尖锐湿疣和假性湿疣病理组织学及人乳头瘤病毒DNA研究

Detecting human papillomavirus DNA of condylomata and pseudo-condylomata by in situ hybridization and polymerase chain reaction in paraffin-embedded specimens

应用免疫组化、核酸原位杂交和聚合酶链反应（ＰＣＲ）等方法，对２７４例尖锐湿疣和假性湿疣病例的活检组织石蜡包埋标本，进行病理组织学和人乳头瘤病毒（ＨＰＶ）６ｂ、１１ＤＮＡ及核壳抗原（ＨＰＶ－Ａｇ）的检测。结果：尖锐湿疣和假性湿疣表面上皮呈乳头状结构，尖锐湿疣有明显的基底细胞增生、上皮增厚、典型的挖空细胞；假性湿疣则无上述改变。尖锐湿疣组织中ＨＰＶ６ｂ、１１ＤＮＡ检测阳性率分别为：核酸原位杂交法８２．５％，ＰＣＲ法８３．９％，免疫组化法检测ＨＰＶ－Ａｇ阳性率为４８．９％。假性湿疣组织中，核酸原位杂交检测ＨＰＶ６ｂ、１１ＤＮＡ和免疫组化法检测ＨＰＶ－Ａｇ无１例阳性，ＰＣＲ法检测ＨＰＶ６ｂ、１１ＤＮＡ，３例阳性。提示：假性湿疣是外阴和阴道粘膜结构异常的表现，局部表现易与尖锐湿疣混淆。ＰＣＲ法检测灵敏，阳性率高，核酸原位杂交法有细胞定位的优点。

ne hundred and thirty seven cases of paraffin-embedded tissue specimens biopsied each from condylomata and pseudo-condylomata of vulva and vagina were examined.Type 6b、11 human papillo-mavirus(HPV)DNA was detected in condylomata by in situ hybridization using digoxigeninlabelled probes and polymerase chain reaction(PCR).The positive rate was 82.5%,83.9%respectively.It was negative in the 1 37 cases of pseudo-condylomata by in situ hybridization,but positive in 3 cases by PCR. For a correct diagnosis,the necessity of combining the data of clinical finding, microscopic exami-nation and in situ hybridization or PCR is emphasized. Our results showed that pseudo-condylomata rep-resent dysplastic appearances of vulval and vaginal mucosa,which become more marked during pregnan-cy and fungal or trichomonal infections,and could rather easily be misdiagnosed as condylomata.