HPV16变异体与LSIL预后的相关性分析  

Analysis of correlation between HPV16 variant and prognosis of LSIL

作　　者：张蕾[1] 孙艳梅 杨宾烈[1] 周爱枝[1] 原杰彦[1] Zhang Lei;Sun Yanmei;Yang Binlie(Department of Obstetrics and Gynecology,Shanghai Pudong New Area People's Hospital,Shanghai201200)

机构地区：[1]上海市浦东新区人民医院妇产科,上海201200

出　　处：《现代妇产科进展》2019年第5期363-366,369,共5页Progress in Obstetrics and Gynecology

基　　金：上海市卫生和计划生育委员会科研基金资助项目(No:201540417)

摘　　要：目的:分析上海地区HPV16变异体与宫颈低度鳞状上皮内病变(LSIL)预后的相关性。方法:选取120例单纯HPV16阳性阴道镜下宫颈活检证实为LSIL的患者,每半年随访1次,持续2年。从宫颈脱落细胞中提取HPV16 DNA E2、E6、E7、LCR双向测序确定变异体类型。结果:检测到40%的A1(欧洲型)和60%的A4(亚洲型)两种变异体亚系。4个片段常见突变位点E6:T178G,T178A;E7:A647G;E2:T135K,R165Q,I210T,D219S E232K,T310K和D344E;LCR:A7175C,T7177C,G7193T,T7201C,C7270T,A7287C,A7289C,G7521A,A7730C。110例患者中,78例病灶消退(78/110,70.91%),24例病灶持续存在(24/110,21.82%),8例进展为HSIL(8/110,7.28%)。A4亚系较A1在LSIL持续存在中有显著统计学意义(P=0.016)。A4亚系中E6、E7、E2、LCR四个片段出现共变SNPs(single nucleotide polymorphism)。结论:上海地区LSIL中主要存在HPV16 A1和A4两种变异体亚系。LSIL患者的2年病灶持续及进展率较高,随访非常必要。A4亚系中某些SNPs可能与LSIL的持续存在相关。Objective: To analyze the correlation between HPV16 variant and prognosis of cervical low-grade squamous intraepithelial lesion (LSIL) in Shanghai. Methods: 120 cases of HPV16 positive LSIL confirmed by colposcopy biopsy were selected.Follow-up was performed every six months for 2 years.Extraction of HPV16 DNA E2,E6,E7 and LCR genes from cervical exfoliated cells and determination of variant types by two-way sequencing were clone. Results: Two subtypes of variant A1 (European type) and A4 (Asian type) were detected.Four common mutation sites E6:T178G,T178A;E7:A647G;E2:T135K,R165Q,I210T,D219S,E232K,T310K and D344E;LCR:A7175C,T7177C,G7193T,T7201C,C7270T,A7287C,A7289C,G7521A,A7730C.Of 110 patients,78 (78/110,70.91%) had focal regression,24(24/110,21.82%) had persistent lesions,and 8(8/110,7.28%) developed HSIL(8/110, 7.28 %).Compared with A1,A4 had significant statistical significance in the persistence of LSIL ( P =0.016).Covariant single nucleotide polymorphisms were found in E6,E7,E2 and LCR fragments of A4 subline. Conclusions: Two variant sublines of HPV16 A1 and A4 were found in LSIL in Shanghai.The 2-year lesion duration and progression rate of LSIL patients was high.Follow-up is necessary.Some SNPs in A4 subline may be associated with the persistence of LSIL.

关 键 词：人乳头瘤病毒 宫颈低度鳞状上皮内病变 变异体 

分 类 号：R711.74[医药卫生—妇产科学]