HPV感染型别及多重感染对宫颈病变的影响  

Types of HPV infection and influence of multiple infections on cervical lesions

作　　者：李洋[1] 李永丽[1] 王芦萍[1] LI Yang;LI Yong-li;WANG Lu-ping(Hena Province People 9s Hospital,Zhengzhou,Henan,450003,China)

机构地区：[1]河南省人民医院健康管理学科

出　　处：《中华医院感染学杂志》2019年第22期3461-3464,3472,共5页Chinese Journal of Nosocomiology

基　　金：河南省基础与前沿技术研究计划基金资助项目(132300410213)

摘　　要：目的探讨人乳头瘤病毒(HPV)感染型别及多重感染对宫颈病变的影响。方法选取2016年2月-2018年2月于河南省人民医院行液基薄层细胞学检查-联合HPV-DNA检查的患者2126例为研究对象。结果2126例受检者中,HPV阳性者362例,阳性率17.03%,共检出17个亚型。HPV感染率最高的3种高危型分别为HPV16(2.92%)、HPV52(1.93%)和HPV56(1.88%),HPV感染率最高的低危型为HPV6(0.75%)。362例HPV阳性者中单一HPV感染322例,占15.15%,多重感染40例,占1.88%。未见上皮内病变或恶性细胞(NILM)、无明确诊断意义的不典型鳞状细胞(ASCUS)、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)和反应性细胞改变伴随炎症分别占67.13%、12.15%、8.84%、2.76%和9.12%。慢性宫颈炎、低级别上皮病变、高级别上皮病变和浸润癌分别占65.19%、18.23%、10.50%和6.08%。不同宫颈病理分级患者HPV感染率不同。校准年龄因素后,HPV型别Logistic回归分析显示HPVl6和HPV18感染与浸润癌的关系较大(P<0.05)。结论HPV16和HPV18能使宫颈病变的发展更快,HPV病毒感染的多寡与宫颈病变存在显著关系,宫颈癌HPV感染倾向于单一HPV感染。OBJECTIVE To explore the types of human papillomavirus(HPV)infection and observe the influence of multiple infections on cervical lesions.METHODS A total of 2126 patients who received Thinprep cytologic test combined with HPV-DNA test in the hospital from Feb 2016 to Feb 2018 were recruited as the study objects.RESULTS Of the 2126 subjects,362 were positive for HPV,with the positive rate 17.03%;totally 17 subtypes were detected.The top 3 high-risk subtypes were HPV16(2.92%),HPV52(1.93%)and HPV56(1.88%),respectively.Among the low-risk subtypes of HPV,the incidence rate of HPV6 infection was the highest(0.75%).Of the 362 patients positive for HPV,322(15.15%)had single HPV infection,and 40(1.88%)had multiple infections.The patients with NILM accounted for 67.13%,the patients with ASCUS 12.15%,the patients with LSIL 8.84%,the patients with HSIL 2.76%,the patients with reactive cell change complicated with inflammation 9.12%.The patients with chronic cervicitis 65.19%,the patients with low-grade epithelial lesions 18.23%,the patients with high-grade epithelial lesions 10.50%,the patients with infiltrating carcinomas 6.08%.The patients with different cervical pathological grades differed in the incidence of HPV infection.After the age was adjusted,the logistic regression analysis of the types of HPV showed that the infiltrating carcinomas was highly associated with the HPV 16 and HPV18 infection(P<0.05).CONCLUSION HPV16 and HPV18 may accelerate the progression of cervical lesions,the HPV infection is remarkably associated with the cervical lesions,and the cervical cancer HPV infection tends to be single HPV infection.

关 键 词：宫颈病变 人乳头瘤病毒 型别 多重感染 

分 类 号：R73[医药卫生—肿瘤]