宫颈疾病HPV混合型感染的检测与分析

Detection of mixed infections of human papillomavirus in cervical diseases by flow-through hybridization

目的:探讨人乳头状瘤病毒(HPV)混合型感染导流杂交法检测宫颈疾病的价值。方法:用导流杂交法,检测本地区304例妇女(其中宫颈癌组35例、宫颈上皮内瘤变组20例、炎症组140例和正常组109例)宫颈脱落细胞21种HPV基因亚型,分析各组患者HPV多重感染的特点。结果:304例标本中检出HPV阳性94例,包括混合型30例,HPV多重感染检出率在宫颈癌组、宫颈上皮内瘤变组、炎症组和正常组分别为34.3%、20.0%、7.1%和2.8%,各组HPV混合型感染率差异有统计学意义(χ2=463.579,P<0.001);混合型感染中检出的HPV亚型由高到低依次为:HPV-16(19.2%)、HPV-52(13.7%)、HPV-58(12.3%)、HPV-18(8.2%)、HPV-11(6.8%)、HPV-6(6.8%)、HPV-31(5.5%)、HPV-33(5.5%)、HPV-66(5.5%)、HPV-39(4.1%)、HPV-53(4.1%)、HPV-68(4.1%)、HPV-56(1.4%)、HPV-59(1.4%)、CP8304(1.4%)。各疾病组检出的混合型HPV感染前3位HPV基因型均为高危型。结论:宫颈癌HPV多重感染率高,主要系高危HPV型感染所致;导流杂交法HPV混合型感染检测值得在宫颈疾病诊断中推广应用。

Objective：To evaluate the clinical application value of flow-through hybridization in identifying of mixed human papillomavirus （HPV） infections on women with cervical diseases. Methods ： A total 304 cases of local women were subdivided into four groups according to their histologic diagnosis including 35 cases thelial neoplasia （CIN） , 140 eases of chronic of cervical cancer,20 cases of cervical intraepicervicitis, and 109 cases of normal histological manifestation. Exfoliated cells prepared from 304 cases were used to detect the HPV genotypes by flow-through hybridization and the muhiplicitas infection of HPV within four groups were analyzed. Results：Among 304 women, specimens from 94 tested positive for HPV infection. Of these,30 were infected with mixed HPV types and mixed HPV infections were present in 34. 3% of cervical cancer,20. 0% of CIN,7. 1% of chronic cervicitis,and 2.8% of normal group, respectively. The detection rate of mixed HPV infections among four groups showed clear statistically significant （ X^2 = 463. 579, P 〈 0. 001 ）. The percent distribution of HPV types among multiplieitas infection eases were HPV-16 （ 19. 2% ）, HPV-52 （ 13. 7% ）, HPV-58 （12. 3%）,HPV-18（8.2%）,HPV-11 （6.8%）,HPV-6（6.8%）,HPV-31 （5.5%）,HPV-33 （5.5%） ,HPV-66（5.5% ）, HPV-39 （4.1%）, HPV-53 （4. 1% ）, HPV-68 （4. 1% ）, HPV-56 （ 1.4% ） , HPV-59 （ 1.4% ） , and CP8304 （ 1.4% ）. Three most common genotypes of HPV in the mixed HPV infected patients were high-risk HPV types. Conclusion：Cervical cancers have a higher mixed HPV infections rate and high-risk HPV types appears to be the key risk factor for cervical cancer. Mixed HPV infections testing in etiological diagnosis of cervical diseases using flow-through hybridization should be promoted.