高危型HPV分型检测在宫颈疾病诊治中的应用价值

Application value of high risk HPV typing detection in diagnosis and treatment of cervical diseases

目的探讨高危型人乳头瘤病毒(human papillomavirus,HPV)分型检测在宫颈疾病诊治中的应用价值。方法收集2013年2月至2014年10月在南充市妇幼保健院门诊进行机会性宫颈癌筛查病例1 374例,采集宫颈脱落细胞,通过实时荧光聚合酶链反应(polymerase chain reaction,PCR)方法进行13种高危型HPV分型检测,对阳性病例及检测阴性但宫颈症状明显患者,进行阴道镜检查,有异常者行多点活检。分析高危型HPV感染与宫颈疾病的关系。结果 1 374例病例中检出高危型HPV感染288例(20.96%),单一感染245例(17.84%),多重感染43例(3.12%);13种高危型HPV亚型排序为:52、58、16、56、51、39、18、33、68、31、59、45、35,其中52型是主要感染型别,占24.16%(79/288);随着宫颈病变升级,高危型HPV阳性率升高;宫颈病变级别升高与多重感染率增高、病毒载量升高有关(P<0.05)。结论高危型HPV分型检测在宫颈疾病诊治中具有重要意义。

Objective To investigate the application value of high-risk HPV typing detection in the diagnosis and treatment of cervical diseases.Methods A total of 1 374 outpatients underwent cervical cancer screenings in Nanchong Maternal and Child Health Hospital from Feb 2013 to Oct 2014 were enrolled.The cervical exfoliated cells of all cases were colleced, 13 kinds of high-risk HPV genotyping were tested by real -time PCR.The colposcopy were applied for the positive cases and negative cases with significant cervical symptoms, multiple biopsy were applied for abnormal cases.The relationship between high-risk HPV infection and cervical diseases were analyzed.Results Among 1 374 patients, 288 cases （20.96 %） were detected of high-risk HPV infection, 245 coses were single infection （17.84%）, 43 cases were multiple infection （3.12%）.13 kinds of high-risk HPV subtypes were ranked in order：52, 58, 16, 56, 51, 39, 18, 33, 68, 31, 59, 45 and 35, in which 52 is the main infection type（24.16 %）.As upgrade of cervical lesions, high-risk HPV infection rate increased.The upgrade of cervical lesions was related to increase of multiple infection rate and viral load （P〈0.05）.Conclusion high risk HPV typing detection is important for the diagnosis and treatment of cervical disease.