阴道微生态与HPV感染基因分型在子宫颈高危型HPV感染中的检测价值

The detection value of vaginal microecology and human papilloma virus infection genotype analysis in cervical high-risk human papilloma virus infection

目的探讨阴道微生态与人乳头瘤病毒(HPV)感染基因分型在子宫颈高危型HPV感染中的检测价值。方法选取2021年5月至2023年5月中国人民解放军海军第九七一医院和青岛市市立医院东院区收治的276例子宫颈高危型HPV感染阳性患者作为观察组。选取同期进行体检且宫颈癌筛查及宫颈HPV筛查阴性的224例健康女性作为对照组。采集阴道分泌物进行阴道微生态检测,采用液态芯片技术分析HPV基因分型,比较HPV基因分型占比及阴道微生态分布情况。结果观察组HPV基因分型占比前5位分别为HPV52(22.10%)、HPV16(15.22%)、HPV18(14.13%)、HPV33(9.06%)、HPV56(9.06%)。与对照组比较,观察组细菌性阴道病(BV)阳性率、乳酸杆菌减少率更高,差异具有统计学意义(P<0.05)。与对照组比较,观察组pH及白细胞酯酶、唾液酸酶、脯氨酸氨基肽酶、凝固酶阳性率更高,差异具有统计学意义(P<0.05);两组清洁度、过氧化氢酶、葡萄糖苷酶、乙酰氨基葡萄糖苷酶阳性率比较,差异无统计学意义(P>0.05)。结论宫颈高危型HPV感染分型以HPV52、HPV16、HPV18、HPV33、HPV56为主,宫颈高危型HPV感染阳性患者的pH及BV阳性、白细胞酯酶、唾液酸酶、脯氨酸氨基肽酶、凝固酶阳性率更高。

Objective To investigate the detection value of vaginal microecology and human papilloma virus(HPV)infection genotype analysis in cervical high-risk HPV infection.Methods A total of 276 cervical high-risk HPV infection positive patients admitted to the 971 Hospital of the People′s Liberation Army Navy and Qingdao City Hospital East Ward from May 2021 to May 2023 were selected as the observation group.A total of 224 healthy women taking physical exam during the same period with negative cervical cancer screening and cervical HPV screening were selected as the control group.Vaginal secretions were collected for vaginal microecology detection,and HPV genotype was analyzed using liquid chip technology,the proportion of HPV genotyping and the distribution of vaginal microbiota were analyzed.Results The top 5 HPV genotypes in the observation group were HPV52(22.10%),HPV16(15.22%),HPV18(14.13%),HPV33(9.06%),and HPV56(9.06%).Compared with the control group,the observation group had a higher of bacterial vaginosis(BV)positive rate and lactobacilli decrease rate,with statistically significant differences(P<0.05).Compared with the control group,pH,positive rate of leukocyte estinase,sialidase,proline aminopeptidase,coagulase were higher in the observation group,with statistically significant differences(P<0.05).There were no statistically difference in cleanliness,positive rate of catalase,glucosidase,acetylglucosaminidase positivity rates between the two groups(P>0.05).Conclusions The main subtypes of cervical high-risk HPV infection are HPV52,HPV16,HPV18,HPV33,and HPV56.Patients with positive cervical high-risk HPV infection have higher pH,BV positivity,leukocyte esterase positivity,sialidase positivity,proline aminopeptidase positivity,and coagulase positivity.