妊娠期妇女高危型人乳头瘤病毒感染与宫颈病变的相关性研究

Correlation between cervical high-risk HPV infection with cervical lesions in pregnant women

目的：探讨妊娠期妇女高危型人乳头瘤病毒（HR‐HPV）感染与宫颈病变的相关性。方法选取重庆华西妇产医院就诊的18～43岁妊娠期妇女486例，行第二代分子杂交捕获技术（HC2‐HPV‐DNA）和超微病原体可视检测技术（TH）2种方法联合检测及电子阴道镜下病理活检，以病理活检结果为诊断宫颈病变的金标准。结果486例妊娠期妇女 HR‐HPV 检测阳性患者161例，阳性率33．12％（161／486）；病理组织学诊断出宫颈癌（ICC）及癌前病变（CIN）24例；HPV 阳性患者的宫颈癌及癌前病变22例，敏感性91．67％（22／24）。 HR‐HPV 感染情况在不同年龄段分布，差异有统计学意义（P＜0．05），HR‐HPV 病毒载量及阳性表达率越高，宫颈病变的程度越高。结论妊娠期妇女不同年龄段的 HR‐HPV 感染率不同；HR‐HPV 阳病毒载量与 CIN 及 ICC 发生有关，与宫颈病变的发生过程有关，但与宫颈病变的严重程度无关；妊娠期妇女 HPV 感染的宫颈病变阳性率和病毒载量与非妊娠期妇女相似；HC2‐HPV‐DNA 法是目前筛查癌前病变及宫颈癌的最佳方法。

Objective To study the correlation between high risk human papilloma virus（HR‐HPV） infection with cervical lesions in pregnant women .Methods A total of 486 pregnant women aged 18 - 43 years old treated in our hospital were selected and performed the second generation hybrid capture technique （HC2‐HPV‐DNA ） ,and pathogens visual detection system （T H） and cervical biopsy under colposcopy .The pathology results served as the gold standard for the diagnosis of cervical lesions .Results Among 486 pregnant women ,161 cases were positive in the HR‐HPV detection with the detection rate of 33 .12% （161/486） ;24 cases of cervical cancer（ICC） and cervical intraepithelial neoplasia（CIN） were diagnosed by histopathology ,in which 22 cases were HPV positive ,the sensitivity was 91 .67% （22/24） .The HR‐HPV infection distribution had statistical difference among different age groups（P＆lt;0 .05） ,the higher the HR‐rHPV viral load ,the worse the cervical lesions .Conclusion The HR‐HPV infection rate is different in different ages of pregnant women ;HR‐HPV positive viral load is related with the occurrence of CIN and ICC ,occurrence process of cervical lesions ,but has no relation with the severity of cervical lesions ;the positive rate of cervical lesions and viral load in pregnant women HPV infection are similar to non pregnant women ;The HC2‐HPV‐DNA method is the best method for screening precancerous lesion and cervical cancer .