HPV16型E6变异体对HSIL锥切术后持续感染及复发的影响

The role of HPV type 16 E6 variant in persistent infection and recurrence of cervical HSILs after conization

目的 :探索HPV16型E6变异体对HSIL锥切术后持续感染及复发的预警作用。方法:选取2011年5月至2012年6月本院HPV16型阳性、LEEP术后切缘阴性的HSIL患者100例,对其宫颈脱落细胞E6基因测序,术后随访2年。持续感染及复发者再次测序明确HPV16变异体。结果:100例均检测出变异体,81.0%为亚洲原型,14.0%为欧洲变异体,2.0%欧洲原型,3.0%非洲1变异体;亚洲原型锥切术后HPV16易清除(P<0.001);欧洲变异体T350G、A442C有更高的HPV16持续感染及复发相关性(P<0.001)。结论 :(1)HPV16变异体与HSIL发生密切相关;(2)上海浦东地区HPV16导致的HSIL多属于亚洲型变异体,锥切后HPV16易清除;(3)欧洲变异体E6 T350G/A442C可能有更高的锥切术后HPV16复发及持续感染相关性。

Objective To explore the role of humall papillomavims （HPV） type 16 E6 variants in the persistent infection and recurrence of the cervical high-grade squamous intraepithelial lesion （HSIL） after conization. Motheds During May to June 2012, lO0 HSIL patients with HPV16 positive but negative at the margin after Loop electrosurgical excision procedure （LEEP） were selected from Shanghai People＇s Hospital of Pudong District. The gene sequencing was done to the E6. The patients were followed up for 2 years. The E6 gene sequencing was done again to detect the HPV16 variants among those with persistent infections and recurrence. Results Among the 100 cases, E6 variants were detected, 81% of them HPV E6 variants Asian prototype, 14% European variant; 2% European prototype （EP） and 3% African variant 1. LEEP for Asian prototype was susceptible to the clearance of HPV16 （P 〈 0.001 ）. The European variants of T350G, and A442C were correlated with persistent infection and recurrence （P 〈 0.001）. Conclusion The HPV16 variant is closely related to the HSIL incidence. HSIL caused by HPV16 in Pudong New Area of Shanghai belong to the Asian type variant. The European variants of E6, T350G/A442C were likely related to the recurrence of HPVI6.