高危型HPV持续感染与宫颈癌前病变的相关性

Correlation between persistent infection of high-risk HPV and precancerous cervical lesions

目的探讨不同型别的HPV持续感染对宫颈病变进展的时效及作用。方法在现有流行病学调查的基础上,对340例持续HPV阳性的妇女进行TCT检测,根据检测结果,将细胞学检查为ASCUS、ASC-H、LSIL、HSIL及CIN1/2/3妇女的HPV检测结果进行对比分析。结果 340例HPV感染者中,感染比例较高的四种优势型别分别为52型(29.41%,100/340),16型(15.59%,53/340),58型(15.29%,52/340)(P<0.05),18型(10.29%,35/340);一年持续感染率为25.76%,持续感染的优势型别分别为:18型(40.00%,14/35),58型(38.46%,20/52),31型(31.25%,5/16),66型(30.00%,3/9),52型(21.00%,21/100),51型(20.00%,5/25)),16型(18.87%,10/53);初感率和持续1年的感率相比较,58型、18型、31型和66型有显著差异(P<0.05);初筛人群中,58,16,18型的HSIL级别病变的发生率显著高于52型(P<0.05);持续感染1年的人群中,58,16,18型HSIL级别病变发生率显著高于52型(P<0.05)。18型的LSIL病变级别的初感染率和持续1年感染率有显著差异(P=0.03)。结论 58,16,18三种型别的持续感染率高且对宫颈病变的进展关系密切。

Objective To investigate the role of different types of high-risk HPV infections on cervical lesions.Methods Based on an epidemiological study,340 cases of persistent HPV infections were detected with the thin prep cytology test（TCT）,and based on the detection results,a contrastive analysis was performed according to the CIN1/2/3 and the results of TCT including ASCUS,ASC-H,LSIL,and HSIL.Results In 340 cases of HPV infections,the most common types of high-risk HPV included type 52（29.41%,100/340）,16（15.59%,53/340）,58（15.29%,52/340）（P〈0.05）,and type 18（10.29%,35/340）,respectively.The prevalence of one-year persistent infection of HPV was 25.76%.The most popular types involved type 18（40.00%,14/35）,58（38.46%,20/52）,31（31.25%,5/16）,66（30.00%,3/9）,52（21.00%,21/100）,51（20.00%,5/25）,and type 16（18.87%,10/53）.There were significant differences（P〈0.05）between the primary and persistent infections in type 58,18,31 and type 66.The incidence rates of HSIL were significantly higher in type 58,16,18 than the rate in type 52（P〈0.05）both in primary and persistent infection more than one year.In the primary infection,the incidence of LSIL with type18 was significantly different from that in the persistent infection（P=0.03）.Conclusion The persistent infection rates of type 58,16,18 are high and they are closely related to the progress of cervical precancerous lesion.