【摘要】 目的了解重庆地区人乳头瘤病毒(human papillomavirus,HPV)感染情况及其亚型分布,探讨HPV的多重感染以及HPV病毒负荷量与不同级别宫颈病变的相关性,并比较HPV-DNA检测杂交捕获法和基因芯片法对宫颈HPV感染的检出效率,评价基因芯片法作为筛查方法的优缺点,为建立最佳筛查方案预防宫颈癌提供科学依据。方法对2009年在重庆市肿瘤医院肿瘤研究所妇科肿瘤科就诊的360例自愿接受宫颈癌机会性筛查的患者进行液基细胞学和HPV-DNA的检测,其中HPV-DNA检测采用杂交捕获法和基因芯片法,并以基因测序为金标准评价两种检测方法的检测效率。结果本次共检出27种HPV亚型,检出率前三位依次为:HPV16、HPV58和HPV52。HPV总阳性率为42.50%,其中高危型检出率为34.17%;低危型检出率为15.56%;多重感染率为15.00%。以液基细胞学检查为标准,随宫颈病变程度的增加,HPV感染率、高危型HPV感染率、多重感染率及病毒负荷量逐渐增加,组间差异有显著性,低危型HPV感染率无规律性改变。杂交捕获法和基因芯片法的灵敏度、特异度和约登指数分别为前者97.56%、98.17%和0.957,后者98.33%、93.40%和0.917。结论高危亚型HPV感染是宫颈上皮内病变的主要因素,HPV16是重庆地区感染率最高的HPV亚型,其次为HPV58和HPV52。HPV的多重感染和病毒负荷量都与宫颈病变程度有一定的相关性。两种HPV检测方法相比,杂交捕获法特异度较高,而基因芯片法灵敏度较高,基因芯片法可作为新的宫颈病变筛查方法。更多还原

【Abstract】 Objective To get the message of the situation and distribution of human papillomavirus types,and to investigate the association of the muhi-infection and the virus load with the level of cervical lesions.Also to compare the efficiency of Hybrid Capture 2 and genotyping diagnosis test.Methods Thin-prep cytology test and HPV test were carried in 360 women who were willing to take cervical cancer screening in 2009.HPV DNA test included Hybrid Capture 2 genotyping diagnosis test and DNA sequencing test.Results 27 types of HPV were detected ,the three most prevalent types were HPV16,HPV58 and HPV52 in turn.The HPV positive rate was 42.5% and the high-risk and low-risk HPV infection rates were 34.17% and 15.56%.The multi-infection rate was 15.00%.The HPV infection rate,high-risk infection rate,lowrisk HPV infection rate,multi-infection rate and the virus load were increasing with the aggravation of the cervical squamous intraepithelial lesion. However,the low risk HPV infection rate didn’t have this regular pattern.The sensitivity,specificity and Youden’s index of Hybrid Capture 2 and genotyping diagnosis test were 97.56%,98.17%,0.957 and 98.33%、93.40%,0.917 respectively.Conclusion Human papillomavirus infection is the reason of cervical cancer and precancerous lesion.HPV16 is the most popular type in Chongqing,and the next two were HPV 58 and HPV 52.In the women with abnormal cytology result,the more severe of cervical disease,the more incidence of HPV infection can be detected.The HR-HPV was especially related to the level of the cervical disease.The multi-infection rate and the virus load is associated with the severity of the cervical disease.To compare with the two methods of HPV DNA test,the Hybrid Capture 2 bad a higher specificity, and the genotyping diagnosis test had a higher sensitivity,so the genotyping diagnosis test also can be used in the cervical cancer screening.更多还原