人乳头状瘤病毒16、18型在宫颈病变进展中的表达意义

Expression of Human Papillomavirus 16,18 in The Development of Cervical Lesions

目的探讨人乳头状瘤病毒(humanpa pillomavirus,HPV)16、18型在宫颈病变进展中表达意义。方法采用实时荧光定量聚合酶链反应(Real timefluorescence qaantitativePCR,PQ-PCR)分别对健康检查妇女480例、宫颈炎116例、宫颈上皮内瘤样病变(cervicalintraepithelial aeoplasia,CIN)Ⅰ级(轻度宫颈不典型增生)48例、CINⅡ级(中度宫颈不典型增生)56例、CINⅢ级(重度宫颈不典型增生及宫颈原位癌)52例进行HPV16、18型的定性、定量检测。结果健康检查者以及宫颈炎、CINⅠ、Ⅱ、Ⅲ级患者感染HPV16阳性率分别为0.63%、25.8%、30.6%、60.7%、71%,HPV16型阳性标本平均拷贝数分别为6.3×102、4.1×104、8.9×105、5.6×106、3.8×107;随着宫颈病情的进展HPV16型阳性率逐渐升高(P<0.01),感染率和病毒载量之间有正相关关系(rs=1,P<0.01);HPV18阳性率分别为0.41%、7.8%、14.6%、10.7%、7.7%,HPV18型阳性标本平均拷贝数分别为1.2×103、4.6×104、5.4×104、3.6×103、6.9×104,宫颈炎、CINⅠ、Ⅱ、Ⅲ级患者HPV18阳性率均比健康检查者明显增加(P<0.01),宫颈炎、CINⅠ、Ⅱ、Ⅲ级患者HPV18阳性率差别无统计学意义(P>0.05),感染率和病毒载量之间无正相关关系(rs=0,P>0.05)。结论宫颈病变程度与HPV16、18型感染密切相关,且宫颈病情进展和HPV16型病毒DNA负荷呈正相关。

[ Objective] To investigate the expression of human papillomavirus （ HPV ） 16, 18 in the development of cervical lesions. [ Methods] Real-Time Fluorescence Quantitative PCR （PQ-PCR ） was adopted to perform qualitative and quantitative analysis of HPV16,18 on 48 cases of cervical intraepithelial neoplasia （CIN） I （mild cervical dysplasia） , 56 cases of C IN Ⅱ （moderate cer- vical dysplasia）, 52 cases of CIN Ⅲ （Severe cervical dysplasia and cervical carcinoma in situ）. [ Results] The positive rate of HPV16 of normal individuals and patients with CIN Ⅰ, Ⅱ- Ⅲ was 0.63%, 25.8%, 30.6%, 60.7%, 71%, respectively. The average ：copy number of HPV 16 positive samples was 6.3 × 10^2, 4.1 × 10^4, 8.9 ×10^5, 5.6 × 10^6, 3.8 × 10^7, respectively. HPV 16 positive rate raised gradually with the development of cervical dysplasia （P〈0.01） ; the infection rate was positively correlated with viral load （rs = 1 ,P〈0.01）. The positive rate of HPV18 was 0.41%, 7.8%, 14.6%, 10.7%, 7.7%, respectively. The average copy number of HPV 18 positive samples was 1.2× 10^3 w 4.6 × 10^4, 5.4× 10^4, 3.6 × 10^3, 6.9 × 10^4 respectively. HPV 18 positive rates of patients with eervicitis and CIN Ⅰ, Ⅱ , Ⅲ Were significantly higher than that of healthy individuals （ P 〈 0.01 ）, while that between those patients was not significant （ P 〉 0.05 ）, the infection rate was not positively correlated with viral load （ rs = 0, P 〉0.05）. [ Coneluslon] The degree of cervical lesions relates with HPV 16, 18 infection closely, and the development of cervical lesionz positively correlates with HPV 16 viral DNA load.