人乳头瘤病毒感染与发生宫颈癌及非癌宫颈疾患危险性分析

采用斑点杂交技术对２４７份项癌、１４３份非癌宫颈疾患活检组织标本分别进行了人乳头瘤毒６／１１（ＨＰＶ６／１１）、ＨＰＶ１６和１８型ＤＮＡ序列检测，实验结果指出：（１）２４７份癌标本中，ＨＰＶ源序列检出率为６５．９９％，其中ＨＰＶ１６型检为５５．０６％，占全部宫颈癌ＨＰＶ阳性一标本的７１．２８％，分别为该组ＨＰＶ６／１１及１８型感染的４．２５倍和５．６７倍。（２）１４３例非癌宫颈疾患标本中，ＨＰＶ检     

多聚酶链反应探讨人乳头瘤病毒的疱疹病毒—2与宫颈疾病的关系

用多聚酶链反应检测正常妇女，慢性宫颈炎患者，宫颈癌患者中ＨＰＶ６、１１、１６、１８ＨＳＶ－２感染情况。结果显示：慢性宫颈炎患者中ＨＰＶ总阳性率，ＨＰＶ６、１１、１６、１８各型阳性率明显高于正常妇女；宫颈癌患者中ＨＰＶ总阳性率６２．５％，其中ＨＰＶ１６阳性率高达５２．５％，明显高于ＨＰＶ６、１１、１８；慢性宫颈炎患者中ＨＳＶ－２感染率为３４．７％，显著高于正常妇女，但低于ＨＰＶ总阳性率。     

应用FISH法检测宫颈脱落细胞HPV16／18感染的研究

采用宫颈脱落细胞直接抽滤点样于硝酸纤维素膜上，进行斑点原位杂交的方法（ＦＩＳＨ法）检测脱落细胞中ＨＰＶ１６／１８型的感染。以核酸分子斑点杂交为标准，ＦＩＳＨ法的敏感度、特异度分别为６４．５％、７９．２％。应用ＦＩＳＨ法检测３９６例宫颈脱落细胞标本，结果ＨＰＶ１６／１８总阳性率为７．２％，各年龄组间阳性率无显著差异。此结果提示在宫颈癌普查中，ＦＩＳＨ法可作为一种辅助诊断方法，对巴氏涂片Ⅱ级以上的人群再检测ＨＰＶ１６／１８感染，为宫颈癌的防治重点提供了依据。     

血液透析及肾移植患者乙型和丙型肝炎病毒感染状况分析

测定２０９例肾透析患者血液中ＨＢＶ－ＤＮＡ和ＨＣＶ－ＲＮＡ，阳性率ＨＢＶ－ＤＮＡ为２．４％、ＨＣＶ－ＲＮＡ为１６．３％；７６例肾移植后患者阳性率ＨＢＶ－ＤＮＡ为２．６％、ＨＣＶ－ＲＮＡ为２３．７％；对照组阳性率ＨＢＶ－ＤＮＡ为１．８％、ＨＣＶ－ＲＮＡ为２．０％。ＨＢＶ－ＤＮＡ阳性率在各组间无显著差异，Ｐ＞０．０５；血液透析组和肾移植组ＨＣＶ－ＲＮＡ阳性率高于对照组，且有显著性差异Ｐ＜０．０１；肾移植组高于肾透析组，但无显著性差异，Ｐ＞０．０５。ＨＢＶ－ＤＮＡ阳性合并ＨＣＶ－ＲＮＡ阳性为４２．９％（３／７）。５２例ＨＣＶ－ＲＮＡ阳性患者基因分型为Ⅱ型７６．９％、ⅡⅢ型１１．５％、Ⅲ型１１．５％。介于目前的状况，对献血检测，对阳性患者进行ＨＢＶ－ＤＮＡ、ＨＣＶ－ＲＮＡ检测，对阳性患者实行分机透析，是降低血透及肾移植患者乙、丙型肝炎病毒医院感染的关键。     

