人乳头瘤状病毒检测与分型在宫颈癌筛查及治疗中的意义

Significance of HPV detection and typing for screening and treatment of cervical cancer

目的探讨人乳头瘤状病毒(HPV)检测与分型在宫颈癌筛查及治疗中的意义。方法选取2020年1月至2020年12月间延安大学附属医院收治的行宫颈病变筛查的400例受试者,进行宫颈薄层液基细胞学(TCT)和高危型HPV检测,统计不同病理级别如正常/炎症、宫颈上皮内瘤变Ⅰ(CINⅠ)、CINⅡ、CINⅢ及宫颈癌鳞状上皮相关性抗原(SCC)中HPV 16和HPV 18阳性率。结果400例受试者中,TCT阴性、HPV阴性136例,TCT阴性、HPV阳性125例,TCT阳性、HPV阴性89例,TCT阳性、HPV阳性50例。宫颈活检结果显示,不同年龄段正常/炎症、CINⅠ、CINⅡ、CINⅢ及SCC比例比较,差异有统计学意义(χ^(2)=18.65,P<0.01)。正常/炎症、CINⅠ、CINⅡ、CINⅢ和SCC中,各高危型HPV感染情况比较,差异有统计学意义(χ^(2)=16.85,P<0.01)。CINⅡ、CINⅢ和SCC的HPV16/HPV18表达阳性率均为100.0%,均高于正常/炎症和CINⅠ,差异有统计学意义(P<0.01)。HPV E6/E7 mRNA拷贝数随着病变级别的递增而增加,各级别间比较,差异有统计学意义(χ^(2)=10.86,P<0.01)。结论HPV检测和分型与宫颈癌前病变及宫颈癌密切相关,可为宫颈癌的早期诊断和治疗提供重要参考依据,值得在宫颈癌及癌前病变筛查中推广。

Objective To explore the significance of human papillomavirus(HPV)detection and typing for the screening and treatment of cervical cancer.Methods Four hundred participants who underwent cervical lesion screening were selected at Yan’an University Affiliated Hospital between January 2020 and December 2020.Liquid based thin layer cytology(TCT)inspection and high-risk type HPV testing were performed.Positivity rates of HPV16 and HPV18 were counted in participants with different pathological level such as normal/inflammatory,cervical intraepithelial neoplasia(CIN I)Ⅰ,CINⅡ,CINⅢand squamous cell carcinoma associated antigen(SCC-Ag).Results Among the 400 participants,136 participants were found TCT negative and HPV negative,125 participants were TCT negative and HPV positive,89 were TCT positive and HPV negative,and 50 were TCT positive and HPV positive.There were significant differences in the proportion of normal/inflammatory pathological results,CINⅠ,CINⅡ,CINⅢand SCC-Ag among patients of different ages(all P<0.05).Moreover,there were significant differences in the proportion of high-risk types of HPV infection among patients with the above indexes(all P<0.05).Positivity rates of HPV16 and HPV18 were 100.0%in patients with CINⅡ,CINⅢand SCC-Ag which were higher patients with normal/inflammatory pathological results and CINⅠ(all P<0.05).The copy number of HPV E6/E7 mRNA expression increased with the increase of the lesion level(all P<0.05).Conclusion The detection and typing of HPV are closely associated with cervical precancerous lesions and cervical cancer.It provides important evidence for the early diagnosis and treatment of cervical cancer,which has important clinical significance and is worthy of promotion in the screening of cervical cancer and precancerous lesions.