高载量HR—HPV感染与宫颈癌及其癌前病变关系的研究

Study on relationship between high viral loads of HR - HPV infection and cervical cancer and precancerous lesion

目的 研究宫颈病变中HR—HPV病毒载量的分布，探讨高载量HR—HPV感染与宫颈癌及其癌前病变发生发展的关系。方法对门诊就诊的3676名妇女进行HC-Ⅱ HPV DNA检测，按HPV病毒载量的不同分为4组：阴性组RLU／CO〈1．0，低载量组1．0≤RLU／CO〈10，中载量组10≤RLU／CO〈100，高载量组RLU／CO≥100，采用非条件多项式logistic回归分析病毒载量与子宫颈各级病变的关系。结果CINⅠ组高载量占23．07％，其OR值仅为9．42（95％CI：6．84—12．99）；CINⅡ组高载量占30．84％，其OR值为22．55（95％CI：14．88—34．18）；CINⅢ组高载量占47．89％，其OR值高达82．13（95％CI：52．69—128．03）；宫颈癌组51．66％呈高病毒载量，其OR值更高达161．90（95％CI：109．45—239．50）。，结论HPV病毒载量与宫颈病变的严重程度密切相关。

Objective To study the loads of HR - HPV in cervical diseases,and to explore the relationship between high viral loads of HR - HPV infection and cervical carcinoma, cervical intraepithelial neoplasia （CIN）. Methods The study was carried out in Liaoning Cancer Hospital,3676 women who received treatment were recruited HPV DNA by hybrid capture Ⅱ （ HC - Ⅱ ） .then they were divided into 4 groups basing on the different levels of the viral loads of HPV DNA ： negative（ RLU/CO 〈 1.0 ） ,low viral loads （ 1.0 ≤ RLU/CO 〈 10 ） , medium viral loads （ 10 ≤ RLU/CO 〈 100） , high viral loads （ RLU/CO ≥ 100 ）. The relationship between viral loads and various cervical diseases were analyzed by unconditional multi - normial logistic regression. Results In CINI group,there was 23.07% of patients in high viral loads,the odds ratio was only 9.42（95ck CI：6.84- 12.99 ）. In CIN2 group,the proportion of high viral loads accounted for 30.84% with odds ratio to 22.55 （ 95 % CI 14.88 -34.18： ）. In CIN3 group,the proportion of high viral loads accounted for 47.89% with odds ratio up to 82.13（95% CI：52.69 - 128.03 ）. In cervical earcinoma group, the proportion of high viral loads was 51.66% with odds ratio more higher up to 161.90（ 95% CI：109.45 -239.50）. Conclusion There is significant correlation between the viral loads of HR - HPV and severity of cervical lesion. High viral loads of HR - HPV which persistently infects predicts high degree of cervical diseases and cervical carcinoma.