安徽省青阳县阴道镜检查女性HPV感染情况与病理分型分析

目的:了解阴道镜检者HPV感染亚型分布等情况,为宫颈病变的精准预防、感染管理和控制提供参考。方法:选取577名行阴道镜检查者为研究对象,通过问卷采集患者基础信息,并进行HPV、TCT检查。结果:12.1%女性有阳性体征,51.1%为TCT检测阳性。HPV检测阳性率为72.8%,多重感染率为27.6%,高危型感染率为86.9%。HPV感染亚型以高危型为主,且在已婚、存在阳性体征、TCT检测和病理检查均阳性的妇女中多见。同时,年龄>55岁、已绝经、有阳性体征和HPV高危亚型感染者中病理结果为CIN2/C1N3/CA的比例升高。结论:青阳县女性HPV感染率高,以HPV52、HPV16、HPV58、HPV53和HPV51高危亚型为主,年龄是影响HPV感染、严重程度和愈后的重要因素,今后须定期开展筛查,对症处理和随访,避免持续感染和多重感染,降低宫颈癌的发病率和死亡率。

HPV分型检测联合TCT检查在早期宫颈癌筛查中的价值

目的研究分析早期宫颈癌筛查中联合应用人乳头状瘤病毒(human papilloma virus,HPV)分型检测与液基薄层细胞学(thinprep cytologic test,TCT)检查的临床价值。方法选取2021年8月—2022年8月在邳州市中医院行宫颈癌筛查女性125例为研究对象,均给予HPV分型检测、TCT检查,以病理组织活检为金标准,统计比较HPV分型检测、TCT检查及两者联合检查的诊断结果。结果与单独应用HPV分型检测诊断比较,联合检查诊断的灵敏度(100.0%)更高,差异有统计学意义(χ^(2)=4.762,P=0.029);与单独应用TCT检查诊断比较,联合检查诊断的灵敏度更高,差异有统计学意义(P<0.05)。结论早期宫颈癌筛查中联合应用HPV分型检测与TCT检查的临床价值更高,可显著提高筛查准确性,为病理分型提供可靠的参考依据。

Relationship between the high-risk HPV infection and the expression of oncogenes, anti-oncogenes in cervical dysplasia

Objective:To study the relationship between the infection of high-risk HPV in cervical precancerous lesion and the expression of oncogene, anti-oncogene.Methods:218 cases ofcervical intraepithelial neoplasia patients in our hospital during May 2014–May 2016 were chosed and divided into high-risk HPV group (n=107), low-risk HPV group (n=111) according to cervical tissue HPV test;another 100 cases of patients received cervical biopsy and confirmed as benign lesions were enrolled in the control group. RT-PCR method was used to detect the mRNA expression of proto-oncogene and anti-oncogene in three groups, Western-blot method was used to detect the protein expression of Sox-2 and Wnt/β-catenin signal pathway.Results: mRNA expression of oncogene DEK, Bmi-1, c-fos, K-ras, Prdx4 in high-risk HPV group were higher than low-risk HPV group and control group (P<0.05);mRNA expression of anti-oncogene P27, P16, DAPK, PTEN, eIF4E3 in high-risk HPV group were lower than low-risk HPV group and control group (P<0.05);expression of Sox-2 and Wnt/β-catenin signaling pathway protein Sox-2,β-catenin, wnt-1, wnt-3a in high-risk HPV group were higher than low-risk HPV group and control group (P<0.05).Conclusions:High-risk HPV infection can increase the expression of oncogenes and reduce the expression of anti-oncogenes in cervical dysplasia tissues on Sox-2- and Wnt/β-catenin signaling pathway manners.

