24种HPV基因型检测在宫颈病变诊断中的意义

Significances of detection of 24 genetypes of HPV in diagnosis of cervical lesions

目的:应用基因芯片技术检测宫颈疾病中人乳头瘤病毒(HPV)的基因型及分布特点,并探讨其临床意义。方法:应用基因芯片技术,对经病理确诊200例宫颈癌前病变及宫颈癌的患者进行24种HPV基因型检测,分析HPV基因型与宫颈病变的相关性。结果:1总共检出24种HPV基因型中的20种基因型,居前5位是HPV16、HPV18、HPV58、HPV59、HPV54,其中高危型HPV占83.9%,以HPV16、HPV18、HPV58多见;低危型占16.1%,以HPV54、HPV6、HPV70多见;2慢性宫颈炎、CIN和宫颈鳞癌居前4位基因型分别是HPV54、HPV16、HPV51、HPV58,HPV16、HPV59、HPV58、HPV18,HPV16、HPV18、HPV51、HPV54,而高危型HPV基因型分别占73.1%、91.0%、76.9%;3HPV感染率为51.5%,随着宫颈病变程度增加而增加(P<0.05);HPV感染率在不同宫颈病变中单一感染率明显高于多重感染率(P<0.05);多重感染、高危型感染、高低混合型感染的各组感染率在不同级别宫颈病变差异有统计学意义(P<0.05)。结论:HPV感染率随着宫颈病变进展而升高,高危型HPV基因型是宫颈癌变的早期事件,多重感染是加重宫颈病变的重要因素,24种HPV基因型检测在宫颈癌筛查和防治过程中具有重要意义。

Objective:To use gene chip technology to detect genetypes and distribution characteristics of human papillomavirus ( HPV) in cervical disease, and discuss their clinical significances. Methods:The gene chip technology was used to detect 24 gene-types of HPV in paraffin tissue from 200 cases of patients' pathologically diagnosed samples with cervical precancerous lesions and cer-vical cancer. Correlations among the genotypes of HPV and the cervical lesions were analyzed. Results:①20 of 24 genetypes of HPV were detected, 5 of the popular types were HPV 16, HPV18, HPV58, HPV59 and HPV54. The rate of high-risk type of HPV was 83. 9%, and the popular types were HPV 16,HPV18 and HPV58. The rate of low-risk type of HPV was 16. 1%, the popular types were HPV 54, HPV6 and HPV70. ②In chronic cervicitis, CIN, and squamous carcinoma of the cervix, 4 of the popular types were HPV 54, HPV16, HPV51 and HPV58, HPV 16, HPV59, HPV58 and HPV18, and HPV 16, HPV18, HPV51 and HPV54, respec-tively;and the genetypes of high-risk type of HPV accounted for 73. 1%, 91. 0% and 76. 9%, respectively. ③The infection rate of HPV was 51. 5% and increased with the aggravation of cervical lesions (P<0. 05). The rate of single HPV infection was significantly higher than that of multiple HPV infection in different cervical lesions (P<0. 05). There were statistical differences of the multiple HPV rate, high-risk HPV rate, and mixed type of low-risk and high-risk of HPV rate among different grades of cervical lesions ( P<0. 05). Conclusions:The HPV infection rate is increasing with the progression of cervical lesions. The genetypes of high-risk type HPV is an early event of cervical lesions. The multiple HPV infection can aggravate the cervical lesions. The detection of 24 genetypes of HPV plays important roles in screening, prevention and treatment of cervical cancer.