宫颈病变组织中HPV-DNA的检测及临床意义分析

Detection and analysis of HPV in cervical lesion and its clinical significance

目的探讨宫颈病变组织中HPV感染类型及病毒载量。方法 284例组织分为慢性子宫颈炎组、CINⅠ级组、CINⅡ级组、CINⅢ级组、浸润性鳞状细胞癌组、腺癌组和外阴尖锐湿疣组,应用表面等离子谐振(SPR)技术对每组进行HPV类型及载量的检测。结果 HPV总阳性率72.54%;高危型中以HPV16、45和18亚型为主,分别占39.81%、24.76%和9.22%;低危型中以HPV6和11亚型为主,分别占20.87%和6.80%。多重感染率占26.21%,主要以双重感染为主85.19%;而外阴尖锐湿疣占多重感染比例高达40.74%。从慢性子宫颈炎到宫颈鳞状细胞癌发展过程中,HPV阳性率呈上升趋势,且病毒平均载量也呈上升趋势。CINⅡ级组、CINⅢ级组、鳞状细胞癌组和外阴尖锐湿疣组分别与慢性子宫颈炎组之间比较统计学差异有显著性意义(P<0.05);而CINⅠ级组和腺癌组分别与慢性子宫颈炎组之间比较统计学差异无显著性意义(P>0.05)。在慢性子宫颈炎组、CINⅢ级组及鳞状细胞癌组中均以感染HPV16亚型为主,且平均载量呈上升趋势。结论宫颈病变与HPV感染密切相关,随着病变程度的增加病毒载量增加。

【Objective】To investigate the type and viral load of HPV in the cervical lesions. 【Methods】284 cases were divided into chronic cervicitis group, cervical intraepithelial neoplasia Ⅰ（CIN Ⅰ） group, CIN Ⅱ group, CIN Ⅲ group, invasive squamous cell carcinoma group, adenocarcinoma group and condyloma acuminatum group. HPV type and the load of each group were detected by surface plasmon resonance（SPR） method. 【Results】The total positive rate of HPV was 72.54%. High risk HPV subtypes were HPV16, 45 and 18, accounted for 39.81%, 24.76% and 9.22%, respectively. And low risk subtypes were HPV6 and 11 which accounted for 20.87% and 6.80%, respectively. Multiple infection rate was 26.21%, which was mainly the double infection about 85.19%, and condyloma acuminatum showed the highest double infection rate（40.74%）. From chronic cervicitis to cervical squamous cell carcinoma, the positive rate of HPV was increased, and the average virus load was also on the rise. It was statistically significant difference between CIN Ⅱ group, CIN Ⅲ group, squamous cell carcinoma group or condyloma acuminatum groups and chronic cervicitis group（P〈0.05）. However, there was no significant difference between CIN Ⅰ group or adenocarcinoma group and chronic cervicitis group（P〉0.05）. It was mainly HPV16 subtype in chronic cervicitis group, CIN Ⅲ group and squamous cell carcinoma group. And the average load was on the rise. 【Conclusion】There was close relationships between cervical lesions and HPV infection.And viral load is increased with the severity of cervical lesions.