生殖道HPV感染合并HCMV、HSV、UU、CT感染情况分析

To study the relationship between the individuals of HPV and 4 pathogens(HCMV,HSV,UU,CT)

目的:对比HPV感染组与HPV未感染组之间合并HCMV、HSV、UU、CT四种病原体的感染情况,探讨生殖道HPV感染合并其它病原体感染对宫颈癌的发生、发展的影响。方法:收集经检测已知为HPV分型一种亚型或合并多种亚型呈阳性的宫颈分泌物DNA提取液87例,及HPV分型亚型呈阴性的宫颈分泌物DNA提取液43例,应用PCR结合反向寡核苷酸探针杂交技术检测(RDB);应用实时荧光定量PCR扩增检测技术(FQ-PCR)对上述标本进行了测定。结果:①HPV阳性组(87例)和HPV阴性组(43例)合并HCMV、HSV、UU、CT病原体感染的综合检出率分别为74.71%和49.42%;②HPV阳性组(87例)中合并HCMV、HSV、UU、CT感染的单项检出率分别为22.99%(20例)、1.15%(1例)、57.47%(50例)、24.13%(21例),HPV阴性组(43例)合并HCMV、HSV、UU、CT感染的单项检出率分别为9.3%(4例)、0%(0例)、41.86%(18例)、6.98%(3例);③HPV阳性组按亚型不同可分为高危型组和低危型组。其中高危型组(78例)中合并HC-MV、HSV、UU、CT感染分的单项检出率分别为19.23%(15例)、1.28%(1例)、52.56%(41例)、17.94%(14例),低危型组(9例)中合并HCMV、HSV、UU、CT感染的单项检出率分别为55.56%(5例)、0%(0例)、100.00%(9例)、77.78%(7例);④HPV阳性组中以分型为16亚型的合并感染率最高;HCMV、UU、CT分别为40.00%(8/20)、28.00%(14例)、19.05%(4例);⑤在87例HPV阳性组的病例中,查到30例有宫颈上皮内瘤样变(CIN)病例资料。这30例中有23例合并HCMV、UU、CT感染,其单项检出率分别为21.08%(6例)、69.57%(16例)、30.43%(7例);有7例HPV阳性CIN病例不合并HCMV、HSV、UU、CT感染。结论:宫颈上皮细胞HPV感染与宫颈癌的发生、发展有密切关系,HPV感染者也可同时合并其他泌尿生殖道常见病原体感染。多种病原体同时感染宫颈与宫颈癌的发生、发展及预后的关系有待进一步研究。

Objective： 4pathogens HCMV, HSV, UU, CT） were detected among individuals of HPV DNA positive group and HPV DNA negative group in order to study relationship between the two group and cervical cancer. Methods： 87 types of HPV were screened using PCR/reverse dot blot hybridization among cervix scrub DNA samples of 130 cases. 87 cases were HPV positive and 43 cases were HPV negative. HCMV, HSV, UU, CT were then detected by FQ - PCR from these cervix scrub DNA samples. Results： 1. All 4 pathogens were detected among the HPV positive group with detection rate of 74. 71% （62/87） and HPV negative group with detection rate of 49.42% （21/43） ; 2. Single one of 4 pathogens （ HCMV, HSV, UU, CT） was detected among HPV positive group with detection rate of 22. 99% （20/87）, 1.15% （1/87）, 57. 47% （50/87）, 24. 13% （21/87） respectively and among HPV DNA negative group with detection rate of 9.3% （4/43）, 0% （0/43）, 41.86% （18/43）, 6.98% （3/43） respectively; 3. HPV positive groups could be divided into high risk group and low risk group. In the high risk group （78 cases）, the detection rate of single one of 4 pathogens （HCMV, HSV, UU, CT） was respectively 19.23% （15/78）, 1.28% （1/78）, 52. 56% （41/78）, 17.94% （14/78） . In low risk group, the detection rate of single one of 4 pathogens was respectively 55.56% （5/9）, 0% （0/9）, 100% （9/9）, 77.78% （7/9） ; 4. HPV 16 positive individuals had the highest incidence of one of 4 pathogens. Among positive individuals of HCMV, UU, CT, the detection rates of HPV 16 were respectively 40. 00% （8/20）, 28. 00% （ 14/50）, 19.05% （4/21） ; 5. CIN had been found among 30 HPV positive individuals. Of whom there were 23 individuals infected by one of the 4 pathogens and the detection rates of HCMV, UU, CT were respectively 21.08% （6/23）, 69.57% （ 16/23）, 30. 43% （7/23） . Another 7 CIN cases had no infection of the 4 pathogens. Conclusion： Our study shows that individuals infected with HPV will be infected simultaneously by HCMV, UU, CT. It will be further investigated whether or not other pathogens except for HPV will play a key role for cervical cancer.