生殖道感染与宫颈癌前病变及宫颈癌的关系研究

Study on the relationships between genital tract infections and cervical precancerous lesions and cervical cancer

目的研究生殖道感染和宫颈癌前病变及宫颈癌的关系。方法收集2011年5月-2014年5月该院收治的51例宫颈癌、225例宫颈上皮内瘤变(CIN)及300例单纯宫颈炎患者的临床资料,所有患者均接受生殖道人乳头瘤状病毒(HPV)、单纯疱疹病毒Ⅱ型(HSV-2)、沙眼衣原体(CT)、细菌性阴道病(BV)及滴虫检测,观察比较各类患者的感染率,分析生殖道感染与宫颈癌及CIN之间的相关性。结果 CINⅠ、CINⅡ、CINⅢ、宫颈癌的HPV、HSV-2、CT、BV及滴虫感染率依次上升,其中CINⅢ与宫颈癌HPV感染率分别达到了95.16%、98.04%,与单纯宫颈炎比较差异有统计学意义(P<0.05)。CINⅠ、CINⅡ、CINⅢ的高危型HPV感染率依次上升,为65.63%、74.51%、88.14%,宫颈癌最高,为94.00%,与单纯宫颈炎比较差异有统计学意义(P<0.05)。结论 HPV是最主要的生殖道感染病毒,其他如CT、HSV-2、BV等也较常见,宫颈癌前病变及宫颈癌与生殖道感染间的关系十分紧密,其相互作用机制值得进一步研究。

Objective To study the relationships between reproductive tract infections and cervical precancerous lesions and cervical cancer.Methods The clinical data of 51 cases of cervical cancer,225 cases of cervical intraepithelial neoplasia（CIN） and 300 cases of cervicitis from the hospital from May 2011 to May 2014 was collected,all the patients underwent genital human papillomavirus（HPV）,herpes simplex virus type Ⅱ（HSV-2）,Chlamydia trachomatis（CT）,bacterial vaginosis（BV） and trichomoniasis detection,the infection rates of various types were observed and compared,the correlations between reproductive tract infections and cervical cancer and CIN were analyzed.Results The infection rates of HPV,HSV-2,CT,BV and trichomoniasis in CINⅠ,CINⅡ,CINⅢ,cervical cancer patients increased successively,in CINⅢ and cervical cancer patients,HPV infection rates reached to 95.16% and 98.04%,respectively,compared with simple cervicitis patients,the difference was statistically significant（P〈0.05）.The infection rates of high-risk HPV in CINⅠ,CINⅡ,CINⅢ patients increased to 65.63%,74.51%,88.14% in turn,the infection rate of high-risk HPV in cervical cancer patients was the highest（94.00%）,compared with simple cervicitis patients,there was statistically significant difference（P〈0.05）.Conclusion HPV is the most important reproductive tract infection virus,CT,HSV-2,and BV are also common,the relationships between genital tract infections and cervical precancerous lesions and cervical cancer are very close,the mechanism deserves further study.