人乳头瘤病毒亚型在子宫颈疾病中的分布及风险研究  

Distribution and risk of human papillomavirus in cervical lesions

作　　者：朱含笑 叶飘飘 陈旭[2] 南星炜 苏斯静 陈佳华 吴爱雪 赵红琴 颜笑健[2] ZHU Han-xiao;YE Piao-piao;CHEN Xu;NANXing-wei;SU Si-jing;CHEN Jia-hua;WU Ai-xue;ZHAO Hong-qin;YAN Xiao-jian(Department of Obstetrics and Gynecology,Taizhou Hospital Affiliated to Wenzhou Medical University,Taizhou 317000,China)

机构地区：[1]温州医科大学附属台州医院妇产科,浙江台州317000 [2]温州医科大学附属第一医院妇科,浙江温州325000 [3]温州医科大学附属苍南医院妇产科,浙江温州325800

出　　处：《中国实用妇科与产科杂志》2019年第11期1261-1264,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金（81503293）

摘　　要：目的探讨子宫颈疾病患者中人乳头瘤病毒(HPV)的亚型分布特点及致病风险。方法选择2015年1月至2017年7月于温州医科大学附属第一医院就诊的5735例患者,包括997例子宫颈炎症、1568例低级别鳞状上皮内病变(LSIL)、2576例高级别鳞状上皮内病变(HSIL)和594例子宫颈癌。获取各组HPV分型结果进行分析。结果子宫颈炎症、LSIL、HSIL和子宫颈癌组HPV阳性率为分别为57.0%、78.3%、90.5%和93.9%(P<0.05)。各组HPV感染亚型均以高危型为主,其中子宫颈炎症组及LSIL组常见的HPV感染亚型以52、53、16、58、18型为主,HSIL及子宫颈癌以16、52、58、33、18型为主。HPV16、18、58、52、33、31以及45型在4组中累积归因率合计分别为22.2%、38.4%、68.4%和80.1%。HPV16、31、45型感染后发生子宫颈癌的风险分别是子宫颈炎症组的27.7倍、14.3倍、8.2倍。36例HPV检测阴性的子宫颈癌患者通过HPV E6/E7 DNA检测出8例阳性。结论 HPV16、18、58、52、33、31以及45型在子宫颈鳞状上皮内病变及子宫颈癌患者中感染率、累积归因率及风险值高,临床上应重视以上HPV亚型,将其纳入子宫颈癌预防及筛查范围。HPV E6/E7 DNA检测作为临床上子宫颈癌筛查的一种策略具有一定意义。Objective To analyze the distribution and pathogenicity of 27 HPV(Human papillomavirus)subtypes in cervical lesions.Methods A retrospective analysis was carried out in 5735 patients with cervical lesions admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2015 to July 2017,including 997 cases of cervicitis,1568 cases of LSIL(low-grade squamous intraepithelial lesion),2576 cases of HSIL(high-grade squamous intraepithelial lesion)and 594 cases of cervical cancer. The HPV subtypes,histopathological results and ages were obtained for analysis.Results The positive rates of HPV in cervicitis group,LSIL,HSIL group and cervical cancer group were 57.0%,78.3%,90.5%,and 93.9%(P<0.05)respectively. The five most prevalent HPV types in cervicitis and LSIL group were 52,53,16,58 and 18;in HSIL and cervical cancer they were 16,52,58,33 and 18. The cumulative attribution rates of HPV16,18,58,52,33,31 and 45 in cervicitis,LSIL,HSIL and cervical cancer were 22.2%,38.4%,68.4% and 80.1%,respectively. The incidence of cervical cancer after HPV16,31 and 45 infection was 27.7,14.3 and8.2 times higher than that of cervicitis. Among the 36 cervical cancer tissue samples with negative HPV,8 cases were detected positive by HPV E6/E7 DNA detection.Conclusion HPV16,18,58,52,33,31 and 45 have a high prevalence,cumulative attribution rates and risk values in patients with squamous intraepithelial lesions and cervical cancer. The above-mentioned subtypes of HPV should be included in the prevention and screening of cervical cancer.HPV E6/E7 DNA detection may be a reliable assay for HPV-based screening for prevention of cervical cancer.

关 键 词：子宫颈鳞状上皮内病变 子宫颈肿瘤 人乳头瘤病毒 

分 类 号：R719.8[医药卫生—妇产科学]