HPV16、18、31、33亚型在≥30岁妇女宫颈癌筛查中的作用

The significance of HPV16 ,18 ,31,33 subtype detection in Cervical cancer screening

目的 探讨HPV16、18、31、33亚型感染在≥30岁妇女宫颈癌筛查中的作用.方法 2008年1月至2009年3月在我院妇产科门诊同时行宫颈TCT及HPV-DNA分型检测的≥30岁妇女,对其中HPV16、18、31、33亚型检测阳性的妇女进一步行阴道镜及宫颈活检病理检查,分析HPV16、18、31、33亚型感染与宫颈浸润癌及CINⅡ、Ⅲ的相关性.结果 275例HPV16、18、31、33亚型检测阳性妇女,年龄30～72（41.76±8.88）岁;16亚型感染占64.0%,单一亚型感染占64.7%;210例细胞学异常的妇女中有127例（60.5%）诊断为CINⅡ＋.在宫颈细胞学结果为ASC-US、ASC-H、LSIL、HSIL、SCC及AGC患者中分别检出CINⅡ＋的为32.6%、67.8%、42.3%、81.8%、100.0%、50.0%（P=0.000）;在65例细胞学正常的妇女中,宫颈活检组织病理学检出CINⅡ、Ⅲ患者10例（15.4%）,占所有被检出CINⅡ＋的7.3%,其中9例发现在HPV16亚型感染者中.结论 HPV16、18、31、33亚型感染在≥30岁妇女宫颈癌筛查中具有作用,可在细胞学正常的妇女中额外检出7.3%的CINⅡ、Ⅲ,尤其是在HPV16亚型感染的妇女中.

Objective To discuss the significance of HPV16, 18,31,33 subtype infection in cervical cancer screening for women whose age is beyond 30. Methods The patients who choose the combination use of TCT and HPV-DNA genotyping for screening during Jan. 2008-Mar. 2009 in our Gyn.Out-patient department, for that HPV16,18,31,33 positive ones, colposcopy and biopsy were used for further examination to get the histopathology result. Results There were 275 patients in total who suffers HPV16,18,31,33 infection, their age ranges from 30-72, the average age is 41.76 ± 8.88; HPV 16 infection accouts for 64.0%, one single subtype infection accouts for 64.7%; Among 210 ones who have an abnormal cytology test result, 127（60.5%）were confirmed to be CIN Ⅱ ＋ by histopathology. In patients whose cytology test result were ASC-US,ASC-H,LSIL, HSIL,SCC and AGC, there were 32.6% ,67.8% ,42. 3%,81.8% , 100. 0%, 50.0% P = 0.000） of them who were confirmed to be CIN Ⅱ ＋ by histopathology separately;There were 65 ones whose cytology result is negative, 10 patients were certified of CIN Ⅱ , Ⅲ by histopathology（15.4%） ,it accounts for 7.3% of all patients whose histopathology result is advanced of CIN Ⅱ,Ⅲ, 9 were found in HPV 16＇s group. Conclusion HPV16, 18,31,33 subtype infection have a significance in cervical cancer screening program for women whose age is beyond 30. We can detect another extra 7.3% CIN Ⅱ , Ⅲ ,especially in HPV16＇s group.