外耳道乳头状瘤患者病变组织中人乳头状瘤病毒型别分布及疫苗保护的分析  

Analysis of HPV typing distribution and vaccine protection in cases of papilloma of the external auditorycanaltissues

作　　者：梅静 郭正 耿建祥[3] 鲁媛媛 路亮 包磊 陈淼[3] 丰宇芳 何秋香 Mei Jing;Guo Zheng;Geng Jianxiang;Lu Yuanyuan;Lu Liang;Bao Lei;Chen Miao;Feng Yufang;He Qiuxiang(Department of Pathology,Dangtu People's Hospital,Ma'anshan 243100,China;Department of Otorhinolaryngology,Dangtu People's Hospital,Ma'anshan 243100,China;Department of Pathology,Nanjing Hospital of Chinese Medical Affiliated to Nanjing University of Chinese Medicine,Nanjing 210022,China)

机构地区：[1]当涂县人民医院病理科,马鞍山243100 [2]当涂县人民医院耳鼻咽喉科,马鞍山243100 [3]南京中医药大学附属南京中医院病理科,南京210022

出　　处：《国际耳鼻咽喉头颈外科杂志》2023年第6期311-315,共5页International Journal of Otolaryngology-Head and Neck Surgery

基　　金：江苏省南京市卫健委中医专项(2009-92)。

摘　　要：目的 探讨外耳道乳头状瘤(papilloma of the external auditory canal,PEAC)患者病变组织中23种人乳头状瘤病毒(HPV)感染型别的分布状况及疫苗保护的临床意义.方法 收集2010年1月至2022年12月当涂县人民医院病理科诊断为PEAC的石蜡组织标本115例.从PEAC患者石蜡组织中提取HPV DNA,采用聚合酶链式反应(PCR)和基因芯片技术对其病变组织行23种HPV检测,并对患者HPV感染分布状况及疫苗保护情况进行分析.结果 115例PEAC患者中,HPV总检出率为77.39%(89/115),发病年龄60~79岁.89例HPV感染者中,一型感染者79例,占88.76%(79/89),均为6型,6型是重要的感染型别;多型感染者10例,占11.24%(10/89),以6+16型为主要感染型别.PEAC、PEAC伴低级别病变、PEAC伴高级别病变中,低危一型HPV(6型)感染率分别为78.43%、64.52%、0,组间比较差异有统计学意义(χ^(2)=7.212,P<0.05),高危+低危型HPV(高危型+6型)感染率分别为0、11.29%、100.00%,组间比较差异有统计学意义(χ^(2)=28.917,P<0.05).结论 HPV感染是PEAC发生最主要的因素,以低危一型HPV(6型)感染为主,多型HPV感染为辅,低危一型HPV(6型)感染率与PEAC上皮内瘤变级别的增加成反比,高危+低危型HPV(高危型+6型)感染率与PEAC上皮内瘤变级别的增加成正比.对PEAC患者大样本病变组织行HPV分型检测,有利于PEAC病因学诊断,对防止该病变的传播、复发、恶变和疫苗保护评估都具有重要的临床指导意义.Objective To investigate the distribution of different kinds of genotype of HPV in papilloma lesion of the external auditory canal(PEAC)and the clinical value of HPV vaccine protection.Methods Specimens from 115 male and female patients with PEAC from the People's Hospital of Dangtu County in Anhui provinces from January 2010 to December 2022 were collected.HPV DNA was extracted from the paraffin papilloma tissues of PEAC patients.By the combinaion of polymerase chain reaction(PCR)and gene chip technology,23 genotypes of HPV were detected,and the distribution of different kinds of genotype of HPV and HPV vaccine protection percentage were analysed.Results In 89 of 115 PEAC patient's HPV test result shows positive,the positive rate is 77.39%,and their age range from 60 to 79 years old.Among the 89 PEAC patients,79 are single type(88.76%)affected,10 are multi-type affected(11.24%).Type 6 was found in the single type HPV affection cases,while type 6+16 is the main type in the cases of HPV multi-type affection.The low-risk HPV(type 6)infection rates in PEAC group,PEAC with lowgrade lesion group,PEAC with high-grade lesiongroup were 78.43%,64.52%and 0%respectively.And the differences among the three groups were statistically significant(x?=7.212,P<0.05).The high and low-risk HPV(high-risk+type 6)infection rates in the three groups were 0%、11.29%and 100%respectively,and the differences were statistically significant(x2=28.917,P<0.05).Conclusions HPV infection is the most important factor of PEAC happen,the majority is single type(type 6)affection,while the multi-type affection is fewer.The low-risk HPV(type 6)infection rate is inversely proportional to the increase of PEAC epithelial neoplasia grade.High-risk and lowrisk HPVs(high-risk type+type 6)infection rate is directly proportional to the increase of PEAC epithelial neoplasia grade.HPV typing of of PEAC is helpful for etiology diagnosis.It has important clinical significance for preventing disease transmission,recurrence,malignant transformation and for evaluati

关 键 词：乳头状瘤病毒感染 乳头状瘤病毒疫苗 聚合酶链式反应 外耳道乳头状瘤 

分 类 号：R764.1[医药卫生—耳鼻咽喉科]