Systematic Review and Meta-Analysis of Baofukang Suppository(保妇康栓)Combined with Interferon in the treatment of Cervical High-risk HPV Infection

Objective:This study conducted a systematic review of randomized controlled trials in order to evaluate the efficacy and safety of Baofukang Suppository(保妇康栓)combined with interferon on cervical high-risk human papillomavirus(HR-HPV)infection.Methods:Data comes from China National Knowledge Infrastructure(CNKI),Wanfang database,the VIP information database,Chinese Biomedical Literature Database,PubMed,Cochrane Library,Web of Science and Embase.Primary and secondary outcome measures were extracted from 13 included randomized controlled trials:number of HR-HPV turning negative and effective,time of HPV turning negative,duration of abnormal vaginal secretions and adverse events.Results:Baofukang Suppository combined with interferon were better than interferon alone in improving the negative rate of HR-HPV(RR=1.42,95%CI[1.28,1.58],P<0.00001)and the effective rate of HR-HPV RR=1.3,95%CI[1.24,1.37],P<0.00001),time of HR-HPV turning negative(MD=-8.32,95%CI[-9.17,-7.47],P<0.00001),duration of abnormal vaginal secretions(MD=-8.95,95%CI[-11.34,-6.56],P<0.00001).However,there was no statistical difference in improving inflammatory factor(TNF-α:SMD=-0.49,95%CI[-1.02,0.03],Z=1.83,P=0.07;IL-6:SMD=-13.69,95%CI[-41.98,14.6],Z=0.95,P=0.34)and adverse events(RR=-0.73,95%CI[0.48,1.11,P=0.15)between two groups.Conclusion:The results showed that the efficacy of Baofukang Suppository combined with interferon were better than interferon alone in improving the negative and effective rate of HR-HPV,shortening the time of HR-HPV turning negative and duration of abnormal vaginal secretion and reducing adverse events.

Relationship of high-risk HPV infection with MEKK3 and NF-κB expression in cervical intraepithelial neoplasia tissue

Objective:To study the relationship of high-risk human papilloma virus (HPV) infection with mitogen-activated protein kinase/extracellular signal-regulated kinase 3 (MEKK3) and nuclear factorκB (NF-κB) expression in cervical intraepithelial neoplasia tissue.Methods:125 cases of cervical biopsy specimens between May 2013 and March 2016 were collected. The cervical inflammation specimens, cervical intraepithelial neoplasia specimens and cervical cancer specimens were included in inflammation group, CIN group and malignant group respectively. HPV-DNA typing detection kits were used to determine HPV typing, immunohistochemical kits were used to determine MEKK3 and NF-κB protein expression, and fluorescent quantitative PCR kits were used to determine the mRNA expression of MEKK3, NF-κB and downstream molecules.Results: MEKK3 and NF-κB protein expression in high-risk HPV-positive cervical tissue were significantly higher than those in high-risk HPV-negative cervical tissue (P<0.05), and MEKK3, NF-κB, Bcl-2, XIAP, Bmi-1, TGF-β and Vimentin mRNA expression in high-risk type HPV-positive cervical tissue were significantly higher than those in high-risk HPV-negative cervical tissue (P<0.05);Bcl-2, XIAP, Bmi-1, TGF-β and Vimentin mRNA expression in tissue with positive MEKK3 and NF-κB expression were significantly higher than those in tissue with negative MEKK3 and NF-κB expression (P<0.05).Conclusions:High-risk HPV infection will increase the expression of proliferation genes Bcl-2, XIAP and Bmi-1 as well as invasion genes TGF-β and Vimentin in cervical intraepithelial neoplasia tissue through MEKK3/NF-κB pathway.

Application Analysis of High Risk HPV Detection Combined with Cervical Cytology, Colposcopy and Pathology in Cervical Lesions of Women in Tiandeng County

