不同亚型HPV感染情况及与CIN的关系研究

Relationship between Human Papillomavirus Genotypes and Cervical Intraepithelial Neoplasia

目的:探讨不同亚型HPV感染情况及与宫颈上皮内瘤变(CIN)的关系。方法:回顾性分析我院就诊的8640例行HPV检测的临床资料,统计不同亚型HPV感染情况及与不同级别CIN患者之间的关系,以及常见亚型HPV致病力的差异。结果:①HPV阳性1873例(21.7%),多重感染453例(5.24%),单一亚型感染1420例(16.44%),HPV检出频次2417次,检出频次最高的6种高危亚型分别为:HPV16(25.90%),HPV58(11.92%),HPV52(10.22%),HPV33(6.99%),HPV53(6.54%)和HPV18(5.63%)。372例CIN患者中有273例HPV阳性,其中检出频次最高的几个亚型:HPV16(57.51%),HPV18(16.48%),HPV58(13.92%),HPV52(9.16%),HPV33(8.79%)和HPV31(4.40%)。②检出频次较高的6种HPV亚型中,HPV52亚型发病年龄最低。③HPV16、HPV18亚型发生高级别CIN的风险较其他亚型更高(OR=24.056,OR=27.474);单一感染时,HPV16亚型感染导致CIN的发生率比HPV18亚型的高,且差异有高度统计学意义(P=0.003)。HPV58亚型感染导致CIN的发生率较HPV52亚型的高,且差异有高度统计学意义(P=0.003)。结论:CIN患者中感染HPV的常见亚型依次为:HPV16、18、58、52、33、31。HPV52亚型发病年龄低,致病力弱。在单一感染中HPV16亚型的致病力较HPV18亚型强,HPV58亚型的致病力较HPV52亚型强。

Objective：Retrospective analysis of the correlation between different grades of cervcial intra- epithelial neoplasia （CIN） and different genotypes of human papillomavirus （HPV）. Methods： HPV geno- types were detected in 8640 cases. The association between different grades of CIN and HPV genotypes was analyzed, as well as pathogenicity of different genotypes of HPV. Reeults：①HPV-positive cases were 1873 （21.7%）, including 453 multi-infected cases （5. 24% ） and 1420 mono-infected caseS （16.44%）. The de- tection frequency of HPV is 2417, and the most common genotypes were HPV16 （25. 90%）, HPV58 （ 11.92% ）, HPV52 （ 10.22% ）, HPV33 （ 6. 99% ）, HPV53 （ 6.54% ）, HPV18 （ 5.63% ）. In 372 CIN cases, HPV was detected in 273 cases, and the most common HPV genotypes in CIN group were HPV16 （57. 51%）, HPV18 （ 16. 48%）, HPV58 （ 13. 92%）, HPV52 （ 9. 16%）, HPV33 （ 8. 79%）, and HPV31 （4. 40% ）.②The age of onset of HPV52 is younger, while the pathogenicity of type 52 is weaker. It reveals that the pathgenic machanism of HPV52 is different with other HPV types. ③Compared with HPV16 monoin- fected, HPV18 monoinfected is a weaker pathogenic type to cause cervical intraepithelial neoplasia （P = 0. 003）. Compared with HPV58 monoinfected, HPV52 monoinfected is a significant weaker pathogenic type to cause cervical intraepithelial neoplasia（ P = 0. 003）. Conclusions：The most common genotypes of HPV in CIN group are 16,18,58,52,33,31. The pathogenicity of type 52 is weaker. The pathogenicity of HPV16 monoinfected is stronger than that of HPV 18 monoinfected, while the pathogenicity of HPV58 monoinfected is stronger than that of HPV 52 monoinfected.