高危型人乳头瘤病毒的病毒负荷量与宫颈癌及其癌前病变的关系

Correlation of High-risk Human Papilloma Virus Viral Load with Cervical Cancer and Precancerous Lesions

目的探讨高危型人乳头瘤病毒的病毒负荷量与宫颈癌及其癌前病变的关系。方法选择我院妇科门诊进行宫颈病变检查的患者2290例,检测所有患者高危型HPV-DNA的载量并对其宫颈组织进行病理活检。结果 2290例宫颈病变患者中,病理诊断为慢性宫颈炎占93.58%;Ⅰ期癌前病变占1.83%;Ⅱ期癌前病变占1.62%;Ⅲ期癌前病变占1.79%;宫颈癌占1.18%;537例患者高危型HPV-DNA检测结果为阳性;其余为阴性。慢性宫颈炎、Ⅰ、Ⅱ、Ⅲ期癌前病变、宫颈癌的高危型HPV病毒负荷量的四分位数间距分别为:0.35～0.15 pg·mL-1、38.52～0.20 pg·mL-1、516.89～3.88 pg·mL-1、420.82～16.66 pg·mL-1、1243.81～14.53 pg·mL-1。与宫颈炎患者比较,Ⅰ、Ⅱ、Ⅲ期癌前病变、宫颈癌患者的病毒负荷量显著升高(P<0.05)。Ⅰ期癌前病变患者的病毒负荷量显著低于Ⅱ、Ⅲ期癌前病变和宫颈癌患者(P<0.05)。结论高危型人乳头瘤病毒的病毒负荷量与宫颈癌及其癌前病变有密切的关系。

Objective To investigate the viral load of high-risk human papilloma virus and its relationship with cervical cancer and precancerous lesions. Methods Select 2290 cases of patients with cervical lesions from the hospital outpatient service of gy-naecology department, and detect the viral load of high-risk HPV-DNA of all patients and the cervical tissue pathological biopsy. Results In 2290 patients with cervical lesions, the pathological diagnosis of chronic cervicitis accounted for 93.58%;stageⅠprecancerous lesions accounted for 1.83%;stageⅡprecancerous lesions accounted for 1.62%;stageⅢprecancerous lesions ac-counted for 1.79%;Cervical cancer accounted for 1.18%. 537 cases of patients had positive results of high-risk type HPV-DNA test and the rest were negative. The interquartile range of high-risk type HPV virus load were 0.35~0.15 pg·mL-1, 38.52~0.20 pg·mL-1, 516.89~3.88 pg·mL-1, 420.82~16.66 pg·mL-1, 1243.81~14.53 pg·mL-1 respectively for chronic cervicitis,Ⅰ,Ⅱ,Ⅲprecancerous lesions, cervical cancer. Compared with patients with cervicitis, patients withⅠ,Ⅱ,Ⅲperiod precancerous le-sions, cervical cancer had significantly increased viral load （P〈0.05）. Patients withⅠperiod precancerous lesions also had signifi-cantly lower viral load than those withⅡprecancerous lesions,Ⅲprecancerous lesions and cervical cancer （P〈0.05）. Conclusion High-risk human papilloma virus viral load has a close relationship with cervical cancer and precancerous lesions.