2193例HPV感染类型与宫颈病变关系的相关研究

Carreted study on relationship between 2 193 cases of HPV infection types and cervical lesions

目的探讨宫颈病变患者人乳头状瘤病毒(HPV)的类型及多重HPV亚型感染与宫颈病变之间的关系。方法收集2018年1-12月该院妇科及宫颈科门诊患者病理资料,对其中HPV阳性、宫颈活检病理为低度病变以上的2193例患者,通过HPV分型检测及宫颈病理结果对比,分析HPV的感染类型及多重感染对宫颈上皮内病变的关系。结果HPV单一、二重、三重及以上感染在宫颈高度鳞状上皮内瘤变(HSJL)及以上病变(HSIL+)与低度鳞状上皮内病变(LSIL)中感染率比较,差异无统计学意义(P>0.05)。并对多重感染进行分层分析,对单一组、高/高危组、高/低危组比较,差异无统计学意义(P>0.05)。在HSIL+组患者中HPV亚型以16、52、58类型常见,73亚型复合型感染出现3例;而低危型81型在HSIL+中单一感染出现7例;进行单一高、低危及多重HPV感染分析,3组组间比较差异有统计学意义(P<0.05)。结论在宫颈HSIL+患者中,宫颈病变程度与宫颈HPV复合感染数量及合并高低危亚型无明确的直接关系;宫颈HSIL+病例中出现低危型HPV81型,提示HPV81型可能在女性生殖系统归应为高危型致癌类型。

Objective To study the types of HPV in the patients with cervical lesions and the relationship between multiple HPV subtype infections and cervical lesions.Methods The pathological data of the patients from the departments of gynecology and cervical clinic of this hospital from January to December 2018 were collected.Among them,2193 cases were HPV positive and above low-grade lesions by biopsy pathology.The relationship between HPV infection types and multiple infection with cervical endothelial lesions was analyzed by HPV typing detection and cervical biopsy pathological results comparison.Results The infection rates of single HPV,double HPV,triple HPV and more had no statistically significant difference between HSIL+and LSIL(P>0.05).In the stratified analysis of multiple infections,there was no statistical difference among the single groups,high/high-risk groups and high/low risk groups(P>0.05).In the cases of the cervical HSIL+group,HPV subtypes 16,52 and 58 were common and 73 sub-complex infections occurred in 3 cases;while low-risk type 81 showed 7 cases in HSIL+;in the single high,low risk and multiple HPV infection analysis,the difference among the three groups was statistically significant(P<0.05).Conclusion In the patients with cervical HSIL+,the extent of cervical lesions has no direct relation with the number of cervical HPV complex infections and complicating high and low risk subtypes.Among the cervical HSIL+cases,the low-risk type 81 appearance suggests that type 81 should be classified as a high-risk carcinogenic type in the female reproductive system.