人乳头瘤病毒基因分型在宫颈鳞癌及癌前病变的分布规律及临床意义

DISTRIBUTION AND CLINICAL SIGNIFICANCE OF HUMAN PAPILLOMA VIRUS GENOTYPING IN CERVICAL SQUAMOUS CARCINOMA AND PRECANCEROUS LESIONS

为探讨人乳头瘤病毒(human papilloma virus,HPV)基因分型在宫颈鳞癌及癌前病变中的分布规律及其与宫颈鳞癌发生发展的关系,应用PCR-反向点杂交技术对109例宫颈病变患者(宫颈鳞癌40例、CIN69例)进行HPV感染基因分型测定.结果显示,109例标本中HPV阳性检出率为100%,最常见HPV基因型为HPV16型;随着病变程度增加HPV单一感染比例逐渐升高,多重感染比例逐渐下降,单一感染以高危型HPV16型感染为主;HPV16型在CINⅠ、CINⅡ、CINⅢ、SCC中阳性率分别为30.77%(8/26)、59.09%(13/22)、90.48%(19/21)、90%(36/40),阳性率呈依次上升趋势.宫颈鳞癌及癌前病变与HPV感染直接相关,宫颈癌癌前病变是高、低危HPV共同作用的结果;高危型HPV持续感染是高级别子宫病变及癌变发生的必要条件;HPV16型病毒感染是国人子宫颈鳞癌形成的主要原因.

The aim of this work was to explore distribution o{ HPV genotyping in cervical squamous cell carcinoma and precancerous lesions, to correlate HPV with development and progression of squamous cell carcinoma. PCR-RDB was used to detect HPV genotyping in 109 cervical lesions （40 SCC, 69 CIN）. It was found that in all 109 cervical lesions, positive rate was 100%. HPV-16 was the most common of all types. With aggravation of cervical lesion, a single infection ration of HPV gradually increased, but multiple infection proportion gradually decreased. HPV16 gave priority to single infection. The positive rates of HPV16 in CIN Ⅰ CIN Ⅱ CINⅢ, SCC were 30.77% （8/26）, 59.09% （3/22）, 90.48% （9/21）, 90% （6/40） respectively. Positive rate was an upward trend. It is concluded that there was a direct relationship between cervical squamous cell carcinoma, precancerous lesions and HPV infection. Precancerous lesion was the result of HR-HPV and LR HPV. Persistent infection of HR-HPV was necessary for high level uterine lesions and malignant transformation. HPV16 infection was the main reason of SCC in China.