高危人乳头瘤病毒感染与宫颈上皮内瘤变的关系

Correlation between high-risk HPV infection and cervical intraepithelial neoplasia

目的探讨高危人乳头瘤病毒(HPV)感染与宫颈上皮内瘤变(CIN)的关系。方法对1438例患者进行HPV检查、宫颈液基薄层细胞学检查(TCT)和宫颈活检。比较细胞学阳性和阴性患者高危型HPV感染情况,比较分析不同级别宫颈病变患者多重混合感染及病毒载量情况。结果病理活检结果显示,CINⅠ级46例、CINⅡ级37例、CINⅢ级23例和宫颈癌16例,并分别作为CINⅠ组、CINⅡ组、CINⅢ组和宫颈癌组。4组患者高危型HPV多重混合感染率及HPV载量情况比较,差异有统计学意义(P<0.01),且随宫颈病变的加重,高危型HPV多重混合感染率及HPV高载量比例升高。结论高危型HPV感染使CIN患病风险升高,应加强高危HPV感染患者,尤其是多重混合高危型HPV感染及高病毒载量患者的治疗和监测。

Objective To investigate the relationship between high-risk human papilloma virus (HPV) infection and cervical intraepithelial neoplasia (CIN). Method The clinical data of 1438 patients who underwent cervical HPV and thinprep-based cytology test (TCT) or cervical biopsy were retrospectively analyzed. We compared the high-risk HPV infections in patients with positive and negative cytological changes, the multiple infections and viral load in patients with different degree of cervical pathological changes were compared and analyzed. Result It was found by pathological biopsy that, there were 46 cases of CIN I, 37 cases of CIN II, 23 cases of CIN III, and 16 cases of cervical cancer, which were assigned as CIN I group, CIN II group, CIN III group and cervical cancer group, respectively. The multiple infection rate and viral load of high-risk HPV in the four groups differed significantly (P<0.01). As the grade of cervical lesions increased, the multiple high-risk HPV infection rate and HPV viral load elevated. Conclusion High-risk HPV infection increases the risk of CIN, patients with high-risk HPV infection, especially those who had multiple viral infections and high HPV viral load, should be monitored more closely.