HR-HPV在宫颈病变中的表达及不同治疗方法的转阴率分析  

Analysis of the expression of high-risk human papilloma virus in cervical lesions and negative conversion ratio of different therapeutic methods

作　　者：罗汝琼 唐亮[1] 谢萍[1] 胡艳梅[1] 

机构地区：[1]四川省攀枝花市妇幼保健院妇产科,四川攀枝花617000

出　　处：《中国妇幼健康研究》2016年第8期1018-1021,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的分析高危型人乳头状瘤病毒（HR-HPV）在宫颈病变中的表达及不同治疗方法对转阴率的影响。方法选择2010年至2015年在四川省攀枝花市妇幼保健院就诊并经病理检查确诊的400例HR-HPV阳性妇女,根据各患者不同的宫颈病变情况予以相应的治疗,其中50例患者未进行任何治疗,其余350例患者经单纯放置干扰素栓、宫颈锥切术、子宫全切术及宫颈癌根治术等不同治疗方法,3个月后复查各HR-HPV亚型转阴率情况。结果 400例HR-HPV患者中,共检出亚型13种,其中检出率最高的5个为HPV16型82例（20.05%）,HPV58型62例（15.50%）,HPV52型50例（12.50%）,HPV53型37例（9.25%）和HPV18型39例（9.75%）;HPV16的检出率随着CIN分级逐渐升高（χ2=6.720,P=0.035）;治疗后CINⅠ转阴率为59.39%,CINⅡ~Ⅲ转阴率为56.47%,宫颈癌转阴率为69.23%,组间差异无统计学意义（χ2=3.918,P=0.202）;不同宫颈病变治疗后HRHPV亚型转阴率组间比较差异有统计学意义（χ2=18.625,P=0.001）,宫颈癌根治术后转阴率高于其他治疗方式（χ2=4.443,P=0.038）;HPV16亚型患者未经治疗以及经干扰素栓治疗、宫颈锥切术治疗、子宫全切术治疗和宫颈癌根治术治疗后转阴率分别为29.41%、42.86%、81.82%、80.00%、84.00%,组间差异具有统计学意义（χ2=4.810,P=0.031）,手术治疗患者转阴率高于单纯干扰素治疗和未经治疗者（χ2=6.013,P=0.015）。结论 HPV16是各类宫颈病变中为常见的亚型,检出率随着CIN分级逐渐升高,手术治疗后转阴率高于保守治疗,对宫颈病变筛查以及预后判断具有积极意义。Objective To evaluate the expression of high-risk human papilloma virus（ HR-HPV） in cervical lesions and the influence of different therapeutic methods on negative conversion ratio. Methods From 2010 to 2015,400 cases of HR-HPV-positive diagnosed by pathological examination were selected in Panzhihua City Women and Children Hospital,and appropriate therapeutic methods were given.Fifty patients did not accept any treatment,and the other 350 cases were provided with interferon alone,conization of cervix,total hysterectomy and radical hysterectomy,respectively. Negative rate situation were detected after 3 months. Results Totally 13 kinds of HRHPV subtypes were detected in 400 patients,of which the highest detection rate were found in HPV16 type in 82 cases（ 20. 05%）,HPV58 type in 62 cases（ 15. 50%）,HPV52 type in 50 cases（ 12. 50%）,HPV53 type in 37 cases（ 9. 25%） and HPV18 type in 39cases（ 9. 75%）. HPV16 detection rate gradually increased with CIN grade increasing（ χ2= 6. 720,P = 0. 035）. After treatment negative rate of CINⅠwas 59. 39%,CINⅡ-Ⅲ negative rate was 56. 47% and cervical cancer negative conversion rate was 69. 23%（ χ2= 3. 918,P = 0. 202）. There was statistical significance in HR-HPV subtypes negative conversion ratio after different therapies（ χ2= 18. 625,P =0. 001）. Negative conversion ratio of radical hysterectomy was higher than other treatments（ χ2= 4. 443,P = 0. 038）. Negative conversion ratio of HPV16 subtype in patients without treatment,those with interferon therapy,cervical conization,hysterectomy and radical hysterectomy was 29. 41%,42. 86%,81. 82%,80. 00% and 84. 00%,respectively（ χ2= 4. 810,P = 0. 031）. Patients with surgery had higher negative conversion ratio than interferon therapy alone or no treatment（ χ2= 6. 013,P = 0. 015）. Conclusion HPV16 is a common subtype in cervical lesions and detection rate gradually increases with CIN grading. After surgery negative conversion ratio is higher than conservative treatment,and it is of po

关 键 词：高危型人乳头瘤病毒 宫颈病变 转阴率 亚型分布 

分 类 号：R711.32[医药卫生—妇产科学]