Purpose: To understand the application of high-risk HPV detection combined with cervical cytology, colposcopy and pathology in cervical lesions of women in Tiandeng County. Method: Women in the outpatient and inpatient departments of our hospital from January 2021 to October 2022 were collected for high-risk HPV testing, TCT, colposcopy and pathological examination according to their personal wishes, to understand the application of relevant examinations in cervical lesions. Result: In 2021, the number of patients was 5801, among whom 1743 patients had received cervical cancer examination in the past, accounting for 30.05% of the total number of patients, and 5795 who had volunteered for TCT examination this time, accounting for 99.90% of the total;A total of 289 cases of atypical squamous cells with unclear significance (ASC-US) were detected, excluding 11 cases of high-grade squamous intraepithelial lesions (ASC-H), 122 cases of low-grade squamous intraepithelial lesions (LSIL), 16 cases of high-grade squamous intraepithelial lesions (HSIL), 2 cases of squamous cell carcinoma (SCC), and 4 cases of atypical adenocyte (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of people who volunteered for high-risk HPV testing was 4237, and the number of positive cases was 740, accounting for 17.47% of the screening population;Among 740 HPV-positive patients, 488 high-risk HPV-positive patients were selected for TCT examination, and 87 patients were found to be TCT positive;From 401 high-risk HPV-positive and TCT negative patients, 287 patients with possible lesions were screened out for colposcopy;The results showed that 60 patients may have certain cervical lesions and need further pathological examination and the results showed that 28 patients had CTN1 and 18 patients had CIN2 - 3. In 2022, 8840 patients received medical treatment, among which 3188 patients had received cervical cancer examination in the past, accounting for 36.06% of the total number of patients, and 8314 patients voluntarily underwent TCT examination, accounting for 94.05% of the total number of patients. 434 cases of atypical squamous cells with ambiguous meaning (ASC-US) were detected, excluding 13 cases of high-grade squamous intraepithelial lesions (ASC-H), 217 cases of low-grade squamous intraepithelial lesions (LSIL), 35 cases of high-grade squamous intraepithelial lesions (HSIL), 1 case of squamous cell carcinoma, and 4 cases of atypical adenocarcinoma (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of volunteers for high-risk HPV testing was 3871 cases, and the number of positive cases was 654 cases, accounting for 16.89% of the screening number. 527 high-risk HPV-positive patients were selected from 654 HPV-positive patients for TCT examination, and the number of TCT-positive patients was found to be 49. From 478 high-risk HPV-positive patients with TCT negative, 276 patients with possible lesions were screened out for colposcopy;The results showed that 66 patients may have certain cervical lesions and need further pathological examination;and then the results showed that 31 cases of CTN1 and 6 cases of CIN2 - 3. Conclusion: Gynecological high-risk HPV examination can provide better etiological sources for cervical cancer screening;Cervical cytology examination has high sensitivity;Colposcopy examination has high specificity;Pathological examination can be used as an effective supplement for cervical cytology examination and colposcopy;So high-risk HPV combined with cytology examination, colposcopy examination and pathological examination has high clinical application value;It is worth popularizing and applying.

Distribution of High-Risk Human Papillomavirus Genotypes among Women with Colposcopic Diagnosis of Cervical Intraepithelial Neoplasia in Bangladesh

Background: The incidence of cervical cancer is high in Bangladesh and there is a high prevalence of preinvasive lower genital tract disease among women of reproductive age. Persistent high-risk Human Papilloma Virus (HPV) infection is the main underlying cause of cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN). Objective: The aim of the study was to identify the subtypes of high-risk HPV infection among women with the colposcopic diagnosis of cervical intraepithelial neoplasia in Bangladesh. Methods: This cross-sectional observational study was conducted in the colposcopy clinic of Dhaka Medical College Hospital over a six-month period. A total of 100 participants were enrolled. Married women, between 30 - 60 years of age with colposcopically diagnosed cervical intra epithelial neoplasia were enrolled. Women with chronic illness, pregnancy, and women unable to consent were excluded from this study. After counselling, colposcopically directed punch biopsies were taken from each CIN case concurrently with high-risk HPV testing by polymerase chain reaction (PCR). Results: The mean age of the patients was 38.69 (SD ±7.76) years. CIN 1 was diagnosed in 57% of participants, while 24% had CIN II and 19% had CIN III lesions. High-risk HPV was present in 52 patients. HPV 16 was the most common identified in 28 (53.84%) and HPV 18 was the second most common with 20 (38.46%) either singly or in combination with other high-risk subtypes. The other HPV strains, HPV 31, 33, 35, 52, 56 and 58, were also detected either as mono or co-infections. Out of the 52 HPV positive cases, 29 (55.8%) had mono infection and 23 (44.2%) had co-infection with several subtypes. The highest incidence (50%) of oncogenic HPV infections was present among women aged 35 - 45 years. Risk factors associated with HPV positive cases were high parity (P 0.05), early age at marriage (P = 0.754) and early age of first child. Conclusion: This study identified a high prevalence of HPV 16 and 18 genotypes. HPV vaccination with the current 9-valent HPV vaccine, which contains HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. Will be an effective public health measure to eradicate cervical cancer in Bangladesh.

