子宫颈低级别鳞状上皮内病变与HR-HPV的关系

Relationship between low-grade squamous intraepithelial lesions and high risk human papillomavirus

目的探讨高危型人乳头状瘤病毒(high risk human papillomavirus,HR-HPV)在子宫颈低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)中的分布特点及感染方式,并分析其在LSIL中的作用。方法应用实时荧光定量PCR和HPV原位杂交技术对328例诊断结果为168例LSIL、160例高级别鳞状上皮内病变(high-grade squamous intraepithelial lesions,HSIL)的子宫颈组织蜡块进行HPV分型检测。结果 HE染色结果显示,LSIL的病变细胞集中在子宫颈鳞状上皮表层,HSIL的病变细胞主要集中在上皮下层。168例LSIL患者中HR-HPV阳性率95.2%;LSIL、HSIL中HPV 16、18阳性率分别为26.2%、57.5%,其他型HR-HPV(不包括HPV 16、18)的阳性率分别为80.9%、55.0%,差异均有统计学意义(P<0.001)。在原位杂交检测组中,HR-HPV的阳性率为70.2%,HR-HPV阳性LSIL中,棕黄色阳性细胞位于子宫颈鳞状上皮表层、中层,基底层未见阳性细胞。结论 HR-HPV感染与LSIL的发生、发展密切相关,尤其是其他型HR-HPV(不包括HPV 16、18);LSIL患者中HR-HPV的感染开始于子宫颈鳞状上皮表层。

Purpose To study the infection mode and dis- tribution of high risk human papillomavirus （HR-HPV） in low- grade squamous intraepithelial lesions （LSILs） and to analysis its effect. Methods HPV genotype of 328 cervical tissues em- bedded by paraffin which contained 168 LSILs and 160 high- grade squamous intraepithelial lesions （HSILs） were detected by the methods of real-time fluorescence quantitative PCR and in si- tu hybridization. Results Diseased cells of LSIL stained with hematoxylin and eosin（HE） were concentrated in the upper lay- er of the cervical squamous epithelium, whereas HSIL were con- centrated in the lower layer of the epithelium in HE staining. In LSIL, the positive rates of HR-HPV was 95.2%. In LSIL and HSIL, HPV 16/18 positive rates were 26. 2% , 57.5% , respec-tively. Other HR-HPV positive rates were 80. 9% , 55.0% , re- spectively. The differences were statistically significant （P 〈 0. 001 ）. HR-HPV positive rate was 70. 2% in the group of in situ hybridization. The positive ceils were confined to the surface and middle layer of the LSIL cervical squamous epithelium. Conclusion HR-HPV infection is closely related to LSIL, es- pecially other HR-HPV （except for HPV 16/18）. The infection mode of HR-HPV in LSIL starts from the surface layer of the cervical squamous epithelium.