宫颈鳞癌组织中HPV感染型别分布情况的分析

Analysis of HPV infection types distribution in tissues of cervical squamous cell carcinoma

目的探讨以江苏省为主的区域性宫颈鳞癌组织中23种人乳头瘤病毒(HPV)的检出率、型别分布及疫苗保护的临床意义。方法从宫颈鳞癌石蜡组织中提取HPV DNA,采用聚合酶链式反应与基因芯片检测技术对1 021例宫颈鳞癌组织行23种HPV检测,同时对患者HPV感染型别分布状况和疫苗保护情况进行分析。结果1 021例宫颈鳞癌患者HPV总检出率为91.77%(937/1 021)。单一型别检出率和多种型别检出率分别为75.42%(770/1 021)和16.36%(167/1 021),宫颈鳞癌组织中HPV检出最主要型别依次为16、18、58、52、33、31、59和45型,二价HPV疫苗的保护谱为68.52%,九价HPV疫苗保护谱为90.82%。结论对女性宫颈鳞癌组织大标本行HPV分型检测,有利于妇产科医师对宫颈上皮内瘤变行HPV感染型别致癌风险度的判断及干预,也有利于对感染了高致癌性HPV女性的随访及HPV疫苗保护谱的评估。

Objective To investigate the detection rate,type distribution and clinical significance of 23 human papillomaviruses(HPV)in cervical squamous cell carcinoma(SCC)tissues in Jiangsu Province.Methods HPV DNA was extracted from paraffin tissue of cervical squamous cell carcinoma,and 23 kinds of HPV were detected in 1 021 cervical squamous cell carcinoma tissues by polymerase chain reaction and gene chip detection.The distribution of HPV infection types and the protection of HPV vaccine were analyzed.Results The total detection rate of HPV in 1 021 cases of cervical squamous cell carcinoma was 91.77%(937/1 021).The detection rates of single type and multiple types were 75.42%(770/1 021)and 16.36%(167/1 021),respectively.The main types of HPV in cervical squamous cell carcinoma were 16,18,58,52,33,31,59 and 45,the protection spectrum of bivalent HPV vaccine was 68.52%,and that of nine-valent HPV vaccine was 90.82%.Conclusion HPV typing of large specimens of cervical squamous cell carcinoma is helpful for gynecologists and obstetricians to judge and intervene the carcinogenic risk of HPV infection type in cervical intraepithelial neoplasia,and also for follow-up of women infected with high carcinogenic HPV and evaluation of the protection spectrum of HPV vaccine.