贵州省黔南州布依族和苗族宫颈癌及宫颈上皮内瘤变患者HPV感染及型别分布比较研究

Comparative study on HPV infection and HPV genotypes distribution of cervical carcinoma patients and cervical intraepithelial neoplasia patients in Qiannan Buyi and Miao autonomous prefecture of Guizhou Province

目的:探讨贵州省黔南州布依族和苗族宫颈癌及宫颈上皮内瘤变患者HPV感染及型别分布情况,并比较两组患者宫颈癌及宫颈上皮内瘤变患者HPV感染及型别的差异。方法:2007年1月～2011年10月在贵州省黔南布依族苗族自治州中医医院、贵州省瓮安县人民医院、贵州省都匀市人民医院、贵州省贵定县人民医院4家医院组织病理学诊断为CINⅡ、CINⅢ级和宫颈鳞癌的组织标本167例作为研究对象,按民族将其分布依族组87例和苗族组80例,采用美国Digene公司第2代杂交捕获试验检测HPV感染情况,分别比较两组宫颈癌及宫颈上皮内瘤变患者HPV感染及型别的差异。结果:①HPV总感染率:167例宫颈癌及宫颈上皮内瘤变患者中,HPV检出156例,HPV感染率为94.4%。②HPV感染率:布依族组HPV感染率为88.5%77例,其中宫颈癌、CINⅡ和CINⅢ级中HPV感染的阳性率分别为71.4%、96.6%、96.7%;苗族组HPV感染率为98.8%80例,其中宫颈癌、CINⅡ和CINⅢ级中HPV感染的阳性率分别为96.0%、100.0%、100.0%;两组比较,P<0.01。③HPV型别感染率:布依族组宫颈癌、CINⅡ级及CINⅢ级HPV感染以HPV16、HPV58、HPV31和HPV33多见;苗族组宫颈癌、CINⅡ级及CINⅢ级HPV感染以HPV18、HPV33和HPV58多见,两组比较,P<0.01。④HPV型别多重感染率:布依族组单一型别感染53例,占60.9%,多重感染24例,占27.6%。多重感染中最常见的为HPV16合并的感染;苗族组单一型别感染49例,占61.3%,多重感染30例,占37.5%。多重感染中最常见的为HPV18合并的感染,两组比较,P<0.05。结论:布依族宫颈癌及宫颈上皮内瘤变患者HPV感染及型别分布与苗族存在民族差异。

Objective：To study the situations of HPV infection and HPV genotypes distribution of cervical carcinoma patients and cervical intraepithelial neoplasia patients in Qiannan Buyi and Miao Autonomous Prefecture,Guizhou,and to compare the difference of HPV infection and HPV genotypes distribution between cervical carcinoma patients and cervical intraepithelial neoplasia patients.Methods：The 167 tissue specimens were taken as research object which were diagnosed as CINII and CIN III and cervical squamous cell carcinoma in histopathology by the four hospitals,which were Guizhou Qiannan Bouyei and Miao Autonomous Prefecture Hospital of Traditional Chinese Medicine,Guizhou Wengan People＇s Hospital,Guizhou Duyun People＇s Hospital and Guizhou Guiding People＇s Hospital from January 2007 to October 2011.The tissue specimens were divided into two parts,which were 87 cases of Buyi and 80 cases of Miao according to the patient＇s nationality.Adopt the world＇s latest HPV detection technique of Digene Company of America-Hybrid Capture II to detect the HPV infection,so as to compare the difference of HPV infection and HPV genotypes distribution between cervical carcinoma patients and cervical intraepithelial neoplasia patients.Results：①Total HPV infection rate： In 167 cervical carcinoma patients and cervical intraepithelial neoplasia patients,156 HPV cases were detected,and the HPV infection rate was 94.41%.HPV was not detected in the other 11 cases,accounting 6.6%.②Comparison of HPV infection rate between the two groups： 77 HPV cases were detected among 87 cases of Buyi group,rating 88.5%.Hereinto,the positive rate of HPV infection of cervical carcinoma,CIN II and CIN III were respectively 71.4%,96.6%,and 96.7%.79 HPV cases were detected among 80 cases of Miao group,rating 98.8%.Hereinto,the positive rate of HPV infection of cervical carcinoma,CIN II and CIN III were respectively 96.00%,100.00%,and 100.00%.Comparing the HPV infection rate of cervical carcinoma between Buyi and Miao,the difference shown statistical significance（P0.01）.③Comparison of the two HPV genotypes infection rates： HPV16,HPV58,HPV31 and HPV33 were very common in the HPV infection of cervical carcinoma,CIN II and CIN III of Buyi.HPV18,HPV33 and HPV58 were common in the HPV infection of cervical carcinoma,CIN II and CIN III of Miao.Comparing the two HPV genotypes infection rates,the difference shown statistical significance（P0.01）.④Comparison of multiple HPV genotypes infection rates between the two groups： there were 53 cases of single infection and 24 cases of multiple infections in Buyi,accounting 60.9% and 27.6% respectively.Merged HPV16 infection was the most common in multiple infections.There were 49 cases of single infection and 30 cases of multiple infections in Miao,accounting 61.3% and 37.5% respectively.Merged HPV18 infection was the most common in multiple infections.Comparing the HPV genotypes multiple infection rates between the two groups,the difference shown statistical significance（P0.05）.Conclusion：There are national differences on HPV infection and HPV genotypes distribution of cervical carcinoma patients and cervical intraepithelial neoplasia patients between Buyi and Miao.