人乳头瘤病毒基因亚型与宫颈病变的相关性及临床意义

The correlation between human papillomavirus gene subtype and cervical lesions and its clinical significance

目的探讨人乳头瘤病毒(HPV)基因亚型与宫颈病变的相关性及临床意义。方法选取2019年在济南市天桥人民医院妇科就诊患者864例作为研究对象,采集患者宫颈细胞进行HPV基因检测并实施宫颈病理活检,组织切片取样行病理学检查,比较HPV基因亚型与病理诊断结果并进行相关性分析。结果864例患者中,正常或炎症宫颈620例,宫颈上皮内瘤变(CIN)Ⅰ级58例,CINⅡ级36例,CINⅢ级88例,宫颈癌62例。HPV阳性检出率随宫颈病变程度不断加重而升高,差异均有统计学意义(P<0.05)。伴随病情不断发展,HPV 16型在不同宫颈病变中的阳性检出率逐渐升高,在宫颈癌患者中同样也是HPV 16型阳性检出优势明显,为77.4%(48/62)。HPV多重感染在不同宫颈病变中的检出情况:正常及炎症11.3%,CINⅠ级17.2%,CINⅡ级27.8%,CINⅢ级29.5%,宫颈癌9.7%;宫颈癌中HPV多重感染占比明显更少,更多的是单一HPV基因型感染,且感染类型全部为高危型。结论随着宫颈病变程度不断加重,HPV阳性检出率随之逐渐升高;宫颈癌中HPV基因亚型主要包括:HPV 16、33、52型。

Objective To investigate the correlation between human papillomavirus(HPV)gene subtype and cervical lesions and its clinical significance.Methods A total of 864 patients who came to Department of Gynaecology in Tianqiao People′s Hospital in 2019 were selected as research objects.Cervical cells were collected for HPV gene detection and cervical pathological biopsy.Tissue sections were taken for pathological examination,and HPV genotypes were compared with pathological diagnosis.The results were analyzed by correlation and clinical significance.Results Of the 864 patients,620 had normal or inflamed cervix,58 had CIN gradeⅠ,36 had CIN gradeⅡ,88 had CIN gradeⅢ,and 62 had cervical cancer.The positive rate of HPV increased with the aggravation of cervical lesions(P<0.05).With the continuous development of the disease,the positive rate of HPV 16 in different cervical lesions was gradually increasing,and the percertage of HPV 16 in cervical cancer patients was also big,which was 77.4%(48/62).The detection of HPV multiple infection in different cervical lesions results showed that the proportion of normal and inflammatory was 11.3%,the proportion of CINⅠwas 17.2%,the proportion of CINⅡwas 27.8%,the proportion of CINⅢwas 29.5%,the proportion of cervical cancer was 9.7%.The proportion of HPV multiple infection in cervical cancer was significantly less,and most of them were single HPV genotype infection,and the infection types were all high-risk subtypes,which indicated that an obvious feature of cervical cancer was high-risk single HPV infection.Conclusion With the increase of cervical lesions,the positive rate of HPV gradually increase.HPV gene subtypes in cervical cancer mainly include HPV 16,33 and 52 types.