尖锐湿疣临床治愈后原皮损区人乳头瘤病毒监测

Monitoring Human Papillomavirus in Original Lesion Area of Condyloma Acuminata after Clinical Curing

目的探讨人乳头瘤病毒(HPV)亚型、存在时间及其与尖锐湿疣(CA)复发的关系。方法采用荧光定量PCR(FQ-PCR)技术,对临床治愈后的CA患者于3、6、9个月在原皮损区取活体组织行HPV亚型的测定。结果HPV6、11型63例,3例临床及病例均支持CA的诊断,但FQ-PCR检查结果阴性;9个月时检出的10例阳性患者中HPV6、112例、HPV16、182例和HPV6、11/16、18混合型6例;而2例HPV6、11型阳性患者中有1例复发,2例HPV16、181例复发,6例HPV6、11/16、183例复发。结论HPV6、11型是最常见的亚型,疣体去除后HPV6、11型和HPV16、18型、HPV6、11/16、183种类型在机体内存在的时间大多>3个月;除疣治疗后6个月时HPV6、11在局部皮肤内大多被清除,这说明该型预后较好,复发率较低;HPV的阳性检出率与临床复发率之间呈密切相关性。

OBJECTIVE To explore the subtypes of human papillomavirus（HPV） resulting in condyloma acuminata （CA）, and to find the relationship of recurrence of CA with subtypes and existence status at different time points of infected HPV. METHODS Fluorogenic quantitative PCR（FQ-PCR） was used for the detection of HPV in the original lesion and the left-over cutaneous lesion areas 3,6 and 9 months after the removal of the lesion. RESULTS nPV6,11 were positive in 63 cases. Both HPV6,11 and HPV16,18 were negative in 3 cases. At the 9 months after the removal of the original lesion, FQ-PCR analysis was positive in 2 of the 63 cases of HPV6,11,2 Of the 17 cases with HPVx6.18 and 6 of the 13 cases with HPV6,11/16,18, respectively（P〈0. 05）. Of all the ten cases with FQ-PCR analysis positive at the 9 months. 1,1 and 3 relapsed in the 2 cases with HPV6,11 , 2 with HPVa6,x8 and 6 with HPV6,11/16,18 ,respectively. CONCLUSIONS From this study, it can be concluded that the predominate HPV resulting in CA is HPV6,11. The other types HPV could be the etiology in a small number cases of CA. The recurrence of CA is related with the subtypes and persistence of existence of the infected HPV. Cases with HPV6,11 have a much better prognosis with a low recurrence compared of the cases with nPV16,18 and HPV6,11/16,18 ,which could be clue to the fact that the virus is cleaned sooner in cases of HPV6,11 than in the latter two types of cases.