尖锐湿疣亚临床感染HPV分型与预后的关系

目的探讨尖锐湿疣(CA)亚临床感染乳头瘤空泡病毒(HPV)分型以及分型与预后的关系。方法对2015年4月至2016年12月期间梅州市人民医院风湿皮肤科收治的158例典型CA(典型组)和108例CA亚临床感染者(亚临床组)的局部疣体标本进行HPV基因型检测,观察亚临床组感染HPV-DNA类型以及感染情况,并与经典组进行对比。同时分析亚临床感染不同类型HPV出现顽固性复发情况。结果 (1)亚临床组患者共检出各类型HPV-DNA合计108个,其中以HPV 6型最高,共55个(50.9%),其次为HPV 11型,共18个(16.7%);低危HPV型共86个(79.6%),高危HPV型22个(20.4%),各型构成比与典型组比较,差异均无统计学意义(P>0.05);(2)典型组单一感染率为60.8%,明显低于亚临床组的75.0%,三重以及三重以上感染率为15.8%,明显高于亚临床组的3.7%,差异均有统计学意义(P<0.05);(3)亚临床组感染复发次数高达3次以及3次以上的患者共14例,占13.0%,包括HPV16+18型4例、HPV16+52型3例、HPV16型3例、HPV18型2例、HPV6+11型1例、HPV43型1例。结论亚临床感染主要亚型为HPV 6型,并以单一感染为主,多种感染者复发率较高。

HPV感染不同分类及其对MSM有关不良结局的影响

男男性行为人群(MSM)持续感染人乳头瘤病毒(HPV),尤其是高危型HPV的持续感染,将导致尖锐湿疣、肛门癌、阴茎癌、口腔癌等不良结局。MSM感染HPV后,按感染型别可分为低危型或高危型HPV感染,按感染时间可分为一过性或持续性HPV感染,按感染数量可分为单一型或多重型HPV感染;明确以上几种类别的划分依据,分析不同分类间的关系及对MSM有关不良结局的影响,探讨今后对该人群开展调查的关注点,对MSM人群HPV感染控制及预防提供参考。

西安市长安区妇科就诊妇女高危型HPV感染及亚型分布调查研究

目的调查西安市长安区妇女高危型HPV感染及亚型分布情况,为今后的宫颈癌前病变、宫颈癌防治提供依据。方法选择2010年8月~2012年1月西安市长安区妇科就诊患者20491例,常规行薄层液基细胞学检查,并应用流式荧光杂交法进行高危型HPV筛查,同时随机选择液基细胞学检查异常者500例,行阴道镜检查并活检。结果西安市长安区妇科就诊妇女高危型HPV感染率为23.56%,宫颈病变妇女高危型HPV感染率为47.60%。高危型HPV各亚型出现的频率较高的为HPV16、18、31、33、56、58。门诊就诊妇女与宫颈病变妇女HPV高危型亚型分布一致。宫颈癌前病变及宫颈癌患者高危型HPV阳性率均明显高于宫颈炎患者,而CINⅡ~Ⅲ级及宫颈癌患者高危型HPV阳性率又明显高于CINⅠ患者。宫颈癌前病变及宫颈癌和高危型HPV阳性率呈明显正相关(P【0.05),差异有统计学意义。结论西安市长安区妇女罹患HPV16、18、31、33、56、58等亚型较高,本调查所掌握资料可以为今后的宫颈癌前病变、宫颈癌防治提供数据。针对以上亚型研发HPV疫苗,对降低长安区妇女宫颈癌及癌前病变发生率,保护妇女健康具有重要意义。

