宫颈癌及其癌前病变与人乳头状瘤病毒负荷量的研究  

Human papillomavirus load and cervical cancer and its precancerous lesions

作　　者：舒维清[1] 武景波[1] 李小静[1] SHU Wei-qing WU Jing-bo LI Xiao-jing(Department of Pathology, the Fifth People＇s Hospital of Shanghai Fudan University, Shanghai 200240, Chin)

机构地区：[1]复旦大学附属上海市第五人民医院病理科,上海200240

出　　处：《诊断病理学杂志》2017年第7期513-516,520,共5页Chinese Journal of Diagnostic Pathology

基　　金：上海市卫计委青年科研项目(编号:20134y008)

摘　　要：目的探讨宫颈癌及其癌前病变的发生与人乳头瘤病毒(HPV)负荷量的关系。方法选取2014-01—2015-12复旦大学附属上海市第五人民医院病理科各类宫颈活检存档蜡块标本147例,其中正常宫颈组织20例,低级别鳞状上皮内病变(LSIL)52例,高级别鳞状上皮内病变(HSIL)46例,宫颈鳞状细胞癌(SCC)29例。通过基因芯片对23种HPV亚型进行检测分型;再通过Real-time PCR方法对其中80例标本进行HPV定量分析,检测HPV负荷量。结果 147例宫颈活检标本HPV总检出率为73.5%,检出HPV亚型14种,其中高危亚型12种,低危亚型2种。高危亚型检出率最高前4位分别为HPV16(33.3%)、HPV31(6.1%)、HPV52(6.1%)以及HPV58(5.4%);随着宫颈病变程度的逐渐加重,HPV负荷量逐渐升高,LSIL组、HSIL组以及SCC组的HPV负荷量均明显高于宫颈正常组织组,差异均显著(P<0.05)。但LSIL组、HSIL组以及SCC组相互之间HPV负荷量差异不显著(P>0.05)。结论 HPV负荷量与宫颈癌前病变及宫颈癌病程的发生关系密切,但尚不能作为判定宫颈病变严重程度的指标。Objective To investigate the relationship between viral load of HPV and the grade of cervical lesions.Methods Samples were obtained from formalin-fixed,paraffin-embedded blocks of cervical biopsies from 147 patients accessioned at the Department of Pathology,the Fifth People＇s Hospital of Shanghai,Fudan University,between January 2014 and December 2015. The specimens included 20 cases of normal cervical tissues,52 cases of low grade squamous intraepithelial lesion（ LSIL）,46 cases of high grade squamous intraepithelial lesion（ HSIL）,and 29 cases of cervical squamous cervical cancer（ SCC）. PCR-reverse dot blot（ PCR-RDB） genotyping chip were used to examine 23 HPV genotype,and real-time PCR were used to detect the virus load of HPV in 80 cases. Results The positive rate of HPV infection in the 147 cases of cervical biopsies was 73. 5%. Fourteen HPV genotypes were detected in these cases,including12 high risk（ HR）-HPV and 2 low-risk（ LR）-HPV. HPV-16（ 33. 3%）,HPV-31（ 6. 1%）,HPV-52（ 6. 1%） and HPV-58（ 5. 4%） were most common gene types of HR-HPV. There was a trend of increased virus load of HPV with the increased grade of cervical lesions. Significant differences were found between LSIL group,HSIL group,SCC group and normal cervical tissue group（ P〈0. 05）; however,no differences were found between LSIL group,HSIL group and SCC group（ P〉0. 05）. Conclusions The virus load of HPV has a close relationship with cervical cancer and its precancerous lesions; however,it cannot be used to determine the severity of cervical lesions.

关 键 词：宫颈癌 癌前病变 人乳头状瘤病毒 负荷量 

分 类 号：R737.3[医药卫生—肿瘤]