上海地区HPV分型及高危型HPV负荷量与宫颈病变的关系

Human papillomavirus genotyping and correlation of high-risk human papillomavirus viral load and cervical lesions in Shanghai

目前发现已鉴定出的100多种HPV亚型在不同国家与地区的流行病学分布不同,而HPV负荷量的高低与宫颈病变的严重程度存在相关性.为了探讨上海地区HPV亚型的分布特征及高危型HPV负荷量与宫颈病变的关系,收集了就诊于上海市浦东新区公利医院宫颈疾病门诊患者515例,采用导流杂交基因芯片技术(HybriMax)对HPV进行基因诊断和分型;并使用实时荧光定量PCR方法检测HPV负荷量,统计分析负荷量与宫颈病变程度的相关性.结果表明,上海地区共检测出18种HPV亚型,检出率大于5%的HPV亚型(HPV-16,58,33,52,31,18)均属于高危型;4种高危型HPV(16,58,33,52)与宫颈病变严重程度呈显著相关;Spearman等级相关分析显示,HPV负荷量与宫颈病变级别呈正相关(r=0.318,P=0.000);两种高危亚型HPV-16和HPV-33的负荷量为这种正相关性的主导因素.本研究确定了上海地区HPV流行的主要亚型及HPV负荷量与宫颈病变程度的关系,这为开发预防中国人群(特别是上海地区)常见HPV亚型的多价疫苗提供了有效证据,为高HPV负荷量作为高级别宫颈上皮内瘤样病变及宫颈癌筛查的有意义指标提供了佐证.

The epidemiological distribution of human papillomavirus （HPV） subtypes varies among different countries and also in different areas within the same country. HPV viral load is correlated with the grade of cervical intraepithelial lesion. Therefore, HPV subtype and HPV viral load testing have drawn increasing research attention. We investigated 515 cervical disease specimens collected from patients at the Shanghai Pudong New Area Gongli Hospital. We used guide hybrid gene chip technology （HybriMax） to conduct HPV genotyping and measured HPV viral load by RT-PCR. We then analyzed the correlations between HPV genotypes and grade of cervical disease, as well as HPV viral load and cervical disease. We detected 18 HPV subtypes in Shanghai. Six high-risk subtypes （HPV 16, 58, 33, 52, 31, 18） had a detection rate of over 5%, of which four subtypes （HPV 16, 58, 33, 52） were significantly correlated with the severity of cervical lesions. Spearman rank correlation analysis showed that HPV viral load and cervical lesion grade were positively correlated （r=0.318, P=0.000）; this correlation was primarily as a result of HPV-16 and HPV-33. This study presents the prevalent HPV subtypes in Shanghai and analyzes HPV viral load and the relationship to cervical lesions. These results provide evidence for the clinical significance of HPV viral load in rapid screening for cervical lesions, and serves to inform for the development of a polyvalent vaccine for China.