人乳头瘤病毒基因型与宫颈上皮内瘤样病变的关系

Relationship Between Human Papillomavirus Genotype and Cervical Intraepithelial Neoplasia

目的：通过研究各级别宫颈上皮内瘤变中所感染HPV的基因型，来探讨不同基因型HPV的致病力。方法：对225例经活检证实的宫颈上皮内瘤变（CIN）患者的HPV检测结果进行分组分析，根据病变级别分为CINⅠ、Ⅱ、Ⅲ3组。225例GIN患者均有细胞学检查结果，HPV检测采用亚能HPV基因分型检测系统进行23种HPV—DNA亚型分析。结果：HPV-16和58亚型感染位居各级别宫颈病变的前两位，两者感染率占48．4％；本组CIN病例HPV亚型感染频度由高到低依次为HPV-16（30．2％）、58（18．2％）、33（8．6％）、18（7．1％）、56（4．9％）、31（4．4％）、11（3．2％）、35（2．2％）、45（1．6％）、6（1．6％）、52、59、68、43、39、66、73、83、42型；HPV-16（57．3％）、58（21．4％）、18（10．7％）、31（9．8％）、35（7．1％）、56．（3．6％）亚型居CINⅢ组的前6位，说明这些亚型致病力强，更易导致宫颈的高级别病变；在CINI-Ⅲ级病变中HPV二重或三重感染分别占19．4％、27．9％和16．7％，提示HPV双重或多重感染与宫颈病变级别之间无正相关性。结论：本组CIN患者HPV感染的常见亚型是16、58、33、18、56、31，易导致官颈高级别病变的亚型是16、58、18、3l、35、56，HPV—DNA的分型检测对预测病变进展、评估预后、指导治疗有重要价值。

ObJective： To investigate the human papillomavirus （ HPV ） genotype detected in patients with cervical intraepithelial neoplasia （ CIN ） and to analyze the pathogenicity of the various HPV genotypes. Methods： The result of HPV detected in 225 patients with CIN confirmed by biopsy was analyzed in group. According to different cervical disease, they were divided into three group： CIN Ⅰ, Ⅱ , Ⅲ . All the 225 patients had cytological results. Sub -HPV -genotyping system was applied to determine the 23 HPV -DNA types. Results： In different cervical diseases, HPV - 16 and 58 are the most common, the infection rate is 48.4% both. The prevalence of HPV types in CIN from highest to lowest order were follow： HPV- 16 （ 30. 2% ）, 58 （ 18.2% ）, 33 （ 8. 6% ）, 18 （7. 1% ）, 56 （ 4. 9% ）, 31 （ 4.4% ）,11 （3.2%）,35 （2.2%）,45 （ 1.6% ）,6（ 1.6% ）,52,59,68,43 ,39,66,73,83 ,42 ;HPV-16 （57. 3%） ,58 （21.4%.） , 18 （10.7%） ,31 （9.8%） , 35 （7. 1% ）, 56 （3.6%） , were the top six in CIN Ⅲ , which demonstrated the oncogenesis is stronger and more likely to lead to higher grade disease in cervices. Double or multiple HPV type infection in CIN Ⅰ - Ⅲ occurred at 19. 4% , 27.9% , and 16. 7% respectively. It hints that double or multiple HPV type no positive relation with different cervical diseases. Conclusion： HPV - 16 , 58 , 33 , 18 , 56 , 31 are the most common in patients with CIN, HPV - 16 , 58 , 18 , 31 , 35 , 56 have move tendency to lead to higher grade disease in cervices. HPV - DNA genotyping is of great importance in foreseeing progress, assessment of prognosis and instruction of therapy.