女性生殖道人乳头瘤病毒感染与宫颈癌前病变和宫颈癌的关系

Relationship between Female Genital Tract Infection of HPV and Cervical Precancerous Lesion and Cancer of Cervix

目的：探讨女性生殖道人乳头瘤病毒感染与宫颈癌前病变的关系。方法：对２５３例妇科感染患者用ＰＣＲ方法检测ＨＰＶ分型，同时对７８例不同宫颈病变组织行ＨＰＶ１６、１８型原位杂交，并在邻近切片用免疫组化方法检测增殖细胞核抗原。结果：１）女性生殖道ＨＰＶ感染率，由慢性宫颈炎→假性湿疣→疣样病变→尖锐湿疣→ＣＩＮ→宫颈癌，随宫颈病变程度的加重而逐渐升高，ＩＳＨ阳性杂交信号的分布与ＨＥ染色中挖空细胞的分布相一致。２）ＨＰＶ１６、１８型感染率及ＰＣＮＡ表达率均随宫颈病变程度的加重呈升高趋势。挖空细胞核呈ＰＣＮＡ阳性反应，与ＩＳＨ阳性杂交信号出现的部位相一致。结论：ＨＰＶ感染可使宫颈上皮细胞获得较高的增殖活性，也可能通过促进细胞的过度增殖活性而致癌变。

Human papilloma virus (HPV)types were determined in 253 cases of gynecologic diseases using polymerase chain reaction (PCR) technique. Meanwhile, 78 cases of various cervical lesions were analysed by HPV 16, 18 in situ hybridization (ISH), and,proliferating cell nuclear antigen (PCNA) was studied immunohistochemically in the adjacent tissue sections.The results showed that 1) The rate of HPV infection of female genital tract escalated with the progression of pathologic changes of the cervical lesions. 2) The distribution of positive hybridization signal was consistent with the distribution of koilocytic cells in HE stain. 3) The infection rate of HPV 16, 18 and the expression of PCNA increased with the progression of the cervical lesions. In addition, the positive rate of PCNA in koilocyte cell was identical with the site of ISH signal. It is noted that HPV infection may result in high proliferating activity of the cervical epithelia as well as boostering carcinogenesis of the cervical lesion.