聚合酶反应在HBV感染诊断中的意义──附544例检测结果分析

为探讨多聚酶链反应（ＰＣＲ）在评价乙肝病毒（ＨＢＶ）感染中的意义，笔者分析了５４４例ＰＣＲ检测结果。按每六届全国病毒性肝炎学术会议诊断标准分类：慢活肝１１５例、慢迁肝８６例、肝硬化１８例、无症状病原携带者３２５例。据乙肝五项（ＥＬＩＳＡ法）结果分类：１．３．５阳性者２１６例，１．３阳性者４２例，１．４．５阳性者８３例，１．５阳性者９２例，单项ＨＢｓＡｇ阳性者６５例，单项抗ＨＢｓ阳性者４６例。结果：１．３．５和１．５阳性组ＨＢＶＤＮＡ阳性率分别为９９．１％；１．４．５和１．５阳性组ＨＢＶＤＮＡ阳性率分别３４．９％、６０．１％：单项ＨＢｓＡｇ阳性和单项抗ＨＢｓ阳性组ＨＢＶＤＮＡ阳性率分别为１８．５％；６．５％。肝功能正确组和肝功能异常组ＨＢＶＤＮＡ阳性率分别为５４．６％（１６６／３４０）、９２．６％（１８９／２０４），其差异有显著性意义（Ｐ＜０．０１）。慢活肝、慢迁肝、肝硬化、无症状组ＨＢＶＤＮＡ阳性率分别为８８．７％（１０２／１１５）、８０．２％（６９／８６）、１００％（１８／１８）、５１．１％（１６６／３２５）。经统计学分析，前三组与无症状组之间的差异均具显著性意义（Ｐ＜０．０１）。结果提示：（１）用ＰＣＲ     

人乳头瘤病毒和其他因素与宫颈癌关系的研究

对４９例宫颈癌病人和６５例非癌妇女进行了人乳头瘤病（ＨＰＶ）ＤＮＡ序列测定及妇科卫生、生育和矽丈夫等情况调查。结果表明两组中ＨＰＶ阳性率分别为４９％和６．１５％。在调整年龄、文化水平和吸烟３因素后，宫颈癌的危险因素有妇科卫生差、多孕多生、丈夫包皮过长和ＨＰＶ感染等。几个因素共同作用时，除年龄因素外仅ＨＰＶ的ＯＲ值有显著性，表明它可能是从暴露上述危险因素到宫颈癌发生过程中的中间生物标志。     

HPV16及其基因诱导小鼠宫颈癌的毒理学研究

目的　通过动物模型探讨人乳头瘤病毒１６ 型（ＨＰＶ１６） 及其基因从阴道感染小鼠是否可以诱导宫颈癌。方法　用ＨＰＶ１６ 及其Ｅ２Ｅ５ 、Ｅ６Ｅ７ 、Ｅ２Ｅ６Ｅ７ 基因片段从阴道分别感染雌性Ｃ３Ｈ／ＨｅＪ 小鼠,每周３ 次,终生染毒。实验期间,每月阴道涂片１ 次,当阴道脱落细胞出现恶变时,即行处死动物,并对宫颈进行组织病理学检查。结果　四个染毒组动物阴道脱落细胞总损伤率都明显高于对照组（ Ｐ＜ ０ ．０１） ,并随染毒时间延长而增加,ＨＰＶ１６ 及其三个基因组动物的宫颈癌发生率明显高于对照组（ Ｐ ＜ ０ ．０５ ） ;ＨＰＶ１６ 及其基因组之间仅ＨＰＶ１６Ｅ２Ｅ５ 组的宫颈癌发生率明显低于ＨＰＶ１６Ｅ２Ｅ６Ｅ７ 组,其余染毒组间无显著性差别（ Ｐ ＞ ０ ．０５ ） 。结论　ＨＰＶ１６ 及其Ｅ２Ｅ５ 、Ｅ６Ｅ７ 、Ｅ２Ｅ６Ｅ７ 基因片段在Ｃ３ Ｈ／ ＨｅＪ 小鼠体内可诱导宫颈癌,阴道脱落细胞的病理学检查可作为早期发现宫颈癌的预防性监督手段。     

