光线性角化病皮损中β型人乳头瘤病毒检测及分型

Detection and genotype determination of beta-human papilloma virus in actinic keratosis lesions

目的分析光线性角化病（AK）皮损中β型人乳头瘤病毒（HPV）感染情况及型别分布。方法收集39例AK患者皮损以及40例健康对照皮肤，应用巢式PCR进行β-HPv和α-HPV检测。筛选出β-HPV感染阳性标本，设计12对特异性（HPV5、8、15、17、19、20、21、23、36、38、49和80型）引物，应用普通PCR技术对其分型进行分析。结果39例AK患者皮损组织β-HPV检出率为84．6％（33／39），健康对照组为30．0％（12／40），两组差异有统计学意义（χ2=6．76，P〈0．05）。β-HPV分型：病例组以HPV38型检出率最高（36％，12／33），其次为HPV36。健康对照组此12种B-HPV感染率均较低。病例组HPV混合感染10例，健康对照组均未发现混合感染。病例组不同年龄、性别、职业、病程组间β-HPV阳性率差异均无统计学意义（χ2=0．53，0．94，0．81，0．73，均P〉0．05）。病例组α-HPV阳性率为12．8％，对照组为7．5％，差异无统计学意义（χ2=0．91，P〉0．05）。结论AK患者皮损β-HPV感染率远高于健康对照组，以HPV38型感染最为多见。

Objective To detect beta-human papilloma virus （HPV） and determine its genotype in actinic keratosis （AK） lesions. Methods Tissue specimens were collected from the lesions of 39 patients with AK and normal skin of 40 healthy controls. A nested PCR was performed to detect alpha-HPV and beta-HPV DNA in these specimens. The genotype of beta-HPV was determined in beta-HPV DNA-positive specimens by a common PCR using specific primers targeting 12 HPV genotypes, including HPV 5, 8, 15, 17, 19, 20, 21, 23, 36, 38, 49 and 80. Results The detection rate of beta-HPV DNA was 84.6% （30/39） in the patients with AK, and 30.0% （12/40） in the healthy controls （χ2 = 6.76, P 〈 0.05）, while no significant difference was observed in the detection rate of alpha-HPV DNA between the two groups （12.8% vs. 7.5%, χ2 = 0.91, P 〉 0.05）. HPV 38 was the predominant genotype of beta-HPV in these patients with a detection rate of 36% （12/33）, followed by HPV36. The prevalence of all the 12 genotypes of HPV was consistently low in the healthy controls. Mixed HPV infections were observed in 10 AK lesions, but in none of the healthy controls. No statistical difference was noted in the positivity rate of beta-HPV among patients at different ages, of different genders, with different occupations or clinical courses （χ2 = 0.53, 0.94, 0.81, 0.73, respectively, all P 〉 0.05）. Conclusions Compared with healthy controls, the patients with AK showed a higher beta-HPV infection rate, with HPV38 as the predominant genotype.