新疆维吾尔族妇女宫颈癌高危型人乳头瘤病毒负荷量与宫颈病变的相关性研究

The relation between human papillomavirus （HPV） DNA load and cervical intraepithelial neoplasia

目的 探讨新疆维吾尔族妇女宫颈癌高危型人乳头瘤病毒（HPV）负荷量与宫颈病变程度的关系.方法 对在新疆自治区人民医院诊治的906例维吾尔族妇女进行宫颈液基细胞学检测,采用杂交捕获2代（HCⅡ）方法定量检测宫颈HPV-DNA负荷量,并在阴道镜下行宫颈多点活检和颈管诊刮术.按HPV-DNA负荷量＜1、1～、101～、501～、1 001 ～4 263组. 结果 906例患者中宫颈炎、宫颈上皮内瘤变和宫颈癌分别为76.6％、13.3％和10.2％,3者HPV-DNA负荷量总体分布比较,差异有统计学意义.HPV-DNA负荷量≥1时CIN及宫颈癌的阳性诊断率较＜1时显著升高,HPV-DNA负荷量＞100时,CIN及宫颈癌的阳性诊断率显著升高;随着HPV-DNA负荷量增加高宫颈癌的阳性率显著升高,差异均有统计学意义. 结论 HPV-DNA负荷量随宫颈病变的严重程度而增加,可作为宫颈癌前病变及宫颈癌的筛查客观指标.

Objective To explore the relation between human papiUomavirus （HPV） DNA load and cervical in- traepithelial neoplasia （CIN）, and to assess the application of liquid-based cytology test（CCT） and high-risk human papil- lomavirus test in cervical lesion diagnosis. Methods A total of 906 women who received treatments in the People＇ s Hos- pital were included and received CCT and HPV DNA semi-quantitative determination by hybrid capture II （HC2II）. Cervi- cal biopsy was obtained under eolposcopy and histopathologie tests were considered as the final diagnoses According to HPV-DNA loads, the patients were classified into five group ： HPV 〈 1, 1 ≤ HPV ≤ 100, 100 〈 HPV ≤500,500 〈 HPV ≤ 1 000, and HPV 〉 1 000, respectively. Results A total of 694 patients were identified as cervicitis, 120 cervical as in- traepithelial neoplasia, and 92 as cervical cancer. There were significant differences in their HPV-DNA loads among the three groups. It was found that high HPV DNA load increased with aggravation of cervical diseases. The collectivity distri- bution of HPV quantity were significantly different among the three groups. The rate of having a diagnosis of cervical intra- epithelial neoplasia was significantly higher among those with HPV DNA 〉 100 than other groups. The rate of having a di- agnosis of CIN II, CIN III and SCC were significantly higher among those with HPV DNA 〉 1 than the rate among those with HPV DNA 〈 1. Conclusion High HPV DNA load increased with aggravation of cervical diseases. HPV DNA load is an objective index to screen cervical lesion and cervical canner.