高危型HPV型别、病毒载量与宫颈癌前病变的相关性研究

Correlation of High-risk Human Papillomavirus Types and Viral Load with Cervical Precancerous Lesions

目的 研究高危型人乳头瘤病毒（HPV）感染的型别、载量与宫颈癌及癌前病变的相关性。方法 采用双色荧光定量PCR方法对307例宫颈组织细胞样本进行8种高危型HPVDNA（主要高危型：HPV16，18，45，31和次要高危型HPV33，52，58，67）分型及病毒载量检测。结果 307例样本HPVDNA与液基细胞学（LCT）检测结果均是阴性236例，两者均为阳性34例；62例HPVDNA阳性结果中LCT阴性28例、宫颈炎26例以及宫颈上皮肉瘤样病变（CIN）I～Ⅲ8例，245例HPVDNA阴性结果中LCT阳性9例；LCT阴性者感染HPV主要表现为次要高危型（15／28）与HPV16（12／28）感染，宫颈炎感染HPV主要表现为次要高危型HPV（17／26）、HPV16及HPV16伴随其它型别的多重感染（6／26）和HPV31（4／26）感染，不同型别HPV感染，感染的HPV病毒载量均≥102copies／cell。LCT阴性者与富颈癌前病变患者（宫颈炎、CINⅠ～Ⅲ）之间HPV感染率差异有显著性（P〈0．05），而病毒载量差异无显著性（P〉0．05）。结论 HPV16与HPV次要高危型感染是宫颈炎与宫颈癌前病变的主要诱因，高危型HPV病毒载量与宫颈癌前病变无明显相关性。

Objective To study the relationship between the types and viral load of human papilloma virus（HPV） infection and cervical precancerous lesions. Methods Adopting two-channels real time PCR to genotype and quantify eight high risk HPV DNA in 307 cervical epithelia samples （high risk types：HPV16,18,45,31;intermediate risk types .. HPV33, 52 , 58 , 67）. Results Using respectively real time PCR and LCT to test the 307 samples,both negative results are 236;both positive results are 34. 28 negative result of liquid based thin prepcytologytest （LCT）, 26 cervicitis and 8 cervical intraepithelial neoplasias（CIN） ⅦⅠ～Ⅲ are detected in 62 HPV DNA positive samples. 9 LCT positive are detected in 245 HPV DNA negative samples. The types of HPV are mainly intermediate risk （15/28） and 16 （12/28） in positive HPV samples while they are negative for LCT. The mainly HPV types in cervicitis are intermediate risk types （17/26） ,HPV 16 or associated with other types （6/26） and HPV31 （4/26）. The viral loads of HPV infection are all ≥10^2copies/cell among all type of HPV. There is a statistically significant difference in HPV infection rate between the LCT negative patients and the precancerous lesions patients （cervicitis, CIN Ⅰ～Ⅲ） （P〈0.05）. However,there is no statistically significant difference in viral load （P〉0.05）. Conclusion The main causes of cervicitis and precancerous lesions are the infection of HPV16 and intermediate-high risk types （HPV33/52/58/67）. There is no statistically significant difference in viral load between high risk types and precancerous lesions.