人乳头状瘤病毒感染与宫颈病变的相关性分析  

The Investigation and Analysis of HPV Infection in Cervical Intraepithelial Neoplasia and Cervical Carcinoma

作　　者：卢春冬[1] 徐燕[1] 任玉香[1] 李玉艳[1] 胡华[1] 唐帅[1] 包碧惠[2] 

机构地区：[1]重庆市第三军医大学西南医院妇产科,重庆400038 [2]成都军区总医院妇产科,成都610083

出　　处：《肿瘤预防与治疗》2014年第6期259-263,共5页Journal of Cancer Control And Treatment

基　　金：国家自然科学基金编号81101994

摘　　要：目的:分析宫颈上皮内瘤变(CIN)及宫颈癌(CC)中人乳头状瘤病毒(HPV)亚型,探讨HPV感染与宫颈病变的相关性。方法:慢性宫颈炎或液基细胞学异常的妇女检测21种HPV基因亚型和阴道镜下宫颈定位活检,分析2 481例CC和CIN患者的HPV感染情况。结果:在2 481例CIN和CC患者中,HPV感染率85.0%,HPV感染与宫颈组织学结果有较强的相关性(P<0.001,Pearson列联系数=0.648)。CC及CINⅢ、CINⅡ患者以HPV16、18感染最多见,其次见HPV58、33、31、52、45、59、68等亚型。304例患者宫颈感染HPV16、18、58、52、33等亚型后,发生高度鳞状上皮内病变(HSIL)、不明意义的非典型鳞状细胞(ASCUS)及低度鳞状上皮内病变(LSIL)的频率增加,TCT分型与HPV分型有较弱的相关关系(P=0.002,Pearson列联系数=0.322)。细胞学结果提示HSIL、ASCUS,宫颈组织学诊断以CC、CINIII和CINII为多,TCT分型与组织学分型也有较弱的相关性(P=0.026,Pearson列联系数=0.172)。结论:HPV16、18、58、33、52、31、45等高危型HPV感染是宫颈癌(CC)及癌前病变(CIN)最常见的风险因素。高危型HPV单独或混合感染宫颈后,细胞学检测HSIL、ASCUS及LSIL的发生率增加,细胞学结果与组织学分型的相关性促进了CC和CIN的及时诊治。Objective： To investigate 21 HPV genotypes infection in cervical cancer and cervical intraepithelial neoplasia （ CIN） , and the relationship between HPV infections and cervical cancer. Methods：Cases with chronic cervici-tis or abnormal cervical cells detected by liquid-based Thinprep cytology test （ TCT） had 21 HPV genotypes detected and accepted cervical biopsy during colposcopy. HPV infection status in 2 481 cases with cervical carcinoma or cervical intraep-ithelial neoplasia were analyzed. Results： Among 2 481 cases of CIN and cervical carcinoma, HPV-positive patients ac-counted for 85. 0%. There was statistically significant relevance between HPV infection and abnormal cervical histology （P〈0. 001, Pearson correlation coefficient=0. 648）. HPV16, HPV18 infection were most common in patients with CC and CINⅢ, CINⅡ, followed by HPV58, HPV 33, HPV31, HPV52, HPV45, HPV59, HPV68 subtype infections. In 304 pa-tients who got cervical infection with a subtype of HPV16, HPV18, HPV58, HPV52, HPV33, the incidence of high-grade squamous intraepithelial lesions （HSIL）, atypical squamous cells of undetermined significance （ASCUS） and low-grade squamous intraepithelial lesions （LSIL） rose significant （P=0. 002, Pearson correlation coefficient=0. 322）. Morover, CC, CIN III and CIN II had a high rate of HSIL, ASCUS. There were significant correlations between abnormal cervical cytology and histological results （P=0. 026, Pearson correla-tion coefficient=0. 172）. Conclusion：Infection of high risk HPV types such as HPV16, HPV18, PHV58, HPV33, HPV52, HPV31, HPV45 is the main risk factor of cervical carcinoma （ CC） and precancerous lesion （ CIN） . With high-risk HPV infection, cervical cytologic diagnoses of HSIL, ASCUS and LSIL increase. The correlation between cytological and histological findings for CC and CIN promotes timely detection, prevention, intervention,and effective treatment.

关 键 词：人乳头状瘤病毒 宫颈上皮内瘤变 宫颈癌 相关性 

分 类 号：R737.33[医药卫生—肿瘤] R730.231[医药卫生—临床医学]