宫颈病变标本中人乳头瘤病毒感染情况分析

AN ANALYSIS OF HUMAN PAPILLOMA VIRUS INFECTION IN CERVICAL SPECIMEN

目的检测妇科宫颈标本中人乳头瘤病毒（HPV）感染情况,探讨HPV不同基因型感染的致癌性,为临床早期诊断宫颈癌提供实验依据。方法首先采用液基薄层细胞学技术（TCT）筛查各种宫颈标本,对可疑宫颈病变者（慢性宫颈炎、宫颈上皮内瘤变和宫颈癌）再采用基因杂交捕获技术进行HPV-DNA检测,并根据结果进行风险分析。结果 TCT共筛查出各种宫颈病变标本460例,包括慢性宫颈炎303例、宫颈上皮内瘤变（CIN）122例（其中CINⅠ30例,CINⅡ45例,CINⅢ47例）和宫颈癌35例。460例受检者治疗前宫颈HPV感染者211例,感染率为45.87%。慢性宫颈炎、CIN和宫颈癌HPV-DNA阳性率分别为27.06%、77.87%和97.14%,慢性宫颈炎和CIN、宫颈癌标本中的HPV-DNA阳性率比较差异有统计学意义（χ2=79.396,P〈0.01）;而CINⅠ、Ⅱ、Ⅲ组间HPV-DNA阳性率差异无显著性（χ2=1.21,P〉0.05）。宫颈病变标本中常见的HPV感染基因型为HPV-16、52、58、68、18、39等。宫颈癌前病变及宫颈癌的HPV-DNA含量高于慢性宫颈炎,差异有显著性（t=5.581、7.653,P〈0.05）;宫颈癌的HPV-DNA含量也明显高于宫颈癌前病变（t=6.624,P〈0.05）;CINⅠ~Ⅲ的HPV-DNA含量呈递增趋势,但差异无显著性（r=0.991,P〉0.05）。结论 HPV感染在宫颈病变中起重要作用,对经阴道细胞学筛查异常和高危妇女进一步检测HPV-DNA,对早期发现CIN和宫颈癌具有临床意义。

Objective To detect the human papilloma virus（HPV） infection in specimens of cervix in gynecology patients,explore the carcinogenicity of different genotypes of HPV infection,and provide experimental evidence for early diagnosis of cervical cancer. Methods Firstly,the thin-cytologic test（TCT） was used to screen various specimens of cervix,for doubtful specimens,such as chronic cervicitis（CC）,cervical intraepthelial neoplasia（CIN） and cervical cancer,a second-generation hybrid capture 2（HC Ⅱ） for HPV-DNA detection and high-risk analysis was carried out. Results A total of 460 samples were detected by TCT,which included CC（303 cases）,CIN Ⅰ（30）,CINⅡ（45）,CIN Ⅲ（47） and cervical cancer（35）.Of 460 cases detected,211 were infected with HPV before therapy,the infection rate being 45.87%.The HPV-DNA positive rates were 27.06%,77.87% and 97.14%,respectively,in CC,CIN and cancer;the differences of positive rates of HPV-DNA among CC,CIN and cancer were statistically significant（χ2=79.396,P0.01）.While positive rates of HPV-DNA among CINⅠ,CINⅡ and CINⅢ were not statistically different（χ2=1.21,P0.05）.The commonly seen genotypes of HPV infection in the cervix were HPV-16,52,58,68,18,39,etc.HPV-DNA content in CIN and cancer was higher than that of CC,the difference was significant（t=5.581,P0.05）;and that in cervical cancer was higher than that in CIN（t=7.653,P0.05）.HPV-DNA value in cervical cancer was significantly higher than CIN（t=6.624,P0.05）.The HPV-DNA levels in CINⅠ-Ⅲ showed an increase by degrees but with no significant differences among themt（r=0.991,P0.05）. Conclusion HPV infection plays an important effect on the pathological changes of cervix,for those with abnormal colpocytology findings and high-risk women,a further detection of HPV-DNA is of great significance in early discovery of CIN and cervical cancer.