions by investigating the relationship between different human papillomavirus （HPV） subtypes and cervical lesions. Methods： Flow -through hybridization gene chip technique was used to detect 21 kinds of HPV subtypes among 1 430 patients with cervical lesions, 16 kinds of high risk HPV subtypes and 5 kinds of low risk HPV subtypes were included, the positive patients received multiple punch cervical biopsy, histopathological diagnosis was used as gold standard of cervical lesions. Results： Among 1 430 patients with cervical lesions, 210 patients were found with HPV, the positive rate was 14. 68%, including 174 patients （ 82. 86% ） with high risk HPV and 36 patients （ 17.14% ） with low risk HPV ; the top six subtypes of HPV included HPV 16 （43.81%）, HPV 52 （ 15.71% ）, HPV 11 （ 10.00% ）, HPV 58 （8.57%）, HPV 31 （7.62%）, and HPV 33 （7.14%） . 176 patients （83.81%） were found with single infection, and 34 patients （16. 19% ） were found with multiple infection. The incidences of cervical intraepithelial neoplasia （CIN） and cervical cancer induced by high risk HPV infection were significantly higher than those induced by low risk HPV infection; the infection rate of high risk HPV increased with the aggravation of cervical lesions, there was significant difference in the infection rate of high risk HPV between cervical cancer group and control group （P 〈 0. 05 ） . There was significant difference in the multiple infection rate of HPV between cervical cancer group and control group （ P 〈 0.05 ） . Conclusion： HPV infection of different subtypes can induce different cervical lesions, and they are related to the degree of cervical lesions closely. Multiple HPV infection is correlated with the occurrence of cervical cancer. Detections of multiple HPV subtypes play important roles in screening, prevention, and treatment of cervical cancer.

关 键 词：人乳头瘤病毒 亚型 宫颈病变 

分 类 号：R511[医药卫生—内科学] R711[医药卫生—临床医学]