宫颈上皮内瘤变及鳞癌中人乳头瘤病毒不同亚型分布及多重感染的研究  

The distribution and multiple infections of different human papillomavirus subtypes in cervical intraepithelial neoplasia and squamous cell carcinoma

作　　者：陈婷婷[1] 张燕[1] 程会贤 陈名园 王巍[1] CHEN Ting-ting;ZHANG Yan;CHENG Hui-xian;CHEN Ming-yuan;WANG Wei(Department of Pathology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610044, China)

机构地区：[1]四川大学华西第二医院病理科、出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610044

出　　处：《实用医院临床杂志》2022年第1期38-42,共5页Practical Journal of Clinical Medicine

基　　金：四川省科技厅应用基础项目(编号:2019YJ0065);中央高校基本科研业务费专项资金资助(编号:SCU2019C4005)。

摘　　要：目的探讨宫颈上皮内瘤变及宫颈癌中不同HPV亚型分布及多重感染情况的临床意义。方法选取2019年7月至2020年6月四川大学华西第二医院病理科诊断为宫颈上皮内瘤变(CIN)Ⅰ、Ⅱ、Ⅲ级及宫颈癌的四川地区病例384例,其中CINⅠ、CINⅡ、CINⅢ分别为77、50、166例,宫颈癌91例。运用返向点杂交法检测其HPV感染情况,统计不同HPV亚型在CIN及宫颈癌中的分布及多重感染情况。结果384例患者总的HPV感染率为95.80%,各组病变均以高危型感染为主。高危型HPV在CINⅠ、CINⅡ、CINⅢ及宫颈癌中感染占比逐渐升高,分别为88.52%、92.96%、95.05%、97.96%;而低危型HPV在各组间感染占比则逐渐降低,分别从11.48%、7.04%、4.95%到2.04%,各组病变中高、低危型HPV组间差别有统计学意义(P=0.028)。总病例中最常见的HPV感染亚型为16、58、52、33、18型,此五种亚型在宫颈癌中感染率达96.7%,其中HPV16型感染率高达71.43%。感染病例中的多重感染率为25.54%。CINⅠ、CINⅡ、CINⅢ及宫颈癌中多重感染占比分别为50.00%、30.61%、21.25%、10.34%。结论四川地区宫颈上皮内瘤变及宫颈癌均以高危型HPV感染为主,常见感染类型为16、58、52、33、18型。HPV多重感染并未增加宫颈癌的发生风险,多重感染随着病变严重程度的增加而减少。关于不同HPV之间是否存在竞争性抑制关系,有待进一步研究。Objective To explore the clinical significance of distribution and multiple infections of different human papillomavirus(HPV)subtypes in cervical intraepithelial neoplasia(CIN)and cervical cancer.Methods We selected 384 patients diagnosed as CIN and cervical cancer at department of pathology in our hospital between July 2019 and June 2020.Of the 384 cases,77 were CIN I,50 were CINⅡ,166 were CINⅢ,and 91 were cervical cancer.HPV infection was detected by reverse dot blot hybridization.Distribution of different subtypes of HPV and related multiple infections in CIN and cervical cancer were analyzed.Results The total HPV infection rate in the 384 patients was 95.80%,and high-risk HPV infection was the main type in each group.In this study cohort,the proportion of high-risk HPV infections in CINⅠ,CINⅡ,CINⅢ,and cervical cancer was gradually increased from 88.52%,92.96%,95.05%,to 97.96%.The proportion of low-risk HPV infections in each group was gradually decreased from 11.48%,7.04%,4.95%,to 2.04%.There was a statistically significant difference between the high-risk and low-risk HPV infection in each group of lesions(P=0.028).The commonest HPV infection subtypes in this study population were HPV16,58,52,33,and 18.The infection rate of these five subtypes in cervical cancer was 96.7%,among which the infection rate of HPV16 was as high as 71.43%.In addition,the multiple infection rate among infected cases was 25.54%.The proportions of multiple infections in CINⅠ,CINⅡ,CINⅢand cervical cancer were 50.00%,30.61%,21.25%and 10.34%,respectively.Conclusion CIN and cervical cancer in Sichuan area are mainly high-risk HPV infections,and the commonest infection types are HPV16,58,52,33,and 18.Multiple HPV infections do not increase the risk of cervical cancer,and multiple infections are decreased when the severity of the lesions is increased.Further study is needed to answer whether there is a competitive inhibition relationship between different HPV subtypes.

关 键 词：宫颈上皮内瘤变 宫颈癌 人乳头瘤病毒 亚型 多重感染 

分 类 号：R365[医药卫生—病理学]