宫颈鳞癌患者人乳头瘤病毒感染和治疗后转归情况分析

Study on high risk human papillomavirus infection and changes after treatment in patients with cervical squamous carcinoma

目的探讨宫颈鳞癌患者中人乳头瘤病毒感染和治疗后的转归情况。方法采用realtime PCR方法检测228例宫颈鳞癌患者HPV高危基因型。结果 228例宫颈鳞癌患者中人乳头瘤病毒(human papillom avirus,HPV)感染者共200例(87.7%),其中HPV16阳性150例(65.8%),HPV33/52/58/67阳性59例(25.9%),HPV18/45阳性20例(8.8%),HPV31阳性14例(6.1%)。HPV16在<30岁、30～39岁、40～49岁、50～59岁、60～69岁和≥70岁各年龄组患者中的感染阳性率分别为83.3%、70.4%、72.2%、63.6%、65.7%和26.7%,差异有统计学意义(P=0.030)。HPV33/52/58/67在<30岁、30～39岁、40～49岁、50～59岁、60～69岁和≥70岁各年龄组患者中的感染阳性率分别为16.7%、14.8%、15.2%、16.7%、54.3%和80.0%,差异有统计学意义(P=0.000)。59例获随访的HPV阳性患者治疗后1个月和3个月转阴率分别为40.7%和69.5%。结论宫颈鳞癌患者中HPV感染亚型与年龄有关,并对治疗敏感。

Objective To investigate the infection of high risk human papillomavirus （HD-HPV） and the effects of different therapeutic methods in patients with cervical squamous carcinoma. Methods 228 women with cervical squamous carcinoma were selected for high risk HPV genotypes detected by real-time PCR. Re- suits HPV infection was detected in 200 of 228 eases （87.7%） with cervical squamous carcinoma, 150 （65.8%） cases of HPV16, 59（25.9% ） cases of HPV33/52/58/67, 20（8.8% ） cases of HPV18/45 and 14 （6.1%） cases of HPV31. The positive rates of HPV16 at different age groups, aged 〈30, 30 -39, 40 -49, 50-59, 60-69, 〉70 years old were83.3%, 70.4%, 72.2%, 63.6%, 65.7% and26.7%, and there were statistical signifieances （P = 0. 030）. The positive rates of HPV33/52/58/67 at different age groups, aged 〈30, 30 -39, 40-49, 50 -59, 60-69, 〉70 years old were 16.7%, 14.8%, 15.2%, 16.7%, 54.3% and 80.0% , and there were statistical significances （ P = 0. 000）. 59 patients were followed up for 6 months and their HPV negative conversion rates were 40.7% and 69.5% at month 1 and 3. Conclusions High-risk HPV infection genotypes are related to age and sensitive to cancer treatments.