高危型人乳头瘤病毒负荷量与各级宫颈病变的关系

The Correlation between Viral Load of High-risk Human Papillomavirus and Different Stage of Cervical Lesion

目的:采用第2代杂交捕获法检测高危型人乳头瘤病毒(high-risk humanpa pillomavirus,HR-HPV)的负荷量,研究其与宫颈各级病变的关系。方法:2006年1月—2008年1月检测HR-HPV阳性的患者956例,同时行薄层液基细胞学检查、阴道镜下活检及病理学检查。结果:956例患者HPV感染高发年龄段在25～44岁。55岁以上妇女病毒负荷量较低,与其他组相比差异有显著性(P<0.05),细胞学异常者(包括不典型鳞形细胞,低度鳞状上皮内瘤变,高度鳞状上皮内瘤变,鳞癌,不典型腺细胞,腺癌)HPV-DNA负荷量(645.70±751.92pg.mL-1)明显高于细胞学正常者(389.92±566.67pg.mL)(P<0.05)。在病理确诊的慢性宫颈炎组HPV-DNA负荷量较低,与其他各组比较有显著性差异(P<0.01),在湿疣组、宫颈上皮内瘤样病变(CIN)组、鳞癌组间差异无显著性(P>0.05),在各级CIN组间(CINⅠ,Ⅱ,Ⅲ)差异亦无显著性(P>0.05),HPV病毒负荷量与宫颈病变严重程度无明显相关性。结论:25～44岁的妇女是HPV-DNA筛查的重点人群,HPV-DNA阳性并且HPV-DNA含量高者为宫颈癌的高危人群,但HPV-DNA的负荷量尚不能作为判别宫颈病变程度的指标。

Objective： This study was performed to investigate the correlation between viral load of high-risk human papillomavirus （HR-HPV） and different stage of cervical lesion. Methods： The hybrid capture Ⅱ （HC Ⅱ ） method was used to examine the viral load of high-risk human papillomavirus. The restrospective study was carried out in 956 women with HR-HPV positive, they received examinatins of Liquid-based Cytology and colposcopy/pathology analysis from January, 2006 to January, 2008 in cervical disease center. Results： Among 956 patients, the high-risk age of HPV-infection was between 25-44 years, the viral load was lower in the group above 55 years then others（P〈0.05）. The viral load was higher in abnormal cytology group （include ASC, LSIL, H SIL, AGUS, squamous carcinoma and adenoearcinoma） （645. 70 ± 751.92 pg · mL^-1）than that in normal cytology group （389.92 ± 566.67 pg · mL^-1 ）（P〈0.05）. According to the pathological diagnosis, the HR-HPV load was lower in chronic cervicitis group than those in other groups （P〈0.01）, there were no significant difference of HR-HPV load among the cervical condyloma group, the CIN group and the cervical carcinoma group（P〈0.05）, and no significant difference of HR-HPV load among differernt CIN stage group（CIN Ⅰ,Ⅱ,Ⅲ）（P〉0.05）. There was no significant correlation between the HR-HPV load and the severity of cervical lesion. Conclusion： Women with 25-44 years are the focus of HPV screening, high load of HR-HPV is high-risk population of cervical carcinoma, but the load of HR-HPV could not be used as predictors of the severity of cervical lesion.