高危型人乳头瘤病毒与宫颈病变的相关性分析

The relationship between high risk human papillomavirus and cervical lesions

目的探讨不同级别宫颈病变中的高危型人乳头瘤病毒(high risk-human papilloma virus,HR-HPV)感染情况,为防治宫颈癌及其癌前病变提供参考。方法回顾性分析2016年12月至2017年9月在首都医科大学附属北京友谊医院妇产科门诊行人乳头瘤病毒(human papilloma virus,HPV)分型检测、阴道镜检查及多点活检的523例患者的临床资料、HPV分型检测及宫颈病理结果。结果病理确诊为慢性宫颈炎173例,低级别鳞状上皮内病变211例,高级别鳞状上皮内病变134例,鳞状细胞癌5例。慢性宫颈炎、低级别鳞状上皮内病变、高级别鳞状上皮内病变、鳞状细胞癌中HR-HPV感染率依次为57.8%(100/173)、80.1%(169/211)、94.78%(127/134)、100.00%(5/5),在所有类型的宫颈病变中HR-HPV感染率排名前5位的HPV型别依次为16型(27.7%)、52型(17.0%)、58型(15.7%)、51型(8.8%)、66型(8.6%)。结论 HR-HPV感染率与宫颈病变严重程度呈正相关。HR-HPV多重感染更常见于宫颈病理学异常而非宫颈炎症,更常见于低级别鳞状上皮内病变而非高级别鳞状上皮内病变。HPV16、52、58是本研究中宫颈病变最常见的3种亚型。

Objective To investigate the results of human papillomavirus testing among patients with different levels of cervical leisons, thereby providing useful information regarding prevention and control strategies for cervical cancer and precancerous lesions. Method A total of 523 patients who underwent HPV DNA testing, colposcopy and colposcopic biopsy at Beijing Friendship Hospital from December 2016 to September 2017 were enrolled in this study. Clinical data, HPV genotypes and pathologic results were collected. Result A total of 173 patients were pathologically confirmed as having cervicitis, 211 patients were pathologically confirmed as having low-grade squamous intraepithelial lesion(LSIL), 134 patients were diagnosed with high-grade squamous intraepithelial lesion(HSIL) and 5 patients were pathologically confirmed as having squamous of cervical carcinoma(SCC). The HR-HPV infection rates in cervicitis, LSIL, HSIL, SCC were 57.8%(100/173), 80.1%(169/211), 94.78%(127/134) and 100.00%(5/5), respectively. In all groups(cervicitis, LSIL, HSIL, SCC), the most common HR-HPV genotypes were HPV-16(27.7%), HPV-52(17.0%), HPV-58(15.7%), HPV-51(8.8%) and HPV-66(8.6%). Conclusion The HR-HPV infection rates positively correlated with the cervical lesion severity. Multiple HR-HPV infection was more common in the abnormal pathology groups than that in the cervicitis group and was more common in the LSIL group than that in the HSIL group. HPV-16, HPV-52 and HPV-58 were the three most frequently detected genotypes in cervical lesions.