宫颈ASC-US、LSIL和HSIL中HPV感染型别分布的研究

Study on HPV infection types distribution in ASC-US,LSIL and HSIL of uterine cervix

目的分析女性宫颈未明确意义的非典型鳞状细胞(ASC-US)、低度鳞状上皮内病变(LSIL)和高度鳞状上皮内病变(HSIL)中人乳头瘤病毒(HPV)感染基因型分布及其临床意义,同时对ASC-US、LSIL和HSIL患者行宫颈病理组织学诊断分析。方法采用基因扩增结合基因芯片技术对236例宫颈ASC-US、36例宫颈LSIL和61例宫颈HSIL标本进行23种HPV基因分型检测,所有ASC-US、LSIL和HSIL患者行宫颈活检病理组织学诊断,并对受检者进行相关资料分析。结果 236例宫颈ASC-US中检出HPV感染者139例,HPV总感染率为58.90%(139/236),其中一型感染率为38.14%(90/236),多型感染率为20.76%(49/236);36例宫颈LSIL中检出HPV感染者26例,HPV总感染率为72.22%(26/36),其中一型感染率为52.78%(19/36),多型感染率为19.44%(7/36);61例宫颈HSIL中检出HPV感染者58例,HPV总感染率为95.08%(58/61),其中一型感染率为68.85%(42/61),多型感染率为26.23%(16/61)。宫颈ASC-US组和LSIL组与HSIL组HPV总感染率比较,差异有统计学意义(P<0.05)。结论 HPV 16、52、58型是宫颈ASC-US、LSIL和HSIL患者中最主要的型别,基因芯片检测技术可用于宫颈细胞HPV分型检测,对宫颈ASC-US患者的进一步分流管理具有重要的临床意义,应引起妇科医师的高度关注。

Objective To analyze the genotypes distribution and clinical significance of human papillomavirus(HPV)infection in atypical squamous cells of undetermined significance(ASC-US),low squamous intraepithelial lesion(LSIL)and high squamous intraepithelial lesion(HSIL)of uterine cervix,meanwhile to conduct the cervical histopathological diagnostic analysis in the patients with ASC-US、LSIL and HSIL.Methods The gene amplification technique(PCR)combined with gene-chips technology were adopted to conduct the 23 kinds of HPV genotype detection on 236 cases of cervical ASC-US,36 cases of cervical LSIL and 61 cases of cervical HSIL specimens.All cases of ASC-US,LSIL and HSIL were performed the cervical biopsy histopathological diagnosis.And then the subjects related data were analyzed.Results Among 236 cases of cervical ASC-US specimens,139 cases of HPV infection were detected with the total HPV infection rate 58.90%(139/236),in which the single genotypes infection rate was 38.14%(90/236)and the multiple genotypes infection rate was 20.76%(49/236);26 cases of HPV infection were detected from 36 cases of cervical LSIL specimens with the total HPV infection rate of 72.22%(26/36),in which the single genotypes infection rate was52.78%(19/36)and the multiple genotypes infection rate was 19.44%(7/36);61 cases of HPV infection were detected from 58 cases of cervical HSIL specimens with the total HPV infection rate of 95.08%(58/61),in which the single genotypes infection rate was 68.85%(42/61)and the multiple genotypes infection rate was26.23%(16/61).The total infection rates had statistically significantly differences among the cervical ASC-US group,LSIL group and HSIL group(P<0.05).Conclusion HPV16,52,58 are the main types in the patients with cervical ASC-US,LSIL and HSIL.The gene-chip technology can be used in the HPV genotypes detection of cervical cells,which has an important clinical significance for further distribution management on ASC-US patients and should draw great attention of gynecologist.