人乳头瘤病毒感染与宫颈病变程度的关系

Relationship between human papillomavirus infection and the severity of cervical lesions

目的分析不同病变程度的宫颈脱落细胞人乳头瘤病毒(HPV)的感染特点,探讨HPV感染与宫颈病变程度的关系。方法采用多重聚合酶链反应(PCR)-反向点杂交(RDB)技术对53例宫颈正常或轻微炎症、79例宫颈上皮内瘤变(CIN)Ⅰ级、42例CINⅡ级、87例CINⅢ级、54例浸润性宫颈癌(ICC)患者的宫颈脱落细胞进行23种HPV基因分型检测,统计HPV感染特点与宫颈病变程度的关系,并分析不同基因型HPV对宫颈病变等级的影响。结果宫颈病变等级与HPV感染有一定的相关性(r=0.500,P<0.05);HPV检出率随着宫颈病变等级的增加而增加(χ~2=43.322,P<0.05),除CINⅢ组与ICC组间HPV检出率差异无统计学意义(χ~2=0.003,P>0.05)外,其他各等级组间的检出率差异均有统计学意义(P<0.01)。HPV多重感染与宫颈病变等级呈一定的等级相关(r=0.496,P<0.05);除ICC组外,随着宫颈病变等级的增加,HPV多重感染的检出率逐渐增加(P<0.01)。随着宫颈病变等级的增加,高危型HPV的检出率及构成比明显增加。不同基因型对宫颈病变等级的影响差异有统计学意义(χ~2=46.775,P<0.05)。对宫颈病变影响较大的5种HPV亚型分别为16型、18型、31型、33型和58型。结论宫颈病变等级与HPV感染的型别、多重感染有关,不同病变程度的宫颈脱落细胞HPV的基因型构成特点不同,随着宫颈病变等级的增加,高危型HPV的检出率及构成比明显增加。

Objective To study the infection characteristics of human papillomavirus(HPV)in cervical cells from different lesion tissues,and to investigate the relationship between HPV infection and the severity of cervical lesions.Methods A total of53cases of normal or mild inflammation,79cases of cervical intraepithelial neoplasia(CIN)Ⅰ,42cases of CINⅡ,87cases of CINⅢ,or54cases of invasive cervical cancer(ICC)were determined for23HPV genotypes by multiplex polymerase chain reaction(PCR)-reverse dot blotting(RDB).The infection characteristics of HPV and the severity of cervical lesions were evaluated,and the relationship between different HPV genotypes and the severity of cervical lesions were investigated as well.Results HPV infection and the severity of cervical lesions had correlation(r=0.500),and the determination rate of HPV increased as the severity of cervical lesions increased(χ2=43.322,P<0.05).The determination rates of HPV with different grades of cervical lesions had statistical significance(P<0.01),except CINⅢand ICC groups(χ2=0.003,P>0.05).Multiple HPV infections were related with the severity of cervical lesions(r=0.496,P<0.05).The determination rate of multiple HPV increased as the severity of cervical lesions increased,except ICC group(P<0.01).The determination rate and the proportion of high-risk HPV infection were increased with the severity of cervical lesions.Different HPV genotypes had statistical significance on cervical lesions(χ2=46.775,P<0.05).The top5HPV genotypes to cervical lesions were type16,18,31,33and58.Conclusions The severity of cervical lesions is correlated with HPV genotypes and multiple HPV infections.The proportions of HPV genotypes among different cervical lesion grades are different.With the severity of cervical lesions increased,the determination rate of high-risk HPV infection and its proportion are increased.