人乳头状瘤病毒不同型别与宫颈病变的相关性研究

Correlation between human papillomavirus type and grading of cervical intraepithelial neoplasia

目的探讨人乳头状瘤病毒（ＨＰＶ）不同型别与宫颈病变性质的关系。方法应用ＰＣＲ技术和原位杂交方法对６１例宫颈上皮内瘤（ＣｅｒｖｉｃａｌｉｎｔｒａｅｐｉｔｈｅｌｉａｌＮｅｏｐｌａｓｉａＣＩＮ）和１２例宫颈鳞癌（ＳＣＣ）进行ＨＰＶ６Ｂ／１１、１６、１８ＤＮＡ检测。结果ＰＣＲ检测结果显示ＨＰＶ６、１１主要分布于低度鳞状上皮内病变（６１９％）和一部分ＣＩＮⅡ中（２０％），而在ＣＩＮⅢ和ＳＣＣ中检测不到；ＨＰＶ１６、１８的检出率随ＣＩＮ级别增高而增加，在ＳＣＣ中高达８３３％。原位杂交结果显示在低度鳞状上皮内病变中，地高辛（Ｄｉｇ）标记的ＨＰＶ６Ｂ／１１、１６、１８ＤＮＡ杂交物质在核中均呈细颗粒状，为“游离型”。上述杂交阳性信号形态亦出现于ＣＩＮⅡ的所有ＨＰＶ６Ｂ／１１及部分ＨＰＶ１６、１８型感染中，而ＣＩＮⅢ和宫颈鳞癌及部分ＣＩＮⅡ中，其杂交阳性信号均为非颗粒状的“整合型”。结论低度鳞状上皮内病变是以ＨＰＶ６、１１低危型为主的多型别病毒的繁殖性感染，ＣＩＮⅢ和宫颈鳞癌为ＨＰＶ１６、１８高危型病毒的整合型感染，而在ＣＩＮⅡ中存在着ＨＰＶ６，１１和ＨＰＶ１６，１８的繁殖性感染及ＨＰＶ１６。

Objective To disclose the correlation between human papillomavirus (HPV ) type and grade of cervical intraepithelial lesion (CIN). Methods PCR and in situ hybridization (ISH) techniques were used to detect the presence of HPV 6B/11, 16, 18 in 61 cases of CIN and 12 cases of cervical squamous cell carcinoma (SCC). Results PCR showed HPV 6, 11 distributing mainly in low grade squamous intraepithelial lesion (LSIL, 61.9%) and partly in CINII (20%), but not in CINIII and SCC. The frequency of HPV 16, 18 increased corresponding to the increasing of CIN grading and up to 83.3% in SCC. ISH showed HPV 6b/11, 16,18 DNA hybridization intranuclear signal were diffusely distributed in LSIL and granular in appearance in episomal HPV. Similar signal were also seen in CINII infected by HPV 6b/11 and partly by HPV 16, 18, anyhow, CINIII, SCC and partly CINII HPV 16, 18 DNA hybridization were nongranular in appearance. Conclusion low grade SIL associated with 'low risk' types of HPV 6, 11 belonged to productive infection. CINIII and SCC associated with “high risk” types of HPV 16, 18 belonged to integrated infection, while CINII belonged to either productive or integrated infection.