不同程度宫颈病变感染人乳头瘤病毒的优势亚型

Optimal HPV Genotype of Women with Different Stages of Cervica Lesions

目的研究不同程度子宫颈病变感染人乳头瘤病毒(humam papillomavirus,HPV)的优势亚型。方法选取子宫颈病变患者270例,其中组织学检查示典型HPV感染改变者54例、CIN1 85例、CIN2 63例、CIN3 48例、子宫颈癌20例。低度鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)包括HPV感染改变者和CIN1,高度鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)包括CIN2和CIN3。采用HPV基因芯片检测及分型方法检测所有患者子宫颈分泌物中的HPV亚型。结果270例子宫颈分泌物中HPV亚型感染频度由高到低的前5位依次为HPV-16(49.7%)、HPV-58(16.8%)、HPV-18(12.6%)、HPV-33(9.0%)、HPV-31(6.0%),而其余亚型所占比例均小于4.0%。子宫颈病变分级不同,感染的HPV亚型亦有区别。HSIL组HPV感染型别前5位由高至低依次为:HPV-16、58、18、33和31,感染率分别为62.6%、14.1%、11.1%、8.1%和6.1%,在HSIL中此5种亚型感染覆盖率为90.8%;而LSIL组HPV感染型别由高至低依次为:HPV-16、18、58、33和31,感染率分别为21.7%、19.6%、17.4%、8.7%和6.5%,其余亚型所占比例均小于5%,LSIL中此5种亚型感染覆盖率为69.6%。采用χ2检验发现,HSIL组HPV-16型感染率明显高于LSIL组,差异具有显著性意义(P<0.05),而LSIL组HPV-18型感染率明显高于HSIL组,差异具有显著性意义(P<0.05)。结论不同程度子宫颈病变感染HPV的优势亚型不同。HPV-16、58、18、33和31型的致癌性较强,其中HPV-16型最强。

Objective To investigate the optimal HPV genotype of women with different stages of cervical lesions.Methods 270 women with different stages of cervical intraepithelial neoplasia(CIN),including 54 cases of human papillomavirus(HPV) infection,85 cases of CIN1,63 cases of CIN2,48 cases of CIN3 and 20 cases of cervical cancer,were studied.High-grade squamous intraepithelial lesions(HSIL): CIN2 and CIN3,and low-grade squamous intraepithelial lesions(LSIL): CIN1 and HPV infection.The HPV genotype in the cervical swabs of these patients was detected by HPV gene chip.Results In the cervical swabs of 270 patients,the prevalence of the first 5 HPV types from highest to lowest order was as follows: HPV-16(49.7%),HPV-58(16.8%),HPV-18(12.6%),HPV-33(9.0%) and HPV-31(6.0%).The prevalence of the other HPV types was less than 4%.The infected HPV genotypes were different in different stages of cervical lesion.The prevalence of the first 5 HPV types in HSIL cases from highest to lowest order was as follows: HPV-16(62.6%), HPV-58(14.1%),HPV-18(11.1%),HPV-33(8.1%) and HPV-31(6.1%) with the coverage being 90.8%.The prevalence of the first 5 HPV types in LSIL cases from highest to lowest order was as follows: HPV-16(21.7%),HPV-18(19.6%),HPV-58(17.4%),HPV-33(8.7%) and HPV-31(6.5%) with the coverage being 69.6%.χ~2 analysis revealed that the HPV-16 infection rate of HSIL was significantly higher than that of LSIL(P<0.05),while the HPV-18 infection rate of LSIL was significantly higher than that of HSIL(P<0.05).Conclusion The optimal HPV genotype of women with different stages of cervical lesions is different.HPV-16,HPV-58,HPV-18,HPV-33 and HPV-31 are more oncogenic,and HPV-16 is the most oncogenic type.