宫颈疾病中HPV高危亚型分型定量研究及其临床意义

Significance of Quantification of High-risk HPV in Cervical Tissues

目的探讨不同程度宫颈疾病患者中HPV高危亚型分型定量检测的意义。方法应用实时荧光定量PCR技术,对东海县人民医院近两年的97例诊断为宫颈疾病的石蜡组织切片进行HPV 8种高危亚型分型定量。结果 8种高危亚型的总感染率为35.2%,慢性宫颈炎(19%)、宫颈炎伴磷化(14.3%)、宫颈息肉伴磷化(33.3%)、CINI(41.7%)、CINII(50%)、CINIII(66.6%)、宫颈癌(72.7%)的感染率具有显著性差异(P<0.05)。8种高危亚型中HPV16(44%)为主要感染亚型,特别在宫颈癌患者中的感染率最高,达75%。HPV的复合感染率为28%,在宫颈癌(25%)、宫颈上皮内瘤变(44.4%)、非宫颈癌类宫颈疾病(12.5%)中复合感染率无显著性差异(P>0.05)。高危亚型的病毒载量研究显示宫颈癌(5.90×107U/ml)和宫颈癌前病变(4.99×106U/ml)的平均病毒载量高于宫颈其他类疾病(1.11E×104U/ml)。8种高危亚型平均感染年龄统计显示,HPV16/18/45、HPV31、HPV33/52/58/67分别为53.9、46.3、45.6。结论 HPV高危亚型的感染概率随宫颈疾病的严重程度增加而增加,特别HPV16亚型与宫颈癌的发生有密切的关系。HPV定量值显示高病毒载量的持续感染增加了宫颈癌发生的风险性。

Objectives To investigate the significance of HPV DNA genotypes detection and viral loads quantification in different cervical diseases. Methods Ninety-seven paraffin sections from Donghai County People's Hospital in recent two years,which were diagnosed as cervical diseases, were detected for 8 genotypes and viral load of HPV DNA through Fluorescent Quantification PCR method. Results The total positive rate of 8 high-risk subtypes is 35.2%. There are significant difference in infection rates among chronic cervicitis(19%), cervicitis with phosphate(14.3%), cervical polyp with phosphate(33.3%),CINI(41.7%), CINII(50%), CINIII(66.6%) and cervical carcinoma(72.7%). HPV16(44.4%) was main subtype in 8 high-risk genotypes, especially in cervical carcinoma, which infection rate reach to 75%. The rate of multiply infection was 28%. There aren't statistics significance among cervical carcinoma(25%), CINIII(44.4%), other cervical diseases(12.5%). The research reveal that mean viral loads of 8 HPV genotypes in cervical carcinoma(5.90×107U/ml) and CIN(4.99×106U/ml) are higher than in other cervical diseases(1.11×104U/ml). Mean ages of HPV16/18/45, HPV31, HPV33/52/58/67 are 53.9, 46.3, 45.6 respectively.Conclusions Infection rates of HPV are increasing by the degree of cervical diseases. There are close relationships between HPV16 infection and cervical carcinoma development. Persistent infection of high viral loads of HPV will increase the risk of cervical carcinoma occurrence.