宫颈鳞状上皮病变与高危型人乳头瘤病毒感染关系的研究  

Investigation on the correlation between cervical squamous epithelial lesions and high-risk human papilloma virus infection

作　　者：魏胜男 苏雅洁 米鑫 WEI Shengnan;SU Yajie;MI Xin(Department of Pathology,Shunyi Maternal and Children’s Hospital of Beijing Children’s Hospital,Beijing 101300,China;Department of Obstetrics and Gynecology,Shunyi Maternal and Children’s Hospital of Beijing Children’s Hospital,Beijing 101300,China)

机构地区：[1]北京市顺义区妇幼保健院北京儿童医院顺义妇儿医院病理科,北京101300 [2]北京市顺义区妇幼保健院北京儿童医院顺义妇儿医院妇产科,北京101300

出　　处：《中国医药科学》2023年第14期98-101,116,共5页China Medicine And Pharmacy

摘　　要：目的探讨高危型人乳头瘤病毒(HR-HPV)感染与宫颈鳞状细胞癌(SCC)及其癌前病变的关系。方法收集北京儿童医院顺义妇儿医院2018年1月至2022年11月确诊的SCC患者85例,并随机抽取同期慢性宫颈炎,低级别鳞状上皮内病变(LSIL)及高级别鳞状上皮内病变(HSIL)病例各85例的临床资料、HR-HPV分型检测、宫颈组织病理学结果及免疫组织化学染色结果。结果患者年龄21~84岁,平均(42.54±11.58)岁,以30~39岁组为主,SCC组平均年龄最高;均以一重感染为主,HSIL组HR-HPV感染率最高,其次为SCC组;排名前3位的HR-HPV亚型依次为HPV16、52、58;HPV阴性角化型SCC肿瘤细胞异型性显著大于HPV阳性角化型SCC;6例HPV阴性的SCC中,5例P16弥漫强阳性,1例P53为突变型。SCC及HSIL病例中,解脲脲原体阳性比例较高。结论HR-HPV感染的种类、持续时间与宫颈病变严重程度有关,HPV16、52、58是本研究中最常见的3种亚型。P16、P53的检测可能有利于早期宫颈HPV无关性SCC的发现。Objective To investigate the correlation between high-risk human papilloma virus(HR-HPV)infection and cervical squamous cell carcinoma(SCC)and its precancerous lesions.Methods A total of 85 cases with SCC diagnosed in Shunyi Women’s and Children’s Hospital of Beijing Children’s Hospital from January 2018 to November 2022 were collected and divided into the SCC group(n=85).In the same period,cases of chronic cervicitis,including low-grade squamous intraepithelial lesion(LSIL)and high-grade squamous intraepithelial lesion(HSIL),were randomly selected and divided into the LSIL group(n=85)and the HSIL group(n=85).Meanwhile,the clinical data,HR-HPV typing test,cervical histopathological results and immunohistochemical staining results were included.Results The age of patients ranged from 21 to 84 years old,with an average age of(42.54±11.58)years old,mainly in the 30-39 years old group,and the average age of the SCC group was the highest.The main infection type was primary infection,with the highest infection rate of HR-HPV in the HSIL group,followed by the SCC group.The top three subtypes of HR-HPV were HPV16,52 and 58,respectively;The tumor cell atypia of HPV-negative keratotic SCC was significantly greater than that of HPV-positive keratotic SCC.Of the 6 cases of SCC with negative HPV,5 showed diffuse strong positive P16,and 1 showed mutant P53.In SCC and HSIL cases,the positive rate of ureaplasma urealyticum was relatively higher.Conclusion The type and duration of HR-HPV infection are related to the severity of cervical lesions.HPV16,52 and 58 are the three commonest subtypes in this investigation.The detection of P16 and P53 may be beneficial to the early discovery of HPV-independent SCC in the cervix.

关 键 词：宫颈鳞状上皮病变 高危型人乳头瘤病毒 HPV无关性鳞状细胞癌 P16 P53 

分 类 号：R737.33[医药卫生—肿瘤]