基于大数据挖掘与可视化的HPV病毒基因组分析研究

感染高危人乳头状瘤病毒(HPV)是宫颈癌发生的必要因素。目前宫颈癌治疗手段以毁损性手术为主,缺乏特效的阻断方法。临床检测仅覆盖23种亚型,占现存亚型10%,而且存在假阳性率和漏诊率问题。高通量测序技术产生的海量基因组大数据为HPV病毒的预防控制研究带来新契机。本文介绍一种易于使用的基于大数据挖掘技术的HPV病毒基因组分析与信息可视化流程框架。通过用比较基因组学分析方法构建的计算流程,实现了对HPV病毒基因组进行全基因组与关键核心基因组进化分析,并且可以对致病危险性较为明确毒株的关键核心基因氨基酸序列进行分类比较分析。通过对基因组大数据的有效挖掘分析,来探究HPV病毒基因组的核酸/氨基酸分子水平结构和氨基酸分类的偏好表达模式,与HPV病毒亚型分化和致病危险性的关系,为新发和未知的HPV病毒的快速确认提供必要的数据和证据支持,为临床宫颈癌的早期预防和诊断提供理论依据。

Relevant Frequency of Multiple Infections with High- and Low-Risk HPV Genotypes among Mexican Women Attending a Tertiary Care Hospital

Aims: To assess the frequency and the main HPV genotypes circulating among a group of women attending at a third level Hospital in Mexico City. Methods: A cross-sectional and descriptive study was performed in a group of 143 female outpatients of the Gynecology and Obstetrics Service at the National Institute of Perinatology of Mexico. Cervical swabs were taken from participants and subjected to simultaneous detection/genotyping of HPV by Linear Array Genotyping Test (Roche Molecular Systems). Mann-Whitney U, median and/or Square Chi tests were used to compare socio-demographical features between HPV-infected and uninfected women. Results: A total of 66 women (46.2%) had HPV infection. Overall, 112 genotypes were detected either as single infections (45.5%) or multiple genotype infections (54.5%). The cumulated frequency of multiple infections with high-/low- and high-/high-risk HPV genotypes was 63.9 %. The most frequent high-risk genotypes were HPV52 HPV58 and HPV51, whereas the most frequent low-risk genotypes were HPV6, HPV53 and HPV84. Infected women were significantly younger and have less stable partner relationships than uninfected women (p < 0.05). Conclusion: A relevant frequency of mixed infections with high- and low-risk HPV genotypes, other than those considered most prevalent worldwide, was observed. Most circulating high-risk genotypes among the women of this study are not covered by commercial vaccine formulations.

HPV prevalent types in a cohort of sexually active Nigerian women:implications for vaccination programmes

Background:The human papillomavirus virus(HPV)is very common with over 150 strains and at least 42 acquired by sexual contact.It is a public health concern among women the world over,with an estimated prevalence of 11.7%globally,and 24%in Sub-Saharan Africa.There are five common HPV types;HPV16,HPV18,HPV52,HPV31,and HPV58.Cervical cancer affects women globally,with estimated 570,000 new cases in 2018.Nearly 90%of the 311,000 deaths worldwide in that year occurred in low-and middle-income countries.Objective:To estimate the prevalence of HPV among sexually active women in Lagos,Nigeria;and to determine the most common HPV type among that category.Methods:A descriptive cross-sectional study design was implemented,with 198 women in total enrolled for the study.Sexually active women from various health facilities in Lagos were screened by obtaining cervical tissue,stirred into PCR cell media,and assayed for HPV genotypes using the Roche COBAS®4800 System.Results:Age of the women ranged from 18 to 65 years(mean 34.6±6.4),with the majority(56.4%)between 25-34 years;65%were married and 63%had a secondary education.Age at first penile-vaginal contact ranged from 9 to 38 years(mean 20.4±3.9).Sixty-five percent of women stated total lifetime sexual partners of between 2 and 4(mean 2.9±2.5).The prevalence of high-risk HPV was 40.4%(95%CI:40.1 to 40.7)and breakdown of types obtained were;HPV16,2.5%(95%CI:2.22 to 2.78);HPV18,3.5%(95%CI:3.22 to 3.78);other high risk(OHR)HPV,28.3%(95%CI:28 to 28.6);HPV16&OHR HPV,1.5%(95%CI:1.22 to 1.78);HPV18&OHR HPV,4.1%(95%CI:3.82 to 4.38);HPV16,18&OHR HPV,0.5%(95%CI:0.221 to 0.779).HPV negative and inconclusive results were 58.1%and 1.5%respectively.Conclusion:Prevalence of OHR HPV is high among Nigerian women.This informs the pattern of HPV existing in the African region,and may aid future efforts at eradicating the virus.The findings are further contributive evidence to the initiative to eliminate cervical cancer as a public health challenge in Nigeria.

