375例宫颈病变患者高危型人乳头瘤病毒感染的研究

Study of correlation between infection of high risk human papillomavirus and cervical lesions

目的探讨高危型人乳头瘤病毒（high—risk Human papillomavirus，hr-HPV）感染与宫颈病变的关系。方法选择2005年1月～2006年6月间在本科住院患者375例，采用第2代杂交捕获试验（HC-Ⅱ）进行hr-HPV DNA的检测，手术切除或阴道镜下定位活检，以病理学结果为确诊标准。结果hr-HPV检测阳性169例，阳性率45．07％，各种病理类型的宫颈病变中hr-HPV感染率分别为：慢性宫颈炎14．67％（55／229）；宫颈上皮内瘤变（cervical intraepithelial neoplasia，CIN）50．00％（18／36），包括CINⅠ、CINⅡ、CINⅢ；宫颈癌（uterine cervix cancer，UCC）87．27％（96／110），包括宫颈鳞癌和宫颈腺癌。随着宫颈病变严重程度的增加，hr-HPV的感染率也增高，它们之间的差异有统计学意义（P〈0．05）。结论hr-HPV感染与宫颈病变严重程度密切相关；HC-Ⅱ检测hr-HPV有助于UCC及癌前病变的早期筛查和诊断。

Objective To explore the relation between high-risk Human papillomavirus（hr-HPV ）infection and cervical lesions. Methods The test study was carried out in which 375 women who received treatments from January 2005 to June 2006 were recruited. HPV DNA was semi-quantitatively determined by hybrid capture Ⅱ （HC- Ⅱ ） ,then cervical biopsy was obtained under col poscope or operation and results of histopathologic tests were the final diagnoses. Results High risk HPV DNA was detected in 169 women （45.07%）. Among them,infection rates of high risk HPV according to different cervical diseases were the as follows： 14.67% of chronic cervicitis,50.00% of cervical intraepithelial neoplasia（CIN）,including CIN Ⅰ ,CIN Ⅱ and CIN Ⅲ ,87.27% of cervical squamous cell carcinoma（SCC） and cervical adenocarcinoma. This rate increased from cervicitis,CIN to uterine cervix canc er （UCC）, and the significant difference was observed between the groups of UCC, CIN and cervicitis （P〈 0.05）. Conclusion There is significant correlation between elevated high risk HPV DNA and severity of cervical lesion. HC- Ⅱ for detecting cervical lesion help to define the diagnosis of UCC and lesion precancerous.