女性下生殖道尖锐湿疣的诊断

Diagnosis between condyloma acuminatum andpseudocondyloma in lower female ginital tractas determined by a PCR-based method

采用分子生物学多聚酶链反应（ＰＣＲ）方法，对女性下生殖道疣状赘生物６１６例妇女（团块型３０７例，丘疹型３０９例），进行人乳头瘤状病毒ＨＰＶ＿（６，１１，１６，１８，３３，３５）ＤＮＡ等４８个亚型检测，并与以免疫组织化学ＡＢＣ方法检测ＨＰＶ－Ａｇ（衣壳抗原）及电镜、光镜、阴道镜等方法进行比较。结果：ＰＣＲ方法的灵敏度和特异性最强，团块型阳性率９７．９０％，丘疹型１．１０％，两型共存者均团块型阳性而丘疹型阴型。团块型ＨＰＶ－Ａｇ阳性率５３．５５％，诊断性空孢细胞７０．４９％、病毒颗粒５．８８％；丘疹型无ＨＰＶ－Ａｇ、无ＨＰＶ颗粒、无诊断性空泡细胞。提示：团块型为ＨＰＶｓ感染的尖锐湿疣，丘疹型为假性湿疣。

rom Jan. 1990- Aug. 1992, 616 patients withpapillomatous growth of the lower female genital tractfthe nodular type 307 cases, the papular type 309cases) were investigated as determined by a PCp.(polymerase chain reaction)-based method, associatedwith immunohistochemistry avidin biotin complex(ABC), electron microscopy, histopathology,colposcopy and clinical follow-up.The PCR is the most sensitive and specific me-thod. Using PCR the HPV DNA 6.1 1.16.18.33 werepositive in 97.90% of the nodular type. However HPVDNA were positive in 1.10% of the papular type. Inthe patients with both type, HPV DNA were also posi-tive in nodular, but negative in papular. In the nodulartype the HPVAg present in 53.55% by ABC method,the koilocytes were 70.49% by microscopy, HPV par-ticles were seen in 5 out of 85 samples by electronmicroscopy. So that the nodular type ftypical cauli-flower like) is genital warts (condyloma acuminatum)bv HPV infection.The papular type (typical papular or finger like)growth on the mucosal surface of the labia minora oflower vagina. They were negative for HPV DNA.HPV-Ag, HPV particks and koilocytes. On follow-upobservation for 3 months to 2 years they had notdeveloped to nodular type and no sexually transmittedfeature was observed. The papular type ispseudocondyloma.