宫颈病变382例高危人乳头瘤病毒亚型分布及其与宫颈癌的相关性分析

Distribution of high⁃risk HPV subtypes in 382 cases of cervical lesions and its correlation with cervical cancer

目的探讨宫颈病变妇女高危人乳头瘤病毒(HPV)亚型分布及与宫颈癌的相关性分析。方法选取2016年1月至2018年8月洪湖市妇幼保健院收治的382例宫颈病变病人进行研究,其中宫颈癌病人95例(宫颈癌组),宫颈癌前病变病人135例(癌前病变组),宫颈炎病人152例(宫颈炎组),对所有受试者进行HPV检测,比较三组病人HPV阳性率、高危HPV亚型分布、感染类型及高危HPV亚型分布与宫颈癌临床分型关系。结果宫颈癌组、癌前病变组HPV阳性检出率(94.74%、72.59%)高于宫颈炎组(23.03%)(P<0.001),宫颈癌组明显高于癌前病变组(P<0.001);宫颈癌组中HPV16、HPV18、HPV52、HPV59、总HPV亚型阳性检出率(32.63%、13.68%、10.53%、7.37%、80.00%)高于宫颈炎组(6.58%、4.61%、2.63%、0.67%、17.76%)(P<0.001),宫颈癌组总HPV亚型阳性检出率(80.00%)高于癌前病变组(64.44%)(P<0.001),三组间HPV16、HPV18、HPV52、HPV59、总HPV亚型阳性检出率比较差异有统计学意义(P<0.05);宫颈癌组、癌前病变组高危HPV阳性病人单一型感染率分别为94.74%、72.41%,明显高于宫颈炎组(P<0.001);宫颈癌病人HPV16亚型在鳞癌中阳性检出率最高,不同临床分型比较差异有统计学意义(P<0.05),HPV18亚型在腺癌中阳性检出率最高,不同临床分型比较差异有统计学意义(P<0.05)。结论HPV亚型分布与宫颈癌发生密切相关,宫颈病变病人以单一亚型感染为主,其中HPV16、HPV18与宫颈癌临床分型相关。

Objective To investigate the distribution of high⁃risk human papillomavirus(HPV)subtypes in women with cervical le⁃sions and its correlation with cervical cancer.Methods Three hundred and eighty⁃two patients with cervical lesions admitted to Honghu Maternal and Child Health Hospital from January 2016 to August 2018 were selected for the study,among them,95 pa⁃tients with cervical cancer(cervical cancer group),135 patients with cervical precancerous lesions(precancerous lesion group),and 152 patients with cervicitis(cervicitis group),all subjects were tested for HPV,the HPV positive rate,distribution of high⁃risk HPV subtypes,and types of infection were compared among the three groups,and the relationship between the distribution of high⁃risk HPV subtypes with clinical stage of cervical cancer were compared.Results The positive rate of HPV in cervical cancer group and precancerous lesion group(94.74%,72.59%)was higher than that in cervicitis group(23.03%)(P<0.001),and the positive rate of HPV in cervical cancer group was significantly higher than that in precancerous lesion group(P<0.001);the posi⁃tive rate of HPV16,HPV18,HPV52,HPV59 and total HPV subtypes in cervical cancer group(32.63%,13.68%,10.53%,7.37%,80.00%)was higher than that in cervicitis group(6.58%,4.61%,2.63%,0.67%,17.76%)(P<0.001),the positive detection rate of total HPV subtype in cervical cancer group(80.00%)was higher than that in precancerous lesion group(64.44%)(P<0.001),the positive detection rates of HPV16,HPV18,HPV52,HPV59 and total HPV subtypes among the three groups were statistically significant(P<0.05);the single infection rate of high⁃risk HPV positive patients in cervical cancer group and precancerous lesion group was 94.74%and 72.41%,respectively,which was significantly higher than that in cervicitis group(P<0.001),there was sig⁃nificant difference among the three groups(P<0.001);the positive detection rate of HPV16 subtype in patients with cervical can⁃cer was the highest in squamous cell carcinoma,and the difference between different clinical classifications was statistically signifi⁃cant(P<0.05).The positive detection rate of HPV18 subtype in adenocarcinoma was the highest,and the difference between differ⁃ent clinical classifications was statistically significant(P<0.05).Conclusion The distribution of HPV subtypes is closely related to the occurrence of cervical cancer,and the patients with cervical lesions are mainly single subtype infection,among which HPV16,HPV18 is related to the clinical classification of cervical cancer.