HPV病毒载量与分型检测在评价子宫颈病变中的价值

Value of Viral Load and Typing of HPV for the Evaluation of Cervical Lesion

[目的]探讨HPV病毒载量、分型及多重感染与子宫颈病变程度的相关性.[方法] 对256例患者采用二代杂交捕获技术（Hybrid capture Ⅱ, HC-Ⅱ）检测高危型HPV（High-risk HPV, HR-HPV）病毒载量,快速导流杂交基因芯片技术（Flow-through hybridization and gene chip, HybriMax）进行HPV分型检测,结合组织病理检查分级,实验分为无子宫颈上皮内病变（negative for intraepithelial lesion or malignancy, NLM）组143例、子宫颈上皮内瘤变（cervical intraepithelial neoplasia, CIN）Ⅰ级组28例、CINⅡ/Ⅲ级组49例和子宫颈癌组36例,分析各组HPV病毒载量、分型及多重感染在评价子宫颈病变中的价值.[结果] HC-Ⅱ检测NLM 组、CIN Ⅰ级组、CINⅡ/Ⅲ级组和子宫颈癌组的HR-HPV感染率分别为27.97%、64.29%、87.75%、100%,与HybriMax方法比较差异无显著性（P〉0.05）;NLM组HR-HPV感染率明显低于CIN Ⅰ级组、CINⅡ/Ⅲ级组和宫颈癌组（P〈0.01）;随着子宫颈病变程度增加,HR-HPV病毒载量也逐渐增加,显示出良好的相关性（r=0.683,P〈0.01）;HPV多重感染率各组间差异无显著性（P〉0.05）,且与子宫颈病变程度亦无相关性（r=-0.062,P〉0.05）.[结论]子宫颈病变程度与HR-HPV病毒载量密切相关,与不同亚型HPV多重感染无关.

[Objective]To explore the relationship between the viral load, typing and multiple infection of human papillomavirus（HPV） and the degree of cervical lesion. [Methods] Two hundred and fifty six cervical smears were detected for the viral load and specific types of high-risk HPV （HR-HPV） by hybrid capture Ⅱ （HC-Ⅱ ） and flow through hybridization and gene chip （HybriMax） system. All subjects were divided into four groups including negative for intraepithelial lesion or malignancy （NLM） group（ n = 143）, cervical intraepithelial neoplasia Ⅰ （CIN Ⅰ ） group（ n = 28）, CIN Ⅱ/Ⅲ group（ n = 49） and cervical cancer group（ n = 36）. The relationship between the viral load and types of HPV and the degree of cervical lesion was analyzed. [Results]The positive rates of HR-HPV infection in the NLM group, women with CIN Ⅰ , CIN Ⅱ/Ⅲ and invasive cervical cancer detected by HC- Ⅱ were 27. 97%, 64. 29%, 87. 75%, and 100%, respectively. The positive rate was higher in women with CIN and cervical cancer than that in NLM group （ P 〈0.01）. No significant difference existed in the rate of HR-HPV infection detected by HC-Ⅱ and HybriMax （ P 〉0.05）. The viral loads were well correlated with the degree of cervical lesion （r = 0. 683, P 〈0.01）. There was no significant difference within four groups （ P 〈0. 05）. The rate of multiple HR-HPV infection showed no correlation with the degree of cervical lesion （r= -0. 062, P 〉0.05）. [Conclusion] The degree of cervical lesion is well correlated with the viral load but not the multiple infection rate of HR HPV.