宫颈沙眼衣原体及其不同基因型感染与宫颈癌的相关性

Study on the correlation between cervical Chlamydia trachomatis and its different genotypes of infection and cervical cancer

目的了解深圳地区宫颈沙眼衣原体(CT)感染及基因型分布情况,探讨其与宫颈癌发病之间的相关性。方法收集2018年6月-2020年3月于深圳市龙岗区第二人民医院和中国医学科学院肿瘤医院深圳医院就诊并诊断为宫颈鳞状上皮内病变者237例为宫颈鳞状上皮内病变组,宫颈癌患者56例为宫颈癌组,宫颈未见任何病变的健康妇女264名为对照组;并根据子宫颈细胞学Bethesda报告系统(TBS)分级标准将宫颈鳞状上皮内病变组分为低度鳞状上皮内病变组(n=162)和高度鳞状上皮内病变组(n=75)。分别采用PCR-荧光探针法检测CT,同时采用限制性片段长度多态性(RFLP)法对CT主要外膜蛋白(ompl)基因进行分型检测,并对检测结果进行统计分析。结果宫颈癌组患者CT感染率为30.36%,明显高于宫颈鳞状上皮内病变组16.03%和对照组8.71%,且宫颈鳞状上皮内病变组患者CT感染率高于对照组,各组间CT感染率比较差异均有统计学意义(P<0.01)。高度鳞状上皮内病变组CT感染率为28.00%,明显高于低度鳞状上皮内病变组患者10.49%,差异有统计学意义(χ^(2)=9.827,P<0.05)。78例CT阳性临床菌株omp1基因共检出CT-D、E、F、G、H、J及K等7个基因型,未检出I基因型,其中宫颈癌组和宫颈鳞状上皮内病变组患者D型检出率最高,分别为41.18%(7/17)和34.21%(13/38),明显高于对照组的13.04%(3/23),差异均有统计学意义(F=11.064,P<0.05)。结论深圳地区宫颈癌患者CT感染率明显升高,且以D型感染为主。宫颈癌发病可能与CT及其不同基因型感染有一定相关性。

Objective To investigate the infection and genotype distribution of Chlamydia trachomatis(CT)in Shenzhen and its correlation with the incidence of cervical cancer(CC).Methods 237 patients from June 2018 to March 2020 admitted to Shenzhen Longgang District the Second People’s Hospital and Shenzhen Hospital of Cancer,Chinese Academy of Medical Sciences diagnosed with cervical squamous intraepithelial lesion were selected as cervical squamous intraepithelial lesion group,56 patients with cervical cancer as cervical cancer group,cervical did not see any pathological changes of 264 cases of healthy women as control group.According to The Bethesda System for Reporting Cervical Cytology(TBS)grading standard,cervical squamous intraepithelial lesion group was divided into low grade squamous intraepithelial lesion group(n=162)and high grade squamous intraepithelial lesion group(n=75).CT was detected by qPCR using flurescence probe.Restriction fragment length polymorphism(RFLP)method was used to detect CT major outer membrane protein gene(ompl)gene.The test results were analyzed statistically.Results CT infection rate of patients in the cervical cancer group was 30.36%,significantly higher than 16.03%in the cervical squamous intraepithelial lesion group and 8.71%in the control group,and the CT infection rate of patients in the cervical squamous intraepithelial lesion group was higher than of the control group;the differences of CT infection rates among different groups were statistically significant(P<0.01).The CT infection rate of high grade squamous intraepithelial lesion group patients was 28.00%,significantly higher than 10.49%of low grade squamous intraepithelial lesion group patients,the difference was statistically significant(χ^(2)=9,827,P<0.05).Seven genotypes including CT-D,E,F,G,H,J and K were detected in 78 cases of CT-positive clinical strain ompl gene,but no I genotype was detected.Among them,patients in cervical cancer and cervical squamous intraepithelial lesion groups had the highest D detection rates,41.18%(7/17)and 34.21%(13/38),respectively,which were significantly higher than 13.04%(3/23)in the control group;the difference was statistically significant(F=11.064,P<0.05).Conclusions The CT infection rate of cervical cancer patients in Shenzhen was significantly increased,and the D-type infection was the main one.Therefore,the incidence of cervical cancer might be associated with CT and different genotypes infections.