摘要
目的 探讨感染人乳头状瘤病毒(human papilloma virus,HPV)后患宫颈癌及癌前病变风险.方法 采用HPV-DNA核酸扩增及导流杂交技术,对7 234例来我院就诊的宫颈异常患者,进行HPV21种亚型的基因检测和宫颈液基薄层细胞学(TCT)检测,对细胞学检测结果为非典型鳞状细胞(ASCUS)以上和/或HPV-DNA检测阳性的患者,行活组织病理检查,对HPV感染后患宫颈癌及癌前病变风险进行分析.结果 HPV总感染率为27.37%,检出率前四位依次是HPV 16型6.97%(504/7 234)、52型5.68%(411/7 234)、58型5.27%(381/7 234)和33型3.33%(241/7 234),其中高危型病毒(HR-HPV)感染占78.16%(2147/2747).宫颈癌患者HPV的检出率为73.33%(33/45).单型HPV感染后患轻度鳞状上皮内瘤变(LSIL)及高度鳞状上皮内瘤变(HSIL)和宫颈癌的风险分别是HPV阴性者的4.055倍(95% CI 2.528~6.505)和5.103倍(95% CI 3.838~6.786),多型混合HPV感染后患宫颈LSIL及HSIL和宫颈癌的风险分别是HPV阴性者的7.313倍(95% CI 4.314~12.397)和7.550倍(95%CI 5.395~10.564).结论 单型HPV感染致宫颈HSIL或宫颈癌的风险是HPV阴性者的5.1倍,多型混合HPV感染致宫颈HSIL或宫颈癌的风险是HPV阴性者的7.6倍.
Objective TO evaluate the risk of cervical cancer and precancerous lesions in patients infected with human papilloma virus (HPV). Methods HPV21 subtypes were detected using HPV-DNA nucleic acid amplification and hybridization diversion in 7234 patients with cervical abnormalities who underwent thin-prep cytology test (TCT). Tissue biopsies were performed in patients with positive HPV-DNA or with atypical squamous cells of undetermined significance (ASCUS); and the correlation of HPV infection with precancerous lesions or cervical cancer was analyzed. Results The total HPV infection rate was 27.37% (1780/7234), with HPV16 ranked the first (6.97%, 504/7234), followed by HPV52 (5.68%, 411/7234), HPV58 (5.27%, 381/7234)and HPV33 (3.33%, 241/7234). The HR-HPV infection accounted for 78.16% of total infection. The rate of HPV infection in patients with cervical cancer was 73.77% (33/45). The risks of low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) and cervical cancer in single-type HPV infected patients were 4.055 (95% CI 2.528 -6.505) and 5.103 (95% CI 3.838 -6.786) times higher than that in HPV-negative patients; and the risks in mixed-type HPV infected patients were 7.313 (95% CI 4.314-12.397) and 7.550 (95% CI 5.395-10.564) times higher than that in HPV-negative patients, Conclusion Both single-type and mixed-type HPV infections increase the risk of cervical HSlL or cervical cancer, and the latter is more prominent.
出处
《浙江医学》
CAS
2010年第6期825-828,832,共5页
Zhejiang Medical Journal