广西沿海地区妇女宫颈病变感染人乳头瘤病毒分布特点

Human Papillomavirus Genotypes in Women with Cervical Cancer in Coastal Areas of Guangxi

目的分析广西沿海地区妇女宫颈病变感染HPV的状况和分布规律;探讨HPV感染与宫颈病变发生的关系。方法将164例临床宫颈有病变、HPV-DNA分型检测阳性患者,按病理检查结果分为3组:慢性炎症组(n=22)、宫颈上皮内瘤变(CINⅠ、Ⅱ、Ⅲ)组(n=73)和宫颈癌组(n=69)。采集患者宫颈脱落细胞样本,用人乳头瘤病毒核酸扩增分型检测方法作HPV基因分型检测,分析HPV感染状况及HPV基因型在各组疾病中的分布。结果 164例HPV阳性标本中,21种亚型有20种亚型被检测到,未被检出是低危型HPV42型;HPV单一感染者117例(71.3%),多重感染47例(28.7%)。慢性炎症组的阳性率13.4%,常见HPV基因型为16、52、58、18、33、53;宫颈上皮内瘤变组阳性率为44.5%,常见HPV基因型为16、18、33、52、58、31;宫颈癌组阳性率为42.1%,常见HPV基因型为16、18、33、31、58、52。结论广西沿海地区妇女宫颈病变以HPV16、18型感染为主,其次是33、52、58、31型。HPV-DNA分型检测可为宫颈癌高危人群的筛查、临床诊断、预后判断及疫苗的研制提供重要的理论依据。

Objective To analyze the status and distribution of human papillomavirus（HPV） in women patients with cervical cancer in the coastal areas of Guangxi,and to investigate the relationship between HPV infection and cervical lesions.Methods According to pathological examination,164 patients with cervical lesions who were positive for HPV-DNA were divided into three groups：chronic inflammatory group（n=22）,cervical intraepithelial neoplasia group（CIN Ⅰ-Ⅲ,n=73） and cervical cancer group（n=69）.The exfoliated cells were collected and HPV genotypes were detected by diagnostic PCR to analyze the status and distribution of HPV in all patients.Results Besides a low-risk type HPV 42,20 of 21 subtypes were detected.A total of 117（71.3%） of 164 HPV-positive patients had a single infection,whereas 47 patients（28.7%） had multiple HPV types.The positive rate was 13.4% in chronic inflammatory group,and the common HPV genotypes were 16,52,58,18,33 and 53.The positive rate was 44.5% in cervical intraepithelial neoplasia group,and the common HPV genotypes were 16,18,33,52,58 and 31.The positive rate was 42.1% in cervical cancer group,and the common HPV genotypes were 16,18,33,31,58 and 52.Conclusion HPV-positive patients with cervical cancer in the coastal areas of Guangxi were infected mainly with HPV genotypes 16 and 18,and secondly with genotypes 33,52,58 and 31.Thus,HPV-DNA testing provides important theoretical basis for vaccine development and cervical cancer screening,diagnosis and prognosis evaluation.