HPV不同基因型感染在宫颈病变过程中的研究

王兰芳; 胡双婕; 葛晓伟; 王朝红; 孙玉秀; 沈继龙

doi:10.16462/j.cnki.zhjbkz.2019.05.009

HPV不同基因型感染在宫颈病变过程中的研究

doi: 10.16462/j.cnki.zhjbkz.2019.05.009

230001 合肥, 安徽省妇幼保健院, 安徽医科大学附属妇幼保健院, 检验科

详细信息

通讯作者:
王兰芳, E-mail: wcm1012@163.com

中图分类号: R711.32;R711.74
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出版历程
- 收稿日期: 2018-10-08
- 修回日期: 2019-03-01
- 刊出日期: 2019-05-10

Study on genotype-associated HPV infection in cervical lesions

Clinical Laboratory, Maternal and Child Care Service Center of Anhui and Maternal and Child Hospital of Anhui Medical University, Hefei 230001, China

More Information

Corresponding author: WANG Lan-fang, E-mail: regnier@ibpc.fr

摘要

摘要: 目的根据宫颈炎、宫颈鳞状上皮内瘤变（cervical intraepithelial neoplasia，CIN）及宫颈原位癌患者感染人乳头瘤病毒（human papillomavirus，HPV）的基因分型，探讨HPV感染与宫颈病变之间的关联。方法选取于2014年10月~2015年10月期间，在合肥市妇幼保健院就诊的464例宫颈活检患者。其中有宫颈炎患者242例，CIN患者222例（其中Ⅰ组76例，Ⅱ组71例，Ⅲ组66例，宫颈癌组9例）。采用杂交芯片技术检测患者宫颈分泌物，以组织病理学活检为参照，进行21种HPV的DNA进行分型。结果在464例宫颈病变患者中，354例患者感染HPV，其感染率为76.3%。其中232例为单一HPV感染，感染率为65.5%，多重感染122人，感染率为34.5%。宫颈炎患者HPV感染率为64.9%，CIN Ⅰ组中HPV感染率为86.8%，CIN Ⅱ组中HPV感染率为87.3%，CIN Ⅲ组HPV感染率为90.9%，CIN组的HPV感染率高于宫颈炎组（P < 0.001）。宫颈癌组中，100%感染HPV。结论持续感染高危型HPV，会增加CIN和宫颈癌发生的风险；HPV DNA的分型检测，对于宫颈癌的筛查、防治具有极其重要的临床意义。
- 人乳头瘤病毒 /
- 基因分型 /
- 宫颈炎 /
- CIN /
- 宫颈癌
Abstract: Objective To explore the association of genotypes of human papillomavirus (HPV) with cervicitis, cervical intraepithelial neoplasia (CIN) and carcinoma in situ of cervix. Methods A total of 464 patients with cervical biology admitted to Hefei women and child health care hospital from October, 2014 to October, 2015 were selected. Among them, there were 242 cases of cervicitis, 222 cases of CIN (76 of group Ⅰ, 71 of group Ⅱ, and 66 of group Ⅲ), and 9 cases of cervical cancer. Hybrid chip technology was used to detect cervical secretions of patients, and 21 kinds of HPV DNA were typed according to histopathological biopsy. Results The HPV infection was found in 464 patients with cervical lesions. Among them, 354 cases (76.3%) had HPV infection with 232 cases (65.5%) of single HPV infection and 122 cases (34.5%) of multiple infections included. The rate of HPV infection was 64.9% in the group of cervicitis, while the rate was 86.8% in group Ⅰ of CIN and in group Ⅱ of CIN, the rate of HPV infection was 87.3%. Surprisingly, the HPV infection rate in group Ⅲ of CIN was as high as 90.9%. The infection rate of HPV in the patients with CIN was significantly higher than those with cervicitis (P < 0.001). All patients with cervical cancer were infected with HPV. Conclusions Persistent infection of high-risk HPV subtypes increases the hazard of cervical tumor and CIN. Therefore, genotyping of HPV DNA is helpful for screening and prediction of cervical cancer.
- HPV /
- Genotyping /
- Cervicitis /
- CIN /
- Cervical cancer

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表 1 宫颈病变患者分布构成比

Table 1. Constituent ratio of patients with cervical lesion

分类	例数(例)	比例(%)
宫颈炎	242	52.2
CINⅠ	76	16.4
CINⅡ	71	15.3
CINⅢ	66	14.2
宫颈原位癌	9	1.9

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表 2 464例患者HPV的感染率

Table 2. HPV infection rate within 464 patients

病理	总例数(例)	阳性例数(例)	感染率(%)	χ²值	P值
炎症	242	157	64.9
CIN Ⅰ	76	66	86.8	13.321	＜0.001
CIN Ⅱ	71	62	87.3	13.164	＜0.001
CIN Ⅲ	66	60	90.9	16.883	＜0.001
宫颈癌	9	9	100.0	4.780	0.029
合计	464	354	76.3

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表 3 354例患者单一和多重HPV的感染率[n(%)]

Table 3. Single HPV and multiple HPV infection rate within 354 patients[n(%)]

	炎症	CIN Ⅰ	CIN Ⅱ	CIN Ⅲ	宫颈癌	合计
单一HPV感染	102(65.0)	36(54.5)	45(72.6)	40(66.7)	9(100.0)	232(65.5)
多重HPV感染	55(35.0)	30(45.5)	17(27.4)	20(33.3)		122(34.5)

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表 4 464例宫颈疾病患者HPV亚型的分布[n(%)]

Table 4. Distribution of HPV subtypes within 464 patients with cervical disease[n(%)]

HPV亚型	炎症	CIN Ⅰ	CIN Ⅱ	CIN Ⅲ	宫颈癌	合计
HPV16	34(21.7)	14(21.2)	25(40.3)	43(71.7)	9(100.0)	125(35.3)
HPV52	30(19.1)	15(22.7)	13(21.0)	7(11.7)		65(18.4)
HPV58	26(16.6)	13(19.7)	12(19.4)	11(18.3)		62(17.5)
HPV53	18(11.5)	7(10.6)	5(8.1)	1(1.7)		31(8.8)
HPV51	16(10.2)	9(13.6)	3(4.8)	2(3.3)		30(8.5)
HPV33	13(8.2)	7(10.6)	8(12.9)	6(10.0)		34(9.6)
HPV18	12(7.6)	6(9.1)	3(4.8)	3(5.0)		24(6.8)
注：部分患者有多重HPV感染, HPV亚型有重复计数现象。

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