HPV L1壳蛋白表达与宫颈上皮瘤变及HPV分型的关系

Relationship of HPV L1 capsid protein expression with cervical squamous imtraepithelial lesiong and HPV typing

目的分析HPV L1壳蛋白的表达与宫颈上皮病变的关系及其在HPV分型中的分布情况。方法对4 320例妇女进行宫颈液基细胞学(LCT)和HPV分型检测,对LCT≥无明确诊断意义的非典型鳞状上皮细胞(ASC-US)或HPV阳性者行HPV L1检测,并对LCT≥ASC-US且HPV阳性者行阴道镜下组织病理学检查。结果对LCT≥ASC-US或HPV阳性者(共401例)进行HPV L1检测,HPV L1阳性率为34.9%(140/401)。对LCT≥ASC-US且HPV阳性者129例进行组织病理学检查,LCT与组织病理学诊断符合率为79.2%。HPV L1在LCT诊断为ASC-US、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)的患者中阳性率分别为40.2%(29/72)、69.2%(18/26)、9.0%(2/22)。386例HPV感染者中,单一型别感染率居前四位的是HPV52、58、16、18型,其HPV L1阳性率分别为53.3%、28.9%、12.2%、5.6%。结论 HPV L1阳性率随宫颈病变级别增高呈下降趋势,LCT联合HPV L1检测可为宫颈病变预后判定提供参考依据。

Objective To analyze the relation between HPV L1 capsid protein expression with cervical squamous intraepithelial lesions and its distribution situation in HPV typing.Methods A total of 4 320 women were performed the liquid based cytology test（LCT）and HPV typing.The cases of LCT ≥ no diagnostic sense of atypical squamous epithelial cells（ASC-US）or HPV positive were performed the HPV L1 detection.Then the cases of LCT ≥ASC-US and HPV positive were performed the colposcopic histopathological examination.Results A total of 401 cases of LCT≥ASC-US or HPV positive were performed the HPV L1 detection,the HPV L1 positive rate was 34.9%（140/401）.One hundred and twenty-nine cases of LCT ≥ASC-US and HPV positive were performed the histopathological examination,the coincidence rate of LCT and histopathological examination was 79.2%.The positive rates of HPV L1 in ASC-US,LSIL and HSIL by LCT were 40.2%（29/72）,69.2%（18/26）and 9.0%（2/22）respectively.Among 386 cases of HPV infection,the top 4of single genotype infection were HPV 52,58,16 and 18,their HPV L1 positive rates were 53.3%,28.9%,12.2% and 5.6% respectively.Conclusion The HPV L1 positive rate shows the decreasing trend with the cervical lesion grade increase.LCT combined with HPV L1 detection can provide reference basis for judging the prognosis of cervical lesion.