Evaluation of HPV Molecular Tests in Primary Screening for Cervical Cancer in Brazil

Background: Incorporation of HPV tests into cervical cancer screening programs may be advantageous over conventional cytology, especially in developing nations, where the largest burden of cervical cancer is observed. Objectives: To conduct an evaluation of commercially available molecular HPV tests in Brazilian women. Study design: Two groups were recruited: group A was composed of 511 women referred to the clinics because of a previous abnormal Pap test while group B consisted of 2464 subjects under routine screening. Cervical samples were collected using SurePath liquid cytology (LBC) device, and split into aliquots which were submitted to molecular testing by Hybrid Capture and cobas HPV. Colposcopy and biopsies were made according to the standard guidelines, directed by cytological diagnosis. Results: Prevalence of HSIL was 5.97% and 0.7% in Group A and B respectively. High-Risk HPV DNA was found in about 9% of group B women, while in group A this frequency was 24%. Having CIN3+ as the study end-point, the negative predictive values for molecular methods were above 99.8%. All “in-situ” and invasive cervical carcinomas were detected by both HPV nucleic acid assays. Conclusion: Use of HPV DNA testing was feasible and highly sensitive in cancer screening settings of Brazil.

浅谈HPV检测及其分型在宫颈疾病中临床应用价值

目的分析HPV检测及其分型在宫颈疾病中临床应用价值。方法随机选取2016年1月-2016年10月的46例宫颈疾病患者,均给予HPV分型检测,对比分析检测结果。结果 25例宫颈炎患者,9例HPV呈阳性,阳性率为36%。5例CINⅠ患者,2例HPV呈阳性,阳性率为40%。4例CINⅡ患者,2例HPV呈阳性,阳性率为50%。7例CINⅢ患者,4例HPV呈阳性,阳性率为57.1%。5例宫颈癌患者,4例HPV呈阳性,阳性率为80%。就HPV呈阳性的患者而言,针对宫颈炎,7例单重感染,2例多重感染,针对CINⅠ,1例单重感染,1例多重感染,针对CINⅡ,1例单重感染,1例多重感染,针对CINⅢ,2例单重感染,2例多重感染,针对宫颈癌,3例单重感染,1例多重感染。结论 HPV分型检测可辅助诊断及筛查宫颈病变,临床应用价值高,值得广泛推广。

一个医学数据集上的决策树分类研究

人乳头瘤病毒(HPV)是导致宫颈癌的一大要素。利用Weka这个数据挖掘平台,对中国肿瘤防治数据库山西子宫颈癌医学数据集进行C4.5决策树分类研究,从决策树中提取了一些比较有意义的规则,发现一些容易导致感染HPV病毒的因素。

应用计算机辅助细胞检测技术与阴道镜下病理活检诊断早期宫颈病变的对比分析

目的 本文拟对应用CCT技术 ,TBS分类所诊断的早期宫颈病变与阴道镜下病理活检结果进行对比 ,以探讨这一技术的应用价值。方法 选择 1 999年 4月 - 2 0 0 0年 4月在甘肃省人民医院门诊行CCT图片检查 2 31 7例 ,其中回报为ASCUS以上病变者 1 42例 ,均在阴道镜下行活检 ,将其结果进行检测 ,活检组织进行病理切片 ,HE染色得出病理活检结果。结果 行CCT技术检查 2 31 7例 ,ASCUS以上病例共 1 42例 ,占 6 1 %。其中ASCUS83例 ,占 3 6% ;LSIL42例 ,占 1 8% ;HSIL1 0例占 0 4% ;子宫颈癌 7例占0 3%。对于CCT检查ASCUS以上病变者均行阴道镜下病理检查 ,得出CCT刮片与阴道镜下病理活检符合率为 86 2 3% ,对细胞学描述的同时行HPV检查得出CCT刮片与阴道镜下病检查结果的HPV感染统计学比较无显著意义 (P >0 0 5 )。结论 CCT技术这一检查方法 ,简单、准确性高 ,就诊条件要求低 ;TBS分类报告内容全面 ,有益于细胞病理学医师与妇科医师间的沟通。因此 ,适合门诊初筛 。

