潮州地区高危型人乳头瘤病毒载量与宫颈病变的关系

The relationship between the HR-HPV load and cervical lesions in Chaozhou area

目的探讨高危型人乳头瘤病毒(high risk human papillomavirus,HR-HPV)载量与宫颈病变级别之间的关系。方法采用RT-PCR对农村35～60岁女性进行HR-HPV DNA定量检测并记录CT值,2 731例阳性者再进行核酸分子快速导流杂交分型技术(HybriMax)和液基薄层细胞学(thinprep liquid-based cytologic test,LCT)检查;对低级别鳞状上皮内病变(low grade squa-mous intraepithelial lesion,LSIL)及以上病变行阴道镜下组织病理学活检。根据LCT及病理活检结果按病变级别分成5组:无上皮内瘤变或恶性病变(non-squamous intraepithelial lesion or neoplasia,NILM)、未明确诊断意义的不典型鳞状上皮细胞(atypi-cal squamous cells of undetermined significance,ASCUS)、LSIL、高级别鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)和鳞状细胞癌(squamous cell cacinoma,SCC)。在同级别宫颈病变中,按照HPV感染的类型分为4组:HPV52、HPV16、HPV58和多重HPV感染。采用方差分析的方法对各组平均CT值进行统计分析。结果随宫颈病变级别的升高,CT均值降低,5组CT均值间差异均具有显著性(P<0.05)。在同级别宫颈病变中,NILM组HPV58和多重HPV差异有显著性(P<0.05),ASCUS组HPV16和多重HPV差异有显著性,其余病变级别各HPV感染组间差异均无显著性(P>0.05)。结论 HR-HPV载量与宫颈病变级别呈正相关,高HR-HPV载量是影响宫颈病变级别的危险因素。

Purpose To study the relationship between the HR-HPV load and cervix lesions. Methods The real-time PCR was used to detect the HR-HPV DNA of Chaozhou rural women age from 35 to 60, the CT value was received during the test. For 2 731 HR- HPV DNA positive cases, HybriMax was used to genotype, and LCT was used to diagnosis. For LSIL or even worse cases, a diagnostic colposeope and biopsy were performed. Aeeording to the diagnosis of LCT and histopathology test, total cases were divide into NILM, ASCUS, LSIL, HSIL and SCC group. Then, each group was further divided into 4 subgroups （HPV52, HPV16, HPV58 and multiple HR-HPV infections） according to the HR-HPV subtype. The CT value of each group was statistically analyzed with variance analysis by SPSS version 16.0 software. Results The CT value was decreased with the cervix lesions getting worse, the lower CT value was typi- cally observed in the higher rank cervix lesions group, and there was significant difference between each group（P 〈 0. 05 ）. However, the significant difference was only found in NILM group （between HPV58 and multiple HR-HPV infections group） and ASCUS group （between HPV16 and multiple HR-HPV infections group）, it was not observed between other groups. Conclusions There was a posi- tive relationship between the HR-HPV load and cervix lesions, the HR-HPV load was one of the risk factor of cervix lesions.