女性宫颈疾病患者HPV分型检测结果分析

HPV subtype analysis in female patients with cervical diseases

目的检测湖北地区罹患宫颈疾病女性的人乳头状瘤病毒(HPV)的感染情况,探讨女性宫颈病变与HPV感染及HPV分型的相关性,为疾病治疗奠定基础。方法对2016年1~12月来武汉市广州军区武汉总医院生殖中心就诊的960例宫颈疾病患者进行阴道镜、组织病理学检查,并采用凯普核酸分子快速导流杂交基因芯片技术进行HPV检测及分型。结果 960例宫颈疾病患者中有446例患者被检测出HPV阳性,总阳性率为46.5%,其中慢性宫颈炎、CINⅠ、CINⅡ、CINⅢ及宫颈癌患者检出率分别为26.1%、74.8%、83.6%、93.2%和100.0%,组间HPV阳性率差异有统计学意义(χ2=306.84,P=0.000 1);HPV-16、52、58、18等4型高危型HPV的总阳性率分别为38.3%、20.4%、18.4%和12.3%,HPV-16型在慢性宫颈炎、CINI、CINII、CINIII和宫颈癌中的对应阳性率分别为12.7%、35.1%、50.0%、5.5%和84.9%。结论 HPV最常见感染为高危型HPV16、52、58、18型;在CIN及宫颈癌患者中高危型HPV感染率较高;在慢性宫颈炎、CIN和宫颈癌患者中HPV-16感染率有逐渐升高的趋势,具有较强的临床指示性。

Objective To detect the infection status of human papillomavirus（HPV） in female patients with cervical diseases from Hubei, and to analyze the correlation between cervical lesions and HPV infection and HPV typing in women, so as to provide a foundation for disease treatment. Methods A total of 960 patients with cervical diseases were examined by colposcopy and histopathology in Center for Reproductive Medicine, Wuhan General Hospital of Guangzhou Military from January 2016 to December 2016. HPV detection and typing were performed by using flow-through hybridization and gene chip technology. Results Among 960 patients with cervical lesion, 446 were positive for HPV, and the total positive rate was 46.5%. The positive rates of chronic cervicitis, CIN Ⅰ, CIN Ⅱ, CIN Ⅲ and cervical carcinoma were 26.1%, 74.8%, 83.6%, 93.2% and 100.0% respectively. The positive rate of HPV was significantly different between the two groups（c2=306.84, P=0.0001）. The total positive rates of four high-risk HPV types（including HPV-16,HPV-52, HPV-58 and HPV-18） were 38.3%, 20.4%, 18.4% and 12.3%, respectively. The positive rates of HPV-16 in chronic cervicitis, CIN Ⅰ, CIN Ⅱ, CIN Ⅲ and cervical cancer were 12.7%, 35.1%, 50.0%, 5.5% and 84.9%, respectively.Conclusion The most common high-risk HPV types were HPV-16, HPV-52, HPV-58 and HPV-18. And the infection rates of high-risk HPV types were higher than that of low-risk HPV types in women with CIN and cervical carcinoma. The infection rates of HPV-16 increased with the order of chronic cervicitis, CIN and cervical carcinoma.