女性外阴尖锐湿疣HPV感染类型及其与临床复发关系研究

The relationship between the type of HPV infection and clinical relapses in female vulva condyloma acuminatum

目的探讨女性外阴尖锐湿疣(vulval condyloma acuminatum,VCA)组织中不同类型人乳头状瘤病毒(human papilloma virus,HPV)感染及其与临床复发的关系。方法采用聚合酶链反应(polymerase chain reaction,PCR)方法检测女性外阴尖锐湿疣疣体组织中的HPV6、11、16、18、31、33,并对VCA患者行局部病灶电灼+α-2b干扰素凝胶外涂,随访3个月,观察HPV感染者低危组和高危组的复发率。结果 VCA患者中各型HPV的阳性率为HPV6(88.1%)、HPV11(90.5%)、HPV16(7.1%)、HPV18(23.8%)、HPV31(0%)、HPV33(2.4%),低危型(LR-HPV,HPV6/11)的阳性率90.5%(38/42)、高危型(HR-HPV,HPV16/18/31/33)的阳性率31.0%(13/42)。其中,大部分高危型(HPV16、18、31、33)感染伴有低危型(HPV6和/或11)的双重感染(11/13)。低危组(即单纯低危型HPV6或11感染的29例)和高危组(即HPV16、18、31、33任一型感染的13例)复发率分别为27.6%(8/29)、38.5%(5/13),两者差异无统计学意义(F=0.495)。结论 VCA中主要感染的HPV型为低危型HPV,部分VCA同时伴有高危型HPV的混合感染。尚无证据表明VCA中高危型HPV感染者较低危型HPV感染容易复发。

Objective To study the relationship between the type of HPV infection and clinical relapses in female vulva condyloma acuminatum（VCA）.Methods The genotypes of HPV6、11、16、18、31、33 in the tissue of VCA were detected by polymerase chain reaction（PCR）for female VCA patients and all patients were treated with local excision and α-2b interferon was applied topically.All patients were followed-up for 3-month and the relapse rate of low-risk group and high-risk group were observed.Results The follow-up rate was 84%（42/50）.The positive rates were HPV6（88.1%）,HPV11（90.5%）,HPV16（7.1%）,HPV18（23.8%）,HPV31（0%）,HPV33（2.4%）respectively.The positive rate of LR-HPV（HPV6/11）and HR-HPV（HPV16/18/31/33）were 90.5% and 31.0% respectively.The recurrence rate of LR-HPV and HR-HPV was 27.6% and 38.5%,there was no statistical significance between two groups（P0.05）.Conclusion HPV6 and HPV11 infection were main causes in VCA.Low-risk type HPV and high-risk type HPV coinfection were in some patients with VCA.There was no evidence that HR-HPV infections were higher relapses rate than that of low-risk type HPV infection.