环介导等温扩增对人乳头瘤病毒可视化分型检测

目的应用环介导等温扩增(LAMP)可视化检测人乳头瘤病毒(HPV)16、18、52、58亚型,探索LAMP技术在基层或现场的使用前景。方法首先,收集临床疑似HPV感染患者的宫颈脱落细胞标本。然后分别根据HPV16、18、52、58亚型E6、E7区域设计LAMP引物并优化反应体系,通过扩增不同亚型的模板验证这引物的特异性,并通过检测经过一系列稀释后的模板分析其灵敏度,同时在体系中加入钙黄绿素并将显色结果与电泳图对比以验证可视化结果的准确性。最后对临床标本分别用LAMP及PCR进行分型检测,将两种方式的结果进行一致性分析,比较两种方式有无统计学差异。结果优化好的LAMP体系特异性较好,对HPV16、18、52、58亚型的检测限分别为100、10^(3)、100、10^(3)IU/μL。另外,加入钙黄绿素后肉眼判定的效果和电泳效果相同。通过对临床样本分型检测的得出,LAMP与PCR的统计学差异不明显(Kappa值=0.854)。结论LAMP具有较好的灵敏度及特异性,可检测未经纯化的HPV病毒,适合条件简陋的基层或现场检测。

宫颈病变与高危型人乳头瘤病毒分型的分布及相关性

目的探讨宫颈病变分级与高危型人乳头瘤病毒分型的分布及其相关性。方法选取2008年1月—2015年12月我院宫颈门诊同时行液基细胞学(thinprep cytologic,TCT)检查、人乳头瘤病毒(human papillomavirus,HPV)高危型分型检测及阴道镜(colposcopy examination,COL)检查的患者1000例为研究对象,对其中1项及1项以上异常者取病理活检,以病理检查结果为金标准,用R×C的Pearsonχ~2检验分析高危型HPV与宫颈病变的相关性,用Spearman相关系数及列联系数(contingency coefficient)作关联性分析。结果 1000例受检者中慢性宫颈炎895例,宫颈病变105例,其中CIN Ⅰ 48例,CIN Ⅱ 33例,CIN Ⅲ 19例,SCC 5例,其中高危型HPV检查96例,确诊为宫颈病变65例。65例中检出HPV高危分型13种,检出率前5位的为HPV16 (29. 2%)、HPV56 (23. 1%)、HPV58 (15. 4%)、HPV18(7. 7%)及HPV52(4. 6%),HPV16、HPV56及HPV58的感染与不同宫颈病变之间有关联性,其列联系数分别为0. 256、0. 208及0. 156,P值分别为0. 001、0. 002及0. 004。结论山东枣庄籍宫颈病变患者中常见的HPV高危型是16、56、58及18,其中HPV16、56及58与宫颈病变存在相关性。

人乳头状瘤病毒分型及肿瘤标志物联合检测在宫颈癌前病变及宫颈癌中的诊断应用分析

目的探讨HPV分型及肿瘤标志物联合检测在宫颈癌前病变及宫颈癌中的诊断应用分析。方法选取2015年6月-2017年8月本院40例宫颈癌患者纳入宫颈癌组,40例宫颈癌前病变患者纳入宫颈癌前病变组,40例体检健康女性纳入健康对照组。比较3组对象HPV亚型阳性结果以及肿瘤标志物Scc、CA125水平、Ki67阳性表达率。结果宫颈癌前病变组及宫颈癌组HPV16、HPV18阳性例数显著高于健康对照组,宫颈癌组HPV16、HPV18阳性例数显著高于宫颈癌前病变组,上述差异均有统计学意义(P<0.05),而3组受试者HPV31、HPV58阳性例数差异无统计学意义(P>0.05)。宫颈癌前病变组及宫颈癌组Scc、CA125、Ki67水平显著高于健康对照组,宫颈癌组Scc、CA125、Ki67水平显著高于宫颈癌前病变组;3组受试者Scc、CA125、Ki67联合检测阳性率较各单项检测阳性率显著提高,上述差异均有统计学意义(P<0.05)。结论 HPV分型、Scc、CA125、Ki67联合检测有助于宫颈癌的早期诊断,更明确的检测结果有待于进一步研究。