高危型HPV型别和分布特点及对LEEP术治疗宫颈鳞状上皮病变的临床价值分析  

The types and distribution characteristics of high-risk HPV and the clinical value of LEEP in the treatment of cervical squamous epithelial lesions

作　　者：郑景孟 庄慧杰 戴泽果 ZHENG Jing-meng;ZHUANG Hui-jie;DAI Ze-guo(Department of Medical Technology,Lufeng People’s Hospital,Lufeng 516500,China)

机构地区：[1]陆丰市人民医院医技科,516500

出　　处：《中国现代药物应用》2021年第8期43-46,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨检测高危型人乳头瘤病毒(HPV)型别及分布特点对评估宫颈环形电切术(LEEP术)治疗宫颈鳞状上皮病变预后的意义。方法回顾性分析8704例行HPV检测的女性患者的临床资料,分析其HPV分型检测结果及分布特点,83例行LEEP术的宫颈鳞状上皮病变患者术前及随访HPV感染情况及病理指标。结果8704例女性检测中,HPV阳性926例,占比为10.64%,其中单一亚型感染769例、占比为83.05%,多重亚型感染157例、占比为16.95%。高危型HPV感染率最高的分型依次为:HPV52、16、58、53、33,感染率分别为2.50%(218/8704)、1.75%(152/8704)、1.08%(94/8704)、0.78%(68/8704)、0.57%(50/8704)。926例HPV阳性患者中最终以病理诊断为宫颈鳞状上皮病变CINⅠ~Ⅲ的有235例,其中HPV16阳性89例、占比为37.87%,HPV52阳性70例、占比为29.79%。83例行LEEP术的宫颈鳞状上皮病变患者中,CINⅠ22例,CINⅡ18例,CINⅢ43例,83例术前HPV检测阳性率为100.00%(83/83),17例(20.48%)为HPV多重感染;高危型HPV感染率由高至低分布依次为HPV16、52、58、33、18、53、39、68、56、73;HPV16患者29例,占比为34.94%;HPV52患者14例,占比为16.87%;HPV58患者14例,占比为16.87%;HPV33患者8例,占比为9.64%;HPV18患者7例,占比为8.43%;HPV53患者5例,占比为6.02%;HPV39患者2例,占比为2.41%;HPV68患者2例,占比为2.41%;HPV56患者1例,占比为1.20%;HPV73患者1例,占比为1.20%;其中29例HPV16型病变中CINⅢ22例。83例行LEEP术的宫颈鳞状上皮病变患者术后随访中,检测高危型HPV阳性5例,占比为6.02%(5/83)。4例经病理活检证实有病变残留或复发,发生率为4.82%(4/83),发现病变残留或复发时间为术后3~12个月,其中3例为CINⅢ,1例为CINⅡ;病变残留或复发患者高危型HPV检测阳性占比为100.00%(4/4),其中HPV16型3例,HPV52型1例。结论宫颈鳞状上皮病变以单一的高危型HPV感染为主,主要型别是HPV16、HPV52,宫颈鳞状上皮病变经LEEP术治疗后,高危型HPV检测可有Objective To discuss the significance of detecting the types and distribution characteristics of high-risk human papillomavirus(HPV)in evaluating the prognosis of cervical squamous epithelial lesions treated with loop electrosurgical excisional procedure(LEEP).Methods The clinical data of 8704 female patients who underwent HPV detection were retrospectively analyzed.The results of HPV typing and distribution were analyzed.The HPV infection and pathological indexes of 83 patients with cervical squamous epithelial lesions who underwent LEEP were analyzed.Results Among the 8704 women tested,926 cases were HPV positive,accounting for 10.64%,of which 769 cases had single subtype infections,accounting for 83.05%,and 157 cases had multiple subtype infections,accounting for 16.95%.The highest infection rate of high-risk HPV were HPV52,16,58,53 and 33,with infection rate as 2.50%(218/8704),1.75%(152/8704),1.08%(94/8704),0.78%(68/8704)and 0.57%(50/8704).Among the 926 HPV-positive patients,235 cases were diagnosed as cervical squamous epithelial lesions CINⅠ-Ⅲby pathology.Among them,89 cases were HPV16 positive,accounting for 37.87%,and 70 cases were HPV52 positive,accounting for 29.79%.Among 83 patients with cervical squamous epithelial lesions who underwent LEEP,there were 22 cases of CINⅠ,18 cases of CINⅡand 43 cases of CINⅢ.The positive rate of HPV detection before LEEP was 100.00%(83/83),and 17 cases(20.48%)were multiple HPV infection.The distribution of high-risk HPV infection rates from high to low were HPV16,52,58,33,18,53,39,68,56,73;there were 29 cases of HPV16 positive,accounting for 34.94%;14 cases of HPV52 patients,accounting for 16.87%;14 cases of HPV58 positive,accounting for 16.87%;8 cases of HPV33 positive,accounting for 9.64%;7 cases of HPV18 positive,accounting for 8.43%;5 cases of HPV53 positive,accounting for 6.02%;2 cases of HPV39 positive,accounting for 2.41%;2 cases of HPV68 positive,accounting for 2.41%;1 case of HPV56 positive,accounting for 1.20%;1 case of HPV73 positive,accounting for 1

关 键 词：高危型人乳头瘤病毒 宫颈上皮内瘤变 宫颈环形电切术 

分 类 号：R737.33[医药卫生—肿瘤]