尖锐湿疣患者皮损中人乳头瘤病毒检测与临床复发关系的研究

Detection of human papillomavirus in patients with condyloma acuminata and its correlation with clinical recurrence

目的探讨杭州地区尖锐湿疣患者中人乳头瘤病毒(HPV)感染的型别,以及不同病毒型别和病毒载量与复发的关系。方法采用实时荧光定量聚合酶链反应(FQ-PCR)检测了289例患者皮损中的HPV,并作临床跟踪观察3个月,记录复发次数。结果289例患者中仅HPV6/11型感染214例,占74.04%;37例为HPV6/11和HPV 16/18混合感染,占12.80%:仅HPV16/18阳性者16例,占5.54%;HPV6/11和16/18均阴性者22例,占7.61%。53例HPV16/18阳性感染者中,男18例,阳性率为13.14%;女35例,阳性率为23.03%,差异有统计学意义(χ2=4.6979,P<0.05)。HPV16/18型感染组与HPV6/11型感染组的3个月复发率差异无统计学意义(P>0.05),但复发次数高于HPV6/11感染组(P<0.05)。不同HPV6/11型病毒载量组之间的3个月复发率和复发次数差异均无统计学意义(P>0.05)。结论尖锐湿疣患者的HPV感染型别以6/11型为主,女性患者中高危型HPV16/18型的感染率明显高于男性。不同HPV型别与复发率无关,但高危型HPV感染者复发次数增加。不同HPV6/11型病毒载量与尖锐湿疣的临床复发无关。

Objective To explore the type and DNA load of human papillomavirus（HPV）in patients with condyloma acuminata（CA） and its correlation with clinical recurrence. Methods Two hundred and eighty nine samples from patients with condyloma acuminata were detected by real-time fluorescence quantitative polymerase chain reaction（FQ-PCR）. The correlation of the type and DNA loads of HPV with its recurrence was determined. Results Two hundred and fourteen cases were HPV6/11 positive（74.04% ）, 37cases were HPV6/11 and 16/18 mixed positive（ 12.80% ）, 16 cases were HPV16/18 positive（5.54% ）and 22 cases were all negative for HPV6/11 and 16/18 （7.61% ） . Of 53 cases HPV16/18 positive, 18 cases were male（ 13.14 % ）and 35 cases female（23.03 % ）. There was difference in infection rate of HPV16/18 between the male and female （χ^2 = 4. 6979, P 〈 0.05）. No difference in clinical recurrence was noticed between the two types of HPV （ Z2 = 3. 3051, P 〉 0.05）, but the frequency of recurrence of HPV16/18 was more than that of HPV6/ 11 （t = 2. 228 2, P 〈 0.05）. There was no difference in recurrence rate and frequency of recurrence between the different HPV DNA loads （ χ^2 = 2.458, P 〉 0.05 ; F = 1.08, P 〉 0.05）. Conclusions HPV6/11 is the main type of virus infection in patients with CA in Hangzhou city.The high risk to HPV16/18 infection is more common in the female than in the male. Different types and HPV6/11 DNA loads are not correlated with recurrence of CA.