HPV33阳性与宫颈高级别病变的关系

Relationship between HPV subtype 33 positive and high-grade cervical lesions

目的探讨人乳头状瘤病毒(HPV)33阳性与宫颈高级别病变的关系。方法回顾性分析2015年1月~2018年1月因宫颈初筛异常就诊于昆山市第二人民医院阴道镜门诊,行阴道镜下宫颈活检的380例患者的临床病例资料并进行统计分析,探讨HPV33阳性与宫颈高级别病变的关系。结果 380例患者中,宫颈良性病变220例,单纯HPV33阳性者20例(9.1%);低度鳞状上皮内病变患者92例,单纯HPV33阳性者12例(13.3%);高度鳞状上皮内病变患者68例,单纯HPV33阳性患者20例(29.4%),随着宫颈病变程度的加重,HPV33感染的阳性率逐渐上升,差异有统计学意义(χ~2=18.097,P=0.000)。在单纯HPV33阳性患者中,随着宫颈病变程度的加重,液基薄层细胞检测异常的发生率逐渐增加,但差异无统计学意义(χ~2=2.708,P=0.258)。结论对于HPV33阳性的患者,或许应积极转诊阴道镜,采取积极有力的干预措施阻断病变进展为癌。

Objective To study the correlation of high-risk human papillomavirus（HPV） subtype 33 positive and highgrade cervical lesions. Methods A total of 380 patients with cervical screening abnormalities, who received cervical biopsy in colposcopy clinic in the Second Hospital of Kunshan from January 2015 to January 2018 were collected and the relationship between HPV subtype 33 positive and high-grade cervical lesions were studied. Results All 380 women enrolled in this study, a total of 220 cases was cervical benign lesions, 20 cases were single type HPV33 infection, a total of 92 cases was LSIL, 12 cases were single type HPV33 infection, a total of 68 cases was LSIL, 20 cases were single type HPV33 infection. The infection rates of single type HPV33 infection in different groups were 9.1%, 13.3%,29.4%. With the aggravation of cervical lesions, infection rates of single type HPV 33 gradually increased, the difference was statistically significant（χ^2= 18.097, P = 0.000）. In patients of single type HPV 33 infection, the abnormality of TCT increased with the aggravation of cervical lesions, but the difference was not statistically significant（χ^2= 2.708,P = 0.258）. Conclusion Patients with single type HPV 33 infection maybe receive colposcopy as soon as possible, and powerful interventions should be taken to block the progression of cervical diseases to cancer.