不同型别人乳头状瘤病毒感染与宫颈病变程度的关系

Relationship between different types of human papillomavirus infections and cervical diseases

目的探讨人乳头状瘤病毒(HPV)感染患者的各HPV型别分布,及各型别HPV感染与宫颈不同程度病变的关系。方法采用核酸分子快速导流杂交基因微阵列分型检测技术,分析740例女性HPV感染者的HPV型别,同时检测宫颈病变程度。结果在740例HPV感染者中常见的21种亚型均被检出,排在前3位的亚型分别为16、58、52;高危型HPV混合低危型HPV的混合感染与单一高危型HPV感染和多种高危型HPV混合感染之间,宫颈不同程度病变差异无统计学意义,而以上几种感染类型与低危HPV感染相比,宫颈病变程度差异有统计学意义(均P<0.01),多元logistic回归分析显示,感染16型HPV(OR=3.56,P<0.01),58型HPV(OR=1.29,P<0.05)使宫颈癌患病风险大大增加;把宫颈上皮内瘤变分为低等级(CINⅠ)和高等级(CINⅡ、CINⅢ)病变,以不同程度的宫颈上皮内瘤变作为分析因素进行二元logistic回归,显示6型HPV(OR=6.99,P<0.01)、11型HPV(OR=5.92,P<0.01)感染将使感染者宫颈上皮内瘤变CINⅠ的风险大大升高。结论相对于低危型HPV,感染高危型HPV是宫颈病变加重的重要因素;高危型的16、18型HPV感染引起宫颈癌的患病风险增加,低危型的6型、11型HPV感染则更易引低级别的宫颈上皮内瘤变的发生。

OBJECTIVE To elucidate the correlation between different types of human papillomavirus infection（HPV） and cervical disease.METHODS The cervical samples of 740 women were detected with flow-through hybridization and gene chip on HPV subtype and various cervical diseases were also analyzed.RESULTS Among the 740 women with HIV infections,21 types HPV were tested out,16/58/52 were the top three common subtypes.There were no differences in various cervical disease among different high-risk HPV infection（all P 0.05）.But the low-risk HPV infection have significant difference with high-risk HPV infection in various cervical disease（all P0.05）.Multiple logistic analysis showed HPV 16（OR=3.56,P0.01）,58（OR=1.29,P0.05） would increase the risk of cervix cancer.CIN was classified into high grade and low grade lesion according to CINⅠ and CIN Ⅱ,CIN Ⅲ.By logistic regression analysis,HPV 6,11 had a certain correlation with CIN 0281,the OR were 6.99,5.92 respectively.CONCLUSIONS The risk of uterine cervix cancer infection is increased in women infected with high risk HPV subtypes.The infected with subtypes 16,18 of high risk HPV types are the important influential factors for the development of uterine cervix cancer.The low-risk subtypes of 6 and 11 of HPV infections have a certain correlation with CIN Ⅰ.