丙型肝炎病毒感染与原发性肝癌关系的病例－对照研究

用频数配比和两个对照组的病例－对照研究方法，分析了丙型肝炎病毒（ＨＣＶ）感染和某些致病因子在肝癌发病中的作用．频数配比的条件为同年龄（±３岁）、同性别、同居住地、病例组的抗－ＨＣＶ阳性率为１５．６０％（１７／１０９）．两个对照组分别为６．４２％（７１／１０９）和１．８３％（２／１０９）．差异均有显著性（Ｐ＜０．０５）。排除输血混杂因素后，病例组与对照组之间，ＨＣＶ感染仍有显著性差异（Ｐ＜０．０５）。经多因素Ｌｏｇｉｘｔｉｃ回归分析．ＨＣＶ感染在病例组和两个对照组间的ＯＲ值分别为９．１８和４２。１８．在肝癌病因中ＨＢＶ感染的病因分值（０．８１６６～Ｏ．８６４１）大于ＨＣＶ感染（０。０９４８～０．１３９４）。     

HPV16型感染与大肠肿瘤关系的研究

应用多聚酶链反应（ＰＣＲ）检测５０例大肠腺癌、３８例大肠腺瘤和２０例正常大肠粘膜组织的ＨＰＶ１６型ＤＮＡ序列，并对其扩增产物进行电泳分析和Ｓｏｕｔｈｅｒｎ核酸杂交分析。结果显示，三组病人ＨＰＶ１６型ＤＮＡ阳性率分别为４２％、３１６％和０。大肠腺癌和腺瘤分别与正常大肠粘膜组织比较，ＨＰＶ１６型ＤＮＡ阳性率差异有显著性（Ｐ＜００５）；大肠腺癌和腺瘤之间比较，ＨＰＶ１６型ＤＮＡ阳性率差异无显著性（Ｐ＞００５）；但ＨＰＶ１６型ＤＮＡ阳性的１２例大肠腺瘤组织均伴组织细胞异型增生。结果表明，ＨＰＶ１６型与国人的大肠腺癌有关，是大肠癌的病因之一。     

２０１４－２０１７年宁波市北仑区男性尖锐湿疣患者 ＨＰＶ 基因型检测分析

摘要：目的　分析２０１４－２０１７年宁波市北仑区男性尖锐湿疣患者病变组织ＨＰＶ 基因型及前列腺液ＨＰＶ６／ １１检测结果,为尖锐湿疣的诊断及治疗提供参考。方法　选取２０１４年１月至２０１７年１２月北仑区人民医院 诊治的男性尖锐湿疣患者８０例,采集病变组织及前列腺液,采用荧光定量聚合酶链反应（ＦＱ－ＰＣＲ） 检 测ＨＰＶ ＤＮＡ。结果　８０ 例患者的病变组织中均检测出ＨＰＶ, 阳性率１００．００％, 其中低危型５７ 例 （７１．２５％）,高危型１５例（１８．７５％）,高危型＋低危型８例（１０．００％）。单一感染４７例（５８．７５％）,多重 感染３３ 例（４１．２５％）。６４ 例患者前列腺液中检出ＨＰＶ６／１１, 阳性率为８０．００％, 其中ＨＰＶ６２９ 例 （４５．３１％）、ＨＰＶ１１１２ 例（１８．７５％）、ＨＰＶ６＋１１２３ 例（３５．９４％）。不同年龄及不洁性生活史患者 ＨＰＶ６／１１阳性率比较差异无统计学意义（犘＞０．０５）。结论　尖锐湿疣患者病变组织及前列腺液中均以低 危型ＨＰＶ６、ＨＰＶ１１感染为主,前列腺液ＨＰＶ６／１１检测有助于无症状的尖锐湿疣早期诊断。 关键词：尖锐湿疣;男性;病变组织;人乳头瘤病毒;基因型;前列腺液;诊断 中图分类号：Ｒ７５２．５＋３　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１８）１２ ０９１３ ０４     

