人乳头瘤病毒基因分型检测在石蜡包埋组织和宫颈脱落细胞中的对比分析

Comparison of the results using cervical tissues and exfoliated cervical cells to evaluate human papillomavirus genotype attribution

目的对比分析石蜡包埋(FFPE)宫颈组织和宫颈脱落细胞中人乳头瘤病毒(HPV)检测结果差异,评估组织样本HPV分型检测的必要性。方法随机抽取2021—2022年于解放军总医院第七医学中心就诊患者101例,其中病理诊断为慢性宫颈炎21例、低级别鳞状上皮内病变(LSIL)20例、高级别鳞状上皮内病变(HSIL)41例、宫颈鳞状细胞癌(CSCC)19例,通过杂交导流技术比较其宫颈脱落细胞和福尔马林固定组织标本中的HPV检测结果。结果宫颈脱落细胞和组织对HPV DNA的总体一致率为78.2%。伴随宫颈病变进展,宫颈脱落细胞和宫颈组织样本中HPV结果一致性显著增高(P<0.0001)。相比于宫颈脱落细胞,宫颈组织HPV检测对宫颈病变具有较高的特异性(P<0.0001)。最常见的组织内HPV感染型别依次为HPV16、52、58,18和33,是较易引起宫颈组织病变的HPV分型和潜在有效的HPV疫苗型别。结论宫颈组织样本HPV DNA分型检测有助于评估病毒感染位置及转染状态并指导疫苗研发。

Objective To evaluate the necessity of HPV genotyping in cervical tissue samples by comparing the HPV detection results in formalin-fixed paraffin-embedded(FFPE)cervical tissues and cervical exfoliated cells.Methods A total of 101 patients who visited the Seventh Medical Center of the Chinese PLA General Hospital between 2021 and 2022 were randomly selected,including 21 cases of chronic cervicitis,20 cases of low-grade squamous intraepithelial lesions(LSIL),41 cases of high-grade squamous intraepithelial lesions(HSIL),and 19 cases of cervical squamous cell carcinoma(CSCC).Hybrid capture technology was used to compare the HPV detection results in cervical exfoliated cells and FFPE tissue specimens.Results The overall consistency rate of HPV DNA detection in cervical exfoliated cells and tissues was 78.2%.As cervical lesions progressed,the consistency of HPV results in cervical exfoliated cells and tissues significantly increased(P<0.0001).Compared with cervical exfoliated cells,HPV detection in cervical tissues had higher specificity for cervical lesions(P<0.0001).The most common HPV infection types in tissues were HPV16,52,58,18,and 33,which were more likely to cause cervical tissue lesions and potential effective HPV vaccine types.Conclusion HPV genotyping in cervical tissue samples can help evaluate the location and transmission status of viral infections and guide vaccine development.