人乳头瘤病毒亚型感染情况与宫颈病变的关系  

Distribution of human papillomavirus genotypes in cervix and its relationship with cervical lesions

作　　者：张一萍[1] 梁保霞[1] 薛毓凤 高雅璐[1] 

机构地区：[1]武警北京总队第三医院妇科,北京100141

出　　处：《宁夏医学杂志》2016年第10期905-908,共4页Ningxia Medical Journal

摘　　要：目的探讨13种高危人乳头瘤病毒(HPV)亚型在人群中的感染情况及其与宫颈病变的关系。方法回顾性分析6 018例接受HPV分型检测和宫颈液基细胞学检测(LCT)者的临床资料,统计各高危HPV亚型在人群中的分布情况。对于LCT异常/HPV 16、18型阳性者行电子阴道镜、宫颈活体组织病理检查,分析高危HPV感染与宫颈病变的关系。结果 HPV阳性1 102例,感染率18.31%(1 102/6 018),其中单一亚型HPV感染和两种以上HPV亚型多重感染分别占阳性总数的71.32%(786/1 102)和28.68%(316/1 102),除去单一低危亚型HPV感染88例(1.46%,88/6 018),13种高危HPV亚型的总感染率为16.85%(1014/6018)。感染率排在前六位的高危HPV亚型,依次为HPV 16(3.61%)、HPV 52(3.26%)、HPV 58(3.24%)、HPV 51(2.41%)、HPV 39(2.29%)和HPV 18型(1.78%)。LCT异常组高危HPV感染率及多重HPV感染比例均高于正常组,差异有统计学意义(P<0.05);多重感染比例(χ2=4.006,P<0.05),排在前六位的高危HPV亚型,依次为HPV 16、HPV 58、HPV 52、HPV 18、HPV 51、HPV 39型。将不同LCT结果分组观察,高危HPV感染率随宫颈病变级别升高而呈增高趋势(P<0.05)。宫颈组织活检病理结果分组观察,高危HPV感染率有同样特点,在高级别宫颈上皮内瘤变和宫颈癌患者中HPV 16、HPV 18型合并感染率分别为69.23%、75.00%。结论此组人群13种高危HPV的总感染率为16.85%,LCT异常组高危HPV感染率及多重HPV感染比例均高于正常组,常见的高危HPV亚型依次为HPV16、HPV 58、HPV 52、HPV 18、HPV 51、HPV 39型;高危HPV感染率与宫颈病变严重程度呈正相关,在高级别宫颈上皮内瘤变和宫颈癌患者中HPV 16、HPV 18型感染占绝对优势。Objective To explore the prevalence and genotype distribution of high - risk human papillomavirus （HPV） in the population and its relationship with cervical lesions. Methods HPV genotypes and liquid based cytology（LCT） were detected in 6018 outpatients in our hospital,biopsy under colposcopy pathology was conducted in LCT- positive and HPV16/18 -positive women,the infenction rates and distribution of high risk HPV subtypes in the population and the association between high - risk HPV infection and cervical lesion were analyzed. Results HPV - positive cases were 1102, the prevalence rate was 18.31% （1102/6018）. Among them, single HPV subtype infection and multiple HPV subtypes infection accounted for 71.32% （786/1102） and 28.68% （316/1102） respectively. Except for 88 cases（ 1.46% ,88/6018） of low risk HPV subtype infection,the prevalence rate of high- risk HPV infection was 16.85% （1014/6018）. The most frequently detected high -risk HPV subtypes were HPV16,52,58,51,39 and 18 orderly. The high - risk HPV infection rate and the multiple HPV infection rate were higher in LCT abnormal group than in the normal group. The top six high- risk HPV subtypes were HPV16,58,52,18,51 and 39. The prevalence rate of high risk HPV increased with the increasing of grade of cervical lesions,this was observed at both cellular and histopathological level. The infection rate of HPV16/18 among high - grade squamous intraepithelial lesion and squamous of cervical carcinoma （SCC） were 69.23% and 75.00%. Conclusion In this group,the prevalence rate of high - risk HPV was 16.85%. The infection rate of high - risk HPV and the multiple HPV were higher in LCT abnormal group than in the normal group,the top six high -risk HPV subtypes were HPV16,58,52,18,51 and 39. High risk HPV infection and cervical lesion severity was positively con：elated. HPV16 and HPV18 were dominantly subtypes in women with high -grade squamous intraepithelial lesion and SCC.

关 键 词：人乳头瘤病毒 基因分型 液基细胞学检查 宫颈病变 

分 类 号：R737.33[医药卫生—肿瘤]