人乳头瘤病毒感染与宫颈高级别病变关系的研究  

Human papillomavirus and high grade squamous intraepithelial lesion

作　　者：张瑞[1] 李晶华[1] 冯力民[1] 

机构地区：[1]首都医科大学附属北京天坛医院妇产科,北京100050

出　　处：《中国微生态学杂志》2018年第2期206-209,共4页Chinese Journal of Microecology

基　　金：北京自然科学基金资助项目(7152051)

摘　　要：目的探讨人乳头状瘤病毒(human papillomavirus,HPV)感染与宫颈高级别病变(highgrade squamous intraepithelial lesion,HSIL)的关系。方法选取2003年1月到2016年8月在首都医科大学附属北京天坛医院行宫腔镜辅助宫颈冷刀锥切术的患者181例,患者行宫腔镜辅助宫颈冷刀锥切术前均有HPV检测、薄层液基细胞学(TCT)以及阴道镜活检及免疫组化的结果。依据病检结果分析HPV感染与宫颈高级别病变的关系。结果在181例宫颈高级别病变中,HPV感染165例,HPV检测阳性率为91.16%。其中高危型HPV感染160例,阳性率为88.40%,占阳性标本的96.97%。HPV16阳性率57.46%,占高危型HPV感染的63.03%。40~49岁高危型HPV检测阳性率最高,但各年龄组比较差异均无统计学意义(各年龄组P值均>0.05)。HPV感染在宫颈高级别病变和子宫颈癌中差异均有统计学意义(P<0.05)。结论 HPV感染在宫颈高级别病变的发生和发展中起关键作用。高危型HPV基因分型诊断在宫颈癌筛查及防治过程中具有重要意义。Objective To explore the relationship between human papilloma virus（HPV）and high grade squamous intraepithelial lesion.Methods 181 patients who underwent cervical cold knife conization through hysteroscopy in our hospital from January 2003 to August 2016 were enrolled.Their results of examinations before the surgery,including HPV detection,Thinprep Cytologic Test（TCT）and colposcopy biopsy,were analyzed in respect to the relationship between HPV infection and high grade squamous intraepithelial lesion.Results Among the 181 cases of high grade cervical squamous intraepithelial lesion,the positive detection rate of HPV was 91.16%.The positive rate of high-risk HPV was 88.40%,accounting for 96.97%of the positive specimens.The positive rate of HPV16 was 57.46%,accounting for 63.03% of the high-risk HPV.Patients in age group of 40~49 years presented the highest positive rate of HPV,but no statistically significant differences were observed among all age groups（P〈0.05）.HPV infection had statistical difference in high grade squamous intraepithelial lesion vs cervical cancer.Conclusion HPV infection plays a key role in the occurrence and development of high grade cervical squamous intraepithelial lesion.Diagnosis of high risk HPV with genotyping method has important significance in the screening and prevention of cervical cancer.

关 键 词：人乳头瘤病毒 宫颈癌 宫颈高级别病变 

分 类 号：R737.33[医药卫生—肿瘤]