人乳头瘤病毒感染与宫内节育器及相关因素的研究

为了解人乳头瘤病毒 (HPV)感染与宫内节育器 (IUD)及 HPV感染的危险因素之间的关系 ,应用HPV6、11型和 HPV16、18型两对引物 ,通过聚合酶链反应 (PCR)技术 ,对 2 5例未置 IUD和 93例置 IUD妇女者的宫颈拭子进行 HPV- DNA的检测。结果 :选择的 118例妇女宫颈拭子的 HPV检出率为 40 .6 8%。其中未置 IUD组、O型环组和 T型环组 (TCu IUD)的 HPV检出率分别为 2 4.0 0 %、37.0 4%和 5 6 .41%。多因素 logistic回归平衡各因素间的作用 ,达到显著意义的因素有 TCu IUD、宫颈糜烂 ,子宫异常出血和阴道炎 ,其 OR值分别为 4.2 6 3、2 .6 86、4.5 38和 3.414。HPV感染与 IUD的类型有关 ,TCu IUD是 HPV感染的危险因素 ,其他危险因素是宫颈糜烂、子宫异常出血和阴道炎     

Herpes simplex virus and risk of cervical cancer: a longitudinal,nested case-control study in the nordic countries

Human papillomaviruses (HPVs) play the major role in cervical carcinogenesis. The authors reevaluated the role of herpes simplex virus type 2 (HSV-2) in this multistage process by conducting a longitudinal, nested case-control study using 1974-1993 data and comparing the results with those from a meta-analysis of studies. A Nordic cohort of 550,000 women was followed up for an average of 5 years, after which 178 cervical carcinoma cases and 527 controls were identified. HSV-2; HPV-16, HPV-18, and HPV-33; and Chlamydia trachomatis antibodies were determined at baseline by HSV-2 glycoprotein gG-2 and HPV virus-like-particle enzyme immunoassays and by using the microimmunofluorescence method. The relative risk of cervical carcinoma was calculated by conditional logistic regression. Longitudinal studies on HSV-2 and cervical neoplasia were identified through MEDLINE (National Library of Medicine, Bethesda, Maryland), and weighted mean relative risks were calculated. Smoking (relative risk = 1.6, 95% confidence interval (CI): 1.1, 2.3) and HPV-16/HPV-18/HPV-33 (relative risk = 2.9, 95% CI: 1.9, 4.3) were both associated with cervical carcinoma. The smoking- and HPV-16/HPV-18/HPV-33-adjusted relative risks for HSV-2 were 1.0 (95% CI: 0.6, 1.7) and 0.7 (95% CI: 0.3, 1.6), respectively, for HPV seropositives. In the meta-analysis, the relative risk for HSV-2 was 0.9 (95% CI: 0.6, 1.3). In both sets of data, HSV-2 did not play a role in cervical carcinogenesis.     

Risk factors for cervical human papillomavirus and herpes simplex virus infections in Greenland and Denmark: a population-based study

Risk factors for genital human papillomavirus (HPV) types 6/11 and 16/18 and any HPV type as well as for herpes simplex virus type 2 (HSV-2) infections were investigated in a population-based study of 1,600 randomly selected women (20-39 years) from Godth?b (native, Nuuk), Greenland, and Nyk?bing Falster, Denmark. A total of 586 Greenlandic women and 661 Danish women were included, respectively. They all had a personal interview and a gynecologic examination with cervical smear and swab for HPV analysis (filter in situ hybridization). Moreover, a blood sample was obtained for analysis for HSV-2 antibodies by enzyme-linked immunosorbent assay. In view of the general concept of HPV as a sexually transmitted virus, it is unexpected that women with "multiple" partners revealed a significantly lower risk for all types of HPV than did women with "few" partners, the odds ratio (OR) being 40-60% decreased in women with greater than or equal to 30 partners compared with women who had 0-4 sexual partners. In contrast, the risk for HSV-2 infection was significantly increased among women with early age at first sexual intercourse (OR = 2.9 for age less than or equal to 13 vs. 14-16 years) and multiple partners (OR = 2.6 for greater than or equal to 20 vs. 0-4 partners) (hereafter referred to as "high sexual activity" as well as with an increasing number of sexually active years with an unprotected cervix (i.e., without the use of barrier contraceptives) (OR = 2.0 for greater than or equal to 15 vs. 0-9 years). The results of this study thus demonstrate a surprising risk pattern for HPV types 6/11 and 16/18, but a pattern for HSV-2 in line with that to be expected for a sexually transmitted virus. This could indicate the existence of factors, especially in women with high sexual activity, which interfere with the expression of HPV or with the ability to detect it and/or that HPV may be transmitted by means other than sexual contact.     

