HPV-DNA分型与宫颈病变的相关性

Relationship Between Human Papilloma Virus Genotyping and Cervical Diseases

目的：探讨妇科门诊病人不同程度的子宫颈病变感染人乳头瘤病毒（human papilloma virus，HPV）的基因亚型，以探讨不同基因型HPV感染的致癌性。方法对160例有宫颈糜烂Ⅰ-Ⅲ度的妇科门诊患者应用聚合酶链反应（Polymerase Chain Reaction，PCR）方法复制扩增病原DNA，再利用膜杂交技术进行基因分型检测HPV亚型，同时对宫颈脱落细胞进行膜式液基超薄细胞学检测（Thinprep cytologic test，TCT），或在阴道镜下行宫颈活检、经病理学诊断确诊。根据细胞学与病理学诊断有无宫颈病变及其病变程度分5组。结果（1）HPV的感染率：宫颈慢性炎为17.3%（13/75），慢性炎见挖空细胞为70.4%（19/27），低度鳞状上皮内瘤变CINⅠ为23.1%（3/13），高度鳞状上皮内瘤变（CINⅡ-Ⅲ）为55.6%（20/36），宫颈癌为88.9%（8/9）。（2）分析HPV感染基因型与宫颈病变程度的关系，CINⅡ-Ⅲ患者中单一高危型HPV感染率60.0%，明显高于混合型（35.0%）和单一低危型（5.0%），其感染的HPV型别有16、18、31、33、45、56、58、73，其中16型感染率为75.0%，具有统计学意义。结论 HPV高危型与宫颈病变程度密切相关，随着宫颈病变程度加重，HPV高度型感染有增加趋势。

Objective To investigate human papilloma virus types detected in outpatients with different degree diseases at cervix and to analyze the carcinogenicity of the various human papilloma virus（HPV） types.Methods 160 outpatients of gynecology who have different degree cervical erosion were tested with polymerase chain reaction to duplicate etiological agent’s DNA and membrane hybridization technique to Genotyping detect HPV hypotype.At the same time Thinprep cytologic test（TCT） were used to detect their cast-off cell or under colposcope gynecatoptron to cervical biopsy pathology to diagnose it.According to the cytological and pathological diagnosis the patients were divided into five groups.Results （1）The infection rate of HPV in chronic cervicitis,chronic cervicitis with koilocystosis,low-grade squamous intraepithelial lesion（CINⅠ）,high-grade squamous intraepithelial lesion（CINⅡ-Ⅲ）,cervical cancer was 17.3%（13/75）,70.4%（19/27）,23.1%（3/13）,55.6%（20/36）,88.9%（8/9）,respect-ively.（2）There was relationship between the genotype of HPV and the disease degree at cervix.The infection rate of single high dangerous HPV was 60.0%,in which the patients had the serious cervical disease.It is much higher than the mixed type（35.0%） and the single-low-danger type（5.0%）,P〈0.05.Its HPV types were 16, 18, 31, 33, 45, 56, 58 and 73.The infection rate of HPV-16 was 75.0%.Conclusion High dangerous HPV has close relationship with the disease degree at cervix.The degree of the cervical diseases was aggravated,and the rate of high dangerous HPV will increase.