人乳头状瘤病毒多重感染不同类型与宫颈病变程度的关系

Relationship between multiple human papillomavirus infections and cervical lesions

目的探讨人乳头状瘤病毒(HPV)多重感染不同类型与宫颈病变的关系,为临床HPV多重感染率与宫颈病变的发生提供依据。方法采用HPV基因分型(PCR-反向点杂交)检测技术,分析192例HPV多重感染者的HPV型别,同时检测其宫颈病变程度;192例HPV多重感染者分为3组,其中高危型HPV多重感染组54例,高危型与低危型HPV的混合感染组108例,低危型HPV多重感染组30例。结果高危型HPV多重感染组中,16、58、52型HPV最常检出,检出率分别为51.85%、48.15%、24.07%,低危型HPV多重感染组中,11、53、6型HPV最常检出,检出率分别为60.00%、46.67%、40.00%;高危型HPV多重感染组与混合感染组相比,宫颈不同程度病变的构成比差异无统计学意义,以上两种感染类型与低危型HPV多重感染组相比,宫颈病变程度的差异均有统计学意义(P<0.01);多元logitic回归分析显示,感染16型HPV(OR值2.94、95%CI:1.47～5.89,P<0.01)使宫颈癌患病风险增加。结论高危型HPV的多重感染是加重宫颈病变的重要因素,高危的16型HPV感染不但多见,而且使宫颈癌的患病风险增加。

OBJECTIVE To explore the correlation between multiple human papillomavirus （HPV） infections and cervical lesions so as to prouide basis for the HPV infections and cervical lesions. METHODS By means of the HPV genotyping detection technique （PCR-reverse pot hybridization）, the subtypes of multiple HPV infections in 192 patients were analyzed, meanwhile the cervical lesions were detected. The 192 patients with multiple HPV infections were divided into three groups, with 54 cases in the high-risk HPV infection group, 108 cases in the mixed high-risk and low-risk HPV infections, and 30 cases in the low-risk HPV infections. RESULTS In the highrisk multiple HPV infections group, the HPV16 （51.85%）, HPV58 （48.15%）, and HPV52（24.07%） were the most common types; in the low-risk multiple HPV infections, the HPV11 （60.00%）, HPV53（46.67%）, and HPV6（40.00%） were the most prevalent types. As compared with high-risk HPV infection group and the mixed infection group,,the difference in the constituent ratio of the cervical lesions was not statistically significant; there was statistical difference in the cervical lesions between the low-risk multiple HPV infection group and the group of mixed more than two types of HPV infections （P〈0.01）. Multiple logistic regression analysis showed HPV16（OR= 2. 94, 95% CI= 1.47- 5. 89, P〈0. 01） would significantly increase the risk of cervix cancer. CONCLUSION The high-risk multiple HPV infections can aggravate the cervical lesions, the high-risk HPV16 infection is common and can increase the risk of the cervical cancer.