Human papillomavirus type 18/16 infection and prevalence among middle-aged and older Chinese rural women: a cross-sectional survey in Wufeng,Hubei Province

This study aimed to measure the prevalence and potential factors related to HPV 16/18 infection among middle-aged and older Chinese rural women. The study was conducted among women aged 35–65 years in rural villages within Wufeng in Hubei Province. Data were collected using a pretested questionnaire between July and August 2015. Cervical specimens were collected for HPV DNA detection and typing by using careHPV. Pearson’s Chi-square and logistic regression analyses were used to examine associations with HPV positivity. Among 1001 participants, the prevalence of HPV 18/16 positive genotyping was 15.88% (n = 159). Husbands’ extramarital sex (adjusted odds ratio [OR] = 15.85, 95% confidence interval [CI] 5.76–43.59), cervicitis (adjusted OR = 9.27, 95% CI 5.06–16.99), condom usage (adjusted OR = 0.16, 95% CI 0.05–0.53), higher average number of live births (adjusted OR = 1.98, 95% CI 1.32–2.96 for two live births; adjusted OR = 3.29, 95% CI 1.39–7.81 for three or more live births) were associated with HPV infection. The prevalence of HPV infection among participating women from rural areas was higher than that in several other areas in China. Our findings can aid efforts to prevent HPV infection to lower the risk of cervical cancer.     

508例女性人乳头瘤病毒感染及相关因素分析

目的探讨人乳头瘤病毒(HPV)感染现状及感染相关因素,为预防和控制HPV感染提供理论依据。方法选取2009年1月至2010年12月于本院妇科门诊就诊的508例自愿接受宫颈HPV检查者为研究对象,取其宫颈脱落细胞标本,采用快速导流杂交技术HPVDNA检测法进行HPV基因型分型。并采用多因素Logistic回归模型分析,探讨HPV感染的相关因素,包括年龄、文化程度、初次性生活年龄、流产次数、性伴侣数、配偶伴侣数、吸烟史及避孕方式等(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,征得受试对象的知情同意)。结果本组508例受试者HPV总感染率为22.05%(112/508),其中高危型HPV(HR-HPV)感染率为18.90%(95/508),低危型HPV(LR-HPV)感染率为2.17%(11/508),中国人常见感染基因型为1.18%%(6/508)。508例受试者中,感染率最高的5种HPV基因型分别为HPV-16(7.68%)-52(4.72%),-58(3.74%),-18(3.15%),-31(2.36%)。影响HPV感染的相关因素为:初次性生活年龄、性伴侣数、配偶性伴侣数、流产次数及吸烟史(χ2=105.539,5.092,37.158,5.076,13.824;P<0.05),进一步行多因素非条件Logistic回归分析显示,初次性生活年龄(OR=13.036)、性伴侣数(OR=5.860)、配偶性伴侣数(OR=2.120)、吸烟史(OR=2.054)为影响HPV感染的独立危险因素(P<0.05)。结论不良的生活习惯及性行为是女性HPV感染的高危因素,改变不良生活习惯及性行为是预防HPV感染的有效手段。     

