高危型人乳头状瘤病毒及病毒载量对宫颈癌癌前病变的相关性分析

Correlation between high-risk human papillomavirus and viral load and cervical precancerous lesions

目的探讨高危型人乳头状瘤病毒(HPV)及病毒载量对宫颈癌癌前病变的相关性分析,为临床诊断提供依据。方法选择2012年4月-2013年10月在医院接受诊治的宫颈癌癌前病变患者263例,其中慢性宫颈炎患者45例、宫颈上皮瘤样病变(CIN)Ⅰ期患者62例、CINⅡ患者89例、CINⅢ患者67例,采用荧光定量PCR术检测HPV-DNA高危型分型及病毒载量,采用统计软件SPSS17.0进行统计分析。结果 263例宫颈癌癌前病变患者中感染高危型HPV患者185例,阳性率为70.34%,其中最常见的高危型亚型以HPV16、HPV18为主,分别占30.81%、21.62%;CINⅠ、CINⅡ、CINⅢ患者HPV高危型阳性率及病毒载量均显著高于慢性宫颈炎患者,差异均有统计学意义(P<0.05);而CINⅠ、CINⅡ、CINⅢ患者HPV高危型阳性率比较,差异无统计学意义,且病毒载量随着宫颈癌癌前病变严重程度的增加而增加。结论宫颈癌癌前病变的发生与高危型HPV及病毒载量密切相关,病毒载量随着宫颈癌癌前病变严重程度的增加而增加,宫颈病变越重感染率越高,宫颈癌癌前病变发生高度与高危型HPV感染相关;故高危型HPV及病毒载量为宫颈癌癌前病变影响的重要危险因素。

OBJECTIVE To explore the correlation between the high-risk papillomavirus （HPV） and viral load and the cervical precancerous lesions so as to provide basis for clinical diagnosis. METHODS A total of 263 patients with cervical precancerous lesions, who were treated in the hospital from Apr 2012 to Oct 2013, were enrolled in the study, including 45 cases of chronic cervicitis, 62 cases of cervical intraepithelial neoplasia （CIN） stage [ , 89 cases of CIN H , and 67 cases of CIN UI , then the high-risk HPV=DNA genotyping and viral load were detected by means of fluorescent quantitative PCR, and the statistical analysis was performed with the use of SPSS17. 0 software. RESULTS Of the 263 cases of cervical precancerous lesions, 185 cases have been infected with high-risk HPV with the positive rate of 70.34~ ; the HPV16 and HPV18 were the most common subtypes, accounting for 30.81~ and 21.62~, respectively. Both the positive rate of high-risk HPV and the viral load were significantly higher in the patients with CIN I , CIN II , or CIN 11I than in the patients with chronic cervicitis, with statistical significance （P^0.05） ; the difference in the positive rate of high-risk HPV between the patients with CIN [ , CIN ]l , and CIN I]I was not statistically significant; the viral load was increased with the severity of the cervical precancerous lesions. CONCLUSION The incidence of the cervical precancerous lesion is closely related to the high- risk HPV as well as the viral load; the viral load is increased with the severity of the cervical precancerous lesions; the severer the cervical precancerous lesions, the higher the infection rate; the incidence of the cervical precancerous lesions is highly correlated with the high-risk HPV infection; the high-risk HPV and viral load are the risk factors for the cervical precancerous lesions.