宫颈上皮内瘤变Ⅱ/Ⅲ级与宫颈癌患者HPV感染基因型的分布差异分析

Analysis on the distribution difference of HPV genotypes in the patients with cervical intraepithelial neoplasia Ⅱ/Ⅲ and the patients with cervical cancer

目的探讨宫颈上皮内瘤变Ⅱ/Ⅲ级与宫颈癌患者人乳头瘤病毒(HPV)感染基因型的分布差异。方法分别选取湖州市妇幼保健院2010年1月~2017年10月收治的260例宫颈癌和280例宫颈上皮内瘤变Ⅱ/Ⅲ级患者并记为癌症组和瘤变组,对其HPV感染情况进行检测和分型鉴定,对比癌症组和瘤变组HPV感染基因型的分布差异,并对比癌症组中不同组织类型患者HPV感染基因型差异。结果癌症组HPV感染阴性构成比低于瘤变组(P<0.05),且单一感染所有高危型构成比均明显高于瘤变组(P<0.05),且单一感染所有低危型构成比均与瘤变组相近(P>0.05),癌症组多重感染构成比明显高于瘤变组(P<0.05);宫颈鳞癌HPV感染阴性、单一感染18型构成比远低于宫颈腺癌(P<0.05),且宫颈鳞癌HPV单一感染16型、多重感染构成比均远高于宫颈腺癌(P<0.05)。结论在宫颈癌患者中HPV感染的风险明显高于宫颈上皮内瘤变Ⅱ/Ⅲ级,且宫颈癌HPV高危型的感染率较高,多重感染的风险也较高,并且可以根据HPV分型判断宫颈癌组织类型。

Objective To investigate the distribution differences of human papillomavirus（HPV） genotypes in the patients with cervical intraepithelial neoplasia grade Ⅱ/Ⅲ and the patients with cervical cancer. Methods 260 cases of cervical cancer and 280 cases of cervical intraepithelial neoplasia grade Ⅱ/Ⅲ patients who were admitted to our hospital from January 2010 to October 2017 were selected and divided into cancer group and neoplasia group respectively.The HPV infection of patients was detected and typing identification was performed. The distribution differences of HPV genotypes in cancer group and neoplasia group were compared. The differences of genotypes of HPV infection in different types of tissues in cancer group were also compared. Results The negative constituent ratio of HPV infection in cancer group was lower than that in neoplasia group（P〈0.05）, and the constituent ratio of all the high-risk types in single infection was significantly higher than that in the neoplasia group（P〈0.05）. The constituent ratio of all the lowrisk types in single infection was significantly similar to that in the neoplasia group（P〈0.05）. The constituent ratio of multiple infections in cancer group was significantly higher than that in neoplasia group（P〈0.05）; the constituent ratios of negative HPV infections and 18 types of single infections in cervical squamous cell carcinoma was much lower than that of cervical adenocarcinoma（P〈0.05）. The constituent ratios of 16 types of HPV and multiple infections in cervical squamous cell carcinoma were much higher than that of cervical adenocarcinoma（P〈0.05）. Conclusion The risk of HPV infection in cervical cancer patients is significantly higher than that of cervical intraepithelial neoplasia grade Ⅱ/Ⅲ,the infection rate of cervical cancer high-risk type HPV is higher, and the risk of multiple infections is also higher.The tissue types of cervical cancer can be determined according to HPV typing.