人乳头状瘤病毒基因亚型与宫颈病变的关系

Correlation between human papillomavirus(HPV) genotypes and cervical neoplasia

目的探讨不同基因亚型人乳头状瘤病毒(HPV)感染在宫颈病变中作用。方法对476例患者宫颈分泌物作病毒分型。其中238例在阴道镜下多点取活组织病理检查,根据病理学诊断结果分三组:(1)正常或炎症组,共43例;(2)低度鳞状上皮内瘤变(LSIL)组,共152例;(3)高度鳞状上皮内瘤变(HSIL)组,包括宫颈浸润癌共43例。根据人乳头状瘤病毒基因(HPVDNA)亚型分布,分析HPV感染基因型与宫颈病变程度的关系。结果高度鳞状上皮内瘤变患者中HPV阳性率达90.5%,原位癌及浸润癌达100%,正常或炎症组、LSIL组、HSIL组HPV感染者分别占48.6%、67.7%、90.5%,HSIL组明显高于其他两组,差异显著(P<0.001)。宫颈病变存在多重HPV感染。结论宫颈病变患者感染HPV52、16、51、58、68、CP8304、11型较多见,HPV16、52、58、31、CP8304、33、18型致癌性较强,多重HPV感染可能促进宫颈癌的发生。

Objective To explore the effect of the various HPV genotypes on cervical neoplasia. Methods The HPV genotypes in cervical of 476 women were examined with hybridization. 238 women had cervical biopsy and were classified as three groups according to the histological diagnosis： （1）Normal group,43 cases; （2）Low grade squmaous intraepithelial lesion LSIL group, 152 cases; （3） High grae squmaous intraepithelial lesion HILS group, 43 cases. Results Positive rate of HPV in cervical carcinoma, HSIL,LSIL and normal groups respectively was 100 % , 90.9 % ,67.7 % ,and 48.6 %. There was significant difference between HSIL group and other two groups（P 〈 0. 001）. The patients with cervical neoplasia had multiple HPV infection. Conclusion The study shows that the infection of HPV-52,26,51,56,68, CP8304,11 often exists in women suffered from cervical neoplasia. The infection of HPV-16,52,58,31, CP8304,33,18 develops into cervical carcinoma more easily. The women with cervical carcinoma maybe have multiple HPV infection.