高危HPV持续感染与宫颈病变发生的相关性

Relationship between persistent infection of high-risk HPV and occurrence of cervical lesions

目的探讨高危型人乳头状瘤病毒(HR-HPV)的感染状态与宫颈病变发生和发展之间的关系。方法选取1023名妇女接受液基细胞检查(TCT),第二代杂交捕获技术(HC2)-HPV-DNA和HPV分型检查。以TCT细胞学正常、高危HPV亚型阳性患者181例作为目标人群,随访重复TCT细胞学检查和HPV基因分型,TCT细胞学异常的妇女在阴道镜下取宫颈组织细胞活检。分析在不同的HPV感染类型,TCT异常的感染状态(持续感染、间歇性感染和感染清除)和宫颈病理学异常的相关性。结果目标组随访1年,宫颈病变的发生率在HPV持续性感染和HPV感染清除或间歇性感染的女性之间没有显着性差异(P>0.05)。目标群体随访2年,持续性HPV感染女性比HPV感染清除或间歇性感染的女性宫颈病变的发生率高(P<0.05)。与单一类型感染相比,多发性HPV感染的宫颈病变发生率并不增高(P>0.05)。HPV16和HPV18感染发生率高,且宫颈病变发生率增高(P<0.05)。结论持续HPV感染2年以上,特别是HPV16和HPV18持续感染,宫颈病变的风险显著增加。临床上,高危HPV分型和感染状态的联合筛查更具临床意义。

Objective To investigate the relationship between the infection status of high-risk human papillomavirus （HR-HPV） and the occurrence and development of cervical lesions. Methods A total of 1023 women underwent liq- uid-based cytologic test （TCT）, second-generation hybrid capture technique （HC2） -HPV-DNA and HPV typing. 181 patients with normal TCT cytology combined with high risk HPV subtypes were chonsen as the target population and underwent repeated TCT cytology and HPV genotyping in follow-up.And cervical tissue biopsy was taken under the colposcopy when TCT cytology was abnormal. The association between different HPV infection types, TCT abnormal in- fection status （persistent infection, intermittent infection and infection clearance） and the occurrence of cervical patho- logical abnormalities was analyzed. Results The target group was followed up for 1 year, and there was no significant difference in the incidence of cervical lesions between the HPV persistent infection women and HPV infection clear- ance or intermittent infection women （P〉0.05）. The incidence of cervical cancer was higher in women with persistent HPV infection than that in women with HPV infection clearance or intermittent infection when the targeted group was followed up for 2 years （P〈0.05）. Compared with that in a single type of infection, the incidence of cervical lesions in multiple HPV infection was not high （P〉0.05）. The incidence of HPV16 and HPV18 infection was high, and the inci- dence of cervical lesions was increased（P〈0.05）. Conclusion When persistent HPV infection for more than 2 years, es- pecially continued infection of HPV16 and HPV18, the risk of cervical lesions increased significantly. Clinically, the combination screening of high-risk HPV typing and infection status is more of clinical significance.