【摘要】 目的:了解兰州市门诊病人人乳头瘤病毒(HPV)感染情况、年龄分布及与宫颈病变相关性,免疫组化法测不同宫颈病变组中P16表达,了解P16在筛查宫颈癌及其癌前病变中的作用。方法:收集兰州市2009年10月至2011年3月782例门诊女病人,核酸分子快速导流杂交基因芯片技术(HyBrimax)对宫颈脱落细胞行HPV分型检测,分析门诊病人中HPV感染状况及年龄分布。部分细胞学异常或高危HPV阳性者阴道镜下宫颈活检,病理检查宫颈病变程度及与HPV感染相关性,免疫组化法检测宫颈组织中P16蛋白表达情况。结果:兰州市门诊782例病人中,HPV阳性率28.64%(224/782),21种亚型检测出17种,排在前5位亚型分别为HPV16、HPV58、HPV68、HPV52、HPV33,各年龄组间HPV感染差异有统计学意义(P<0.05),21-30岁之间感染占37.42%。117例病检组织中,HPV在正常/炎症、CINⅠ、CINⅡ-Ⅲ、ICC组中阳性率分别为35.55%、65.60%、88.46%、100%,各组间HPV感染差异有统计学意义(P<0.01),同时P16表达依次增高,阳性率分别为22.22%、56.25%、84.61%、100%,组间差异有统计学意义(X2=36.124,P=0.001)。结论:兰州市门诊病人HPV感染阳性率为28.64%,各年龄组间感染差异有统计学意义,随宫颈病变加重,HPV检出率及P16蛋白表达均增高,二者联合检测有助于早期诊断及治疗。更多还原

【Abstract】 Objective: To detect the human papillomavirus(HPV) infection in outpatients of Lanzhou City,analysis the age distribution and the relationship with cervical lesion,understand the expression of P16 in different cervical lesion.Methods: Collected the outpatients from Oct.2009 to Mar.2011 and 782 women were obtained,Cervical exfoliative cytology checked for 21 HPV-DNA types by DNA flow-through Hybridization genotyping technique,analysed the age distribution.Some cytological abnormalities or high-risk(HR) HPV-positive women undergo Colposcopy and cervical biopsy,analyze the relationship between Pathological diagnosis and HR-DNA postive cases;using the immunohistochemistry were used to detect the expression of p16 in cervical tissue,to understand correlation between cervical lesion and P16 express intensity.Results: 17 HPV genotype were found in 21 by HyBrimax,in 782 cases,the total positive rate was 28.64%(224/782).The most common HPV genotype was HPV-16,HPV-58,HPV-68,HPV-52,HPV-33.For the different age groups,the HPV infection have statistical significance(X2=25.769,P<0.05),the peak infection age was 21 to 30 years old;in the normal/ Inflammation,CIN1,CIN 2-3,ICC tissues,the postive rate of HPV were 35.55%,65.60%,88.46%,100% respectively,the postive rate of P16 were 22.22%,56.25%,84.61%,100% respectively.There were statistical difference between the groups(X2=36.124,P =0.001).Conclusion: Our study showed that the postive rate of HPV infections in Lanzhou city was 28.64%,the different age groups had statistical difference in infecting HPV,with the development of cervical lesion,HPV infection and P16 expression was increased,and combination of the two will improve the diagnostic Accuracy.更多还原