宫颈上皮内瘤变2/3级及宫颈癌患者中HPV感染型别分析

Prevalence of human papillomavirus genotype infection among women with intraepithelial neoplasia grade 2/3 and cervical cancer

目的研究女性宫颈上皮内瘤变(CIN)2~3级和宫颈癌患者人乳头瘤状病毒(HPV)基因型分布。方法采用PCR-反向点杂交技术对315例患者(CIN2 160例,CIN3 102例及宫颈癌53例)的液基细胞学(TCT)标本进行HPV分型检测,并分析各亚型的感染情况。结果 315个病例中,宫颈癌组HPV感染率高于CIN2组(P<0.05),其他各组间比较差异无统计学意义(P>0.05)。3组阳性率最高的5种HPV依次为:HPV16、HPV52、HPV58、HPV31、HPV18;HPV16、HPV58、HPV52、HPV18、HPV33;HPV16、HPV58、HPV52、HPV31、HPV18。CIN2组,CIN3组和宫颈癌组HPV多重感染率呈下降趋势,而单一感染率呈增高趋势,但三组间HPV多重感染率及HPV单一感染率比较,差异均无统计学意义(P>0.05)。结论漯河地区高级别宫颈病变(CIN2/3及宫颈癌)中最常见基因型依次为HPV16、58、52、31和18。

Objective To study the distribution of genotypes of human papillomavirus（ HPV） among women with cervical intraepithelial neoplasia（ CIN） grade 2/3 and cervical cancer. Methods The PCR reverse dot-blot was used to detect the HPV genotypes of 315 patients（ 160 cases of CIN2,102 cases of CIN3,53 cases of cervical cancer）. Results In all of the 315 cases,the HPV positive rates of cervical cancer were higher than CIN2（ P〈0. 05）. But there were no significant difference among other groups（ P〉0. 05）. The five most predominant genotypes of CIN2 were HPV16,HPV52,HPV58,HPV31,HPV18. The five most predominant genotypes of CIN3 were HPV16,HPV58,HPV52,HPV18,HPV33. The five most predominant genotypes of cervical cancer were HPV16,HPV58,HPV52,HPV31,HPV18. The multiple infections rates were decreasing and the single infections were increasing with the severity of the desease. But there was no significant difference in the multiple infection rate and single infection rate among three groups（ P〈0. 05）. Conclusion The most predominant genotypes of the high grade cervical lesions（ including CIN2/3 and cervical cancer） in Luohe are HPV16,58,52,31 and 18.