男性尖锐湿疣患者HPV亚型与复发的相关性研究

Observation of the relapse rates of condyloma acumimatum with different human papillomavirus genotypes in men

目的探讨男性尖锐湿疣(CA)患者皮损部人乳头瘤病毒(HPV)DNA分型及其与CA复发的相关性。方法采用PCR-反向点杂交法检测128例男性CA患者皮损部的HPV-DNA,同时使用CO2激光对患者进行治疗并随访6个月,统计患者复发情况,使用SPSS17.0进行统计学分析。结果共检出28种HPV-DNA亚型,主要的HPV亚型为HPV6(52.34%),其后依次为11(37.50%)、52(22.66%)、16(13.28%)、43(10.16%),单一型感染者61例(47.66%),多重感染者67例(52.34%),低危型感染者64例(50.00%),含高危型感染者64例(50.00%),多重感染中高低危混合感染42例(62.69%)。所有患者中有65例复发,其中高危型和高低危混合型感染者的复发率高于低危型感染者,含HPV52型感染者的复发率高于非HPV52型感染者,单一型感染者的复发率低于多重感染者的,以上差异均有统计学意义(P<0.05);而含HPV16型的感染者的复发率高于非HPV16型感染者的,但差异无统计学意义。结论本地区男性CA患者感染的HPV亚型以HPV6/1l型为主,感染HPV52型/感染有高危型HPV亚型或多种亚型混合感染者易复发,临床应给予关注。

Objective To obtain the data of Human Papillomavirus（HPV） genotypes distribution in lesions of male Condylomata acuminata（CA） patients in Nanchang of china,and its relationship with clinical relapse rate. Methods 128 tissue specimens were tested by gene chip microarray. 128 samples of patients with male CA were detected by gene chip microarray to obtain the distribution of 28 HPV genotypes;at the same time,the patients were treated with CO2 laser and were followed up for 6 months to determine if the recurrence. EXCEL2003 software was used to describe the distribution of HPV-DNA in male CA and SPSS 17.0software was used to analyze the relationship between the relapse rates and HPV-DNA. Results 28 HPV genotypes were detected in 128 tissue specimens from 128 CA patients;main genotypes were HPV6（52.34%）/11（37.50%）/52（22.66%）/16（13.28%）/43（10.16%）. 67 of 128 HPV DNA positive patients were infected by multiple HPV genotypes,most of which were dual infection（35/67）;64 patients were infected by high risk HPV-DNA,most of which were infected by both high risk and low risk subtypes（42/64）. 65 patiens were recurrence and the rate of recurrence was 50.78%. The relapse rate of the group with infected patiens by high risk HPV genotypes,by HPV52 or by multiple HPV genotypes was higher than the relapse rate of the group with infected patiens by low risk HPV genotypes,by non-HPV52 or by single HPV genotypes（all P〈0.05）. Especially,the relapse rate of patiens by mixed infection with both high risk and low risk HPV genotypes was more obvious than the relapse rate of patiens in low risk group（P〈0.001）. The relapse rate of infected patiens by HPV16 was higher than the relapse rate of infected patiens by non-HPV16,but no statistical significance（P〉0.05）. Conclusion HPV6/11 are the major positive HPV genotypes in male CA. Multiple infection are the major pattern of HPV infection in male CA. The clinical relapes rate of the male CA is significantly higher in infected patiens by high risk HPV genotypes,by HPV52 or by multiple HPV genotypes,who should be more concwened in clinical.