人乳头状瘤病毒感染与子宫颈癌发病关系的探讨

A Study on the Rel ationship between Human Papil l omavirus and the Incidence of Cervical Carcinoma

应用多重引物人乳头状瘤病毒（ＨＰＶ）６Ｂ／１１、１６、１８ 型聚合酶链反应（ＰＣＲ）技术检测９９例不同宫颈病变宫颈组织中人乳头状瘤病毒ＤＮＡ（ＨＰＶＤＮＡ）。其中宫颈湿疣２０例，宫颈上皮内瘤变（ＣＩＮ）１～２级（ＣＩＮ＿（１～２））１８例，ＣＩＮ３级（ＣＩＮ＿３）２０例，宫颈癌２３例和正常对照１８例。结果：上述宫颈组织中ＨＰＶＤＮＡ总检出率分别为８５．０％，８３．３％，８０．０％，８７．０％和２７．８％。宫颈各病变组中ＨＰＶＤＮＡ的检出率均显著高于对照组（Ｐ＜０．０１）。宫颈湿疣及ＣＩＮ＿（１～２）中ＨＰＶ６Ｂ／１１型检出率分别为８５．０％和７２．３％，ＣＩＮ＿３和宫颈癌中ＨＰＶ６和（或）１８型阳性率分别为５０．０％和７３．９％，两者ＨＰＶ型别分布差异有显著意义（Ｐ＜０．０１）。３例腺癌中ＨＰＶ１８型阳性２例，１６型阳性１例。低分化宫颈癌中均为ＨＰＶ１６和（或）１８型感染。提示：宫颈癌及其癌前病变的发生与ＨＰＶ感染高度相关。宫颈湿疣和ＣＩＮ＿（１～２）常与ＨＰＶ６Ｂ／１１型感染有关；ＣＩＮ＿３和宫颈癌的发生则与ＨＰＶ１６、１８型关系密切。

bjective To determine the relationship between the infection by human papillomavirus(HPV)and the incidence of cervical carcinoma. Methods Biopsy and paraffin wax embedded specimens(n=99 ) from various cervical lesions in the departrnent of gynecologic oncology were analysed by polymerase chain reaction(PCR )technique with multiple primers of HPV types 6b/11 , 16 and 18.Resul ts Of 9 9 cervical specimens investigated,2 0 were histopathologically diagnosed as cervical condyloma, 18 as cervical intraepithelial neoplasia(CIN ) grade 1～2(CIN_(1～2)), 20 as CIN grade 3(CIN_3),2 3 as cervical cancer and 1 8 as normal controls. Detection for HPV revealed that the positive rates of the five different groups were 85.0%, 83.3%, 80.0%, 87.0%and 27.8%,respectively. Those of the cervical lesions were significantly higher than that of the normal controls(P<0. 01). The predominant HPV type in condyloma and CIN_(1～2) group were HPV 6b/11 (positive rates 85.0%and72.3%), while HPV 16 and(or)18 DNA were more frequently found in the CIN_3 group(50.0%)and in the cervical cancer group(73.9%), The difference of distribution of HPV types in cervical condylo-ma,CIN_(1～2) and in CIN_3,and cervical carcinoma was statistically significant(P<0.01)。Concl usion HPV infections are intimately linked to condyloma , CIN and carcinoma of the uterine cervix; the low-risk types HPV 6 and 11 seem to be associated with cervical condyloma and the low grade CIN; the high-risk types 16 and 18 are closely related to high grade CIN and cervical carcinom,