维吾尔族和汉族妇女宫颈病变组织中人乳头瘤病毒16存在状态对比研究

Analysis of human papillomavirus 16 in cervical lesions in Uygur and Han women

目的 探讨人乳头瘤病毒（HPV） 16整合在维吾尔族和汉族妇女宫颈病变进展中的作用,以及病毒整合与维吾尔族宫颈癌高发病率低感染率的关系.方法 选择2010年8月至201 1年5月就诊于新疆维吾尔自治区人民医院妇科379例维吾尔族（维吾尔族组）、464例汉族（汉族组）宫颈病变患者活检或手术标本,2组病理分级分别为炎症、宫颈癌前病变（CIN）Ⅰ期、CINⅡ期、CINⅢ期、宫颈鳞癌,提取组织DNA,采用多重实时定量聚合酶链反应检测HPV16 E2和E6拷贝数,通过E2/E6比值判断各样本HPV16 DNA的存在状态.结果 维吾尔族患者HPV16阳性率为32.2％ （122/379）,汉族患者为26.1％（121/464）.维吾尔族和汉族宫颈炎症、CIN Ⅰ期、CINⅡ期、CINⅢ期、宫颈鳞癌患者HPV16整合比率（混合型和整合型所占的比例）随着宫颈病变程度加重呈增大趋势[维吾尔族：20.0％（4/20）,40.6％（13/32）,50.0％ （3/6）,40.0％ （8/20）,79.5％ （35/44）;汉族：31.8％（7/22）,50.0％（17/34）,42.9％（3/7）,46.4％（13/28）,26.7％ （23/30）] （P ＜0.01）.但是在同级别宫颈病变组织中,维吾尔族和汉族患者HPV16整合比率差异无统计学意义（P＞0.05）.维吾尔族和汉族炎症、CIN Ⅰ期、CINⅡ/Ⅲ期、宫颈鳞癌整合率（1-E2/E6）差异无统计学意义（P＞0.05）,但维吾尔族和汉族合为一样本总体时,差异有统计学意义（P＜0.05）,且随着病变程度加重,整合率逐渐增大.结论 HPV16 E2整合是促进新疆维吾尔族和汉族宫颈病变进展的因素之一.暂不能认为HPV16 E2整合是维吾尔族宫颈癌高发病率的原因.

Objective To explore the integration progress of human papillomavirus （HPV） 16 in cervical lesions in Uygur and Han of women;to analyze the relation between virus integration and cervical carcinoma in Uygur women.Methods Biopsy specimens of 379 Uygur and 464 Han patients with cervical lesions were selected and the DNA was extracted.HPV16 E2 and E6 copy numbers were detected by multiplex real-time quantitative polymerase chain reaction,and the existence state of HPV16 DNA was determined by E2/E6 ratio.Results The HPV16 was positive in 122 cases of Uygur patients （32.2%） and in 121 cases of Han patients （26.1%）.The integration ratio of HPV16 （proportion of mixed ＆#177; integrated type） was gradually increased in chronic cervicitis,cervical precancerous lesions （CIN） Ⅰ phase,CIN Ⅱ phase,CIN Ⅲ phase and cervical squamous cell carcinoma （SCC）in both Uygur patients [20.0% （4/20）,40.6% （13/32）,50.0% （3/6）,40.0% （8/20）,79.5% （35/44）] and Han patients [31.8% （7/22）,50.0% （17/34）,42.9% （3/7）,46.4% （13/28）,26.7% （23/30）] （P 〈0.01）.In patients with the same level of cervical lesions,the integration ratio of HPV16 had no significant differences between Uygur and Han patients （P 〉 0.05）.No significant differences in integration rate of HPV16 （1-E2/E6） were found among chronic cervicitis,CIN Ⅰ,CIN Ⅱ/Ⅲ and SCC patients in Uighur and Han patients （P 〉 0.05）.In all the patients,the integration rate of HPV16 （1-E2/E6） was significantly increased with the pathological degree （P 〈 0.05）.Conclusion HPV16 E2 integration is a promoter for the progress of cervical lesions in Uygur and Han women in Xinjiang,but it can not be considered as a cause of high incidence rate of cervical cancer in Uygur women.