【摘要】 目的:探讨人乳头瘤病毒(HPV)亚型感染与宫颈病变的关系。方法:以桂北地区育龄妇女为研究对象,对门诊就诊的1086病例进行HPV分型检测和液基细胞学检查,对细胞学诊断≥ASCUS及HPV检测为阳性的病例进行阴道镜下宫颈组织活检。结果:①HPV检测阳性率为43.92%(477/1086);液基细胞学诊断≥ASCUS为31.49%(342/1086)。在ASCUS、LSIL、HSIL、SCC中HPV的检出率分别为51.45%、70.27%、91.30%、100%。②细胞学诊断阳性≥LSIL(18.78%,204/1086)与组织学诊断阳性≥CINⅠ(21.36%,232/1086)比较差异无统计学意义(χ2=2.250,P>0.05),细胞学与组织学诊断符合率100%为SCC、80.23%为HSIL和90.98%为LSIL。组织学诊断CINⅠ、CINⅡ、CINⅢ、SCC病变中HPV检出率以68.03%、81.67%、93.37%、100%依次递增。③1086例样本中HPV感染共检出21种亚型,低危型4种占17.19%、高危型17种占82.81%,随宫颈病变程度的增加,HPV亚型分布有所变化,低度病变组(CINⅠ)以HPV16、58、l8、56、11和52为常见类型;而高度病变组(CINⅡ～Ⅲ)以HPV16、58、18、56、33、52和11型为最常见。24例宫颈癌共检出6种高危亚型HPV,分别是HPV16、58、18、59、66和33型。HPV16亚型随宫颈病变级别加重感染率呈上升趋势(P<0.0125)。结论:桂北地区宫颈病变常见的HPV亚型是HPV16、58、18、56、33、52和11型,HPV16致癌性最强;HPV分型检测因其准确性高并能明确基因类型,联合液基细胞学和组织学更能有效地筛查宫颈病变细胞,为临床防治宫颈癌提供更可靠的科学依据。更多还原

【Abstract】 Objective:To explore the relationship of subtype HPV infection and cervix lesion.Methods:1086 women in clinic had HPV typing test and liquid-based cytology test(LCT),if the cytology results showed ASCUS or more and HPV test was positive,then colposcope and biopsy would be done.Results:①Positive rate of HPV test was 43.92%(477/1086).LCT ≥ASCUS was 31.49%(342 /1086).The positive rate of HPV test in ASCUS,LSIL,HSIL,SCC were 51.45%,70.27%,91.30%,100% respectively.②There was no significant difference between the propotion of cytology≥LSIL(18.78%,204 /1086) and histology ≥CIN Ⅰ(21.36%,232/1086)(χ2 = 2.250,P>0.05).Positive rate of HPV in CINⅠ,CINⅡ,CINⅢ,SCC were respectively 68.03%,81.67%,93.37%,100%.③ 21 HPV isoforms were found in 1086 women,low risk types accounted for 17.19%,high risk types accounted for 82.81%.The HPV subtypes varied with severity of cervical diseases,CIN Ⅰ group had more subtypes of HPV 16,58,18,56,11 and 52,while CINⅡ～Ⅲ group had more subtypes of HPV l6,58,18,56,33,52 and 11.Six subtypes of high risk HPV were found in 24 cases of SCC,including HPV 16,58,18,59,66 and 33.The infective rate of HPV16 subtype markedly increased along with the severity of cervical lesions(P<0.0125).Conclusions:HPV 16,58,18,56,33,52,11 are the common subtypes found in cervical lesions in Guibei area,the strongest oncogene is HPV16.Because HPV typing test has high accuracy,if combined with liquid medium cytology and histology examination,cervical lesions can be found more easily and effectively,thus offer reliable scientific bases for clinical prevention and curing cervical cancer.更多还原