中国和澳大利亚妇女子宫颈上皮内瘤变人乳头瘤病毒感染和相关危险因素的病例对照研究

目的研究不同型别人乳头瘤病毒（HPV）感染及相关危险因素与子宫颈上皮内瘤变（CIN）发生的关系。方法对来自中国（中组）、澳大利亚（澳组）的212例CIN和427名正常妇女，进行相关危险因素的问卷调查，并采集相应的子宫颈标本，PCR方法检测HPV DNA，用直接测序法及条型反向杂交法鉴定HPV型别。运用logistic回归方法分析HPV感染及其他辅助因素对宫颈病变发生的相对危险度。结果中、澳对照组妇女的HPV感染检出率分别为11％和15％（P〉0．05）。常见型别为HPVl6、58、66、18、31、33、53和MM8等，10％为混合感染。澳组CIN患者的HPV感染检出率高于中组，分别为99％和85％（P〈0．001）；HPVl6型最为常见。中、澳组HPV感染致CIN的OR值分别为43．3和541．6。HPVl6的致瘤危险性最强；中组HPV58和59型次之；澳组HPV31型次之，且该组中HPV混合感染的相对危险度较高。多因素分析显示，在考虑了HPV感染之后，受教育程度（OR 3．88）、子宫颈癌家族史（OR 4．98）分别是中、澳两组妇女发生CIN的辅助危险因素。两组合并后，受教育程度（OR 4．02～5．15）和经常服用维生素（OR 0．40）是相关因素。结论HPV感染是中、澳两组妇女CIN发生的主要致病因素，不同HPV型别的危险性在两组妇女的子宫颈病变发生中存在一定差异，辅助危险因素也略有不同，提示在子宫颈病变防治中应有所侧重。     

人乳头状瘤病毒16 18、单纯疱疹病毒Ⅱ型和巨细胞病毒感染与宫颈癌发生、发展的关系

目的探讨人乳头状瘤病毒（HPV）16／18、单纯疱疹病毒Ⅱ型（HSV-Ⅱ）和巨细胞病毒（CMV）感染与宫颈癌发生、发展的关系。方法对43例宫颈癌、47例宫颈上皮瘤样病变（CIN）、56例宫颈炎和10例正常宫颈进行聚合酶链反应检测HPV16／18、HSV-Ⅱ和CMV感染情况。结果HSV-Ⅱ、HPV16／18和CMV的阳性率在宫颈癌和CIN组、CINⅢ级和CINⅠ～Ⅱ级组均有递减趋势，且差异有统计学意义。Ⅱ期宫颈癌组HPV16／18阳性显著高于Ⅰ期宫颈癌组，高分化宫颈癌组HPV16／18和HSV-Ⅱ阳性高于中分化组，与临床分期及组织类型差异均无统计学意义；CMV阳性与临床分期、组织分级及组织类型差异均无统计学意义。三种病毒感染拷贝数，HSV-Ⅱ和HPV16／18：宫颈癌〉CIN〉宫颈炎；CMV：宫颈癌〉CIN。宫颈癌中出现几种病毒混合感染，其中HPV16／18合并HSV-Ⅱ明显多于HPV16／18合并CMV者。结论HPV16／18、HSV-Ⅱ和CMV感染与宫颈癌的发生发展关系密切，且与病毒负荷量有关，可能是宫颈癌的致病因子。     

人乳头瘤病毒16早期基因E2和E6与核不均一核糖核蛋白E2在宫颈癌变中的作用及其交互效应

目的探讨人乳头瘤病毒(HPV)16早期基因E2和E6与核不均一核糖核蛋白(hnRNP)E2在宫颈癌变中的作用及其交互效应。方法研究对象来源于课题组在山西省介休市建立的"自然人群宫颈病变队列",以2014年6—9月经病理学确诊的正常宫颈(NC)女性、低度宫颈上皮内瘤变(CINⅠ)、高度宫颈上皮内瘤变(CINⅡ/Ⅲ)以及同期在山西医科大学第二医院确诊的宫颈鳞状细胞癌(SCC)病例为研究对象。共纳入257名研究对象,NC、CINⅠ、CINⅡ/Ⅲ、SCC组分别为67名(26.07%)、69例(26.85%)、68例(26.46%)、53例(20.62%)。采用问卷调查收集人口学特征、生活卫生习惯及宫颈病变相关信息,并采集宫颈脱落细胞和宫颈活检组织,检测HPV16的感染、hnRNP E2、HPV16 E2和E6的蛋白表达水平。根据NC组的hnRNP E2、HPV16 E2、E6蛋白表达量及E2/E6比值的M值,将研究对象分为高、低表达组/比值组,采用多因素logistic回归模型分析HPV16早期基因E2和E6、hnRNP E2与宫颈癌变的关联,并应用广义多因子降维模型(GMDR)评价其交互作用。结果NC、CINⅠ、CINⅡ/Ⅲ、SCC组的年龄分别为(47.00±9.07)、(47.64±7.35)、(46.37±8.67)和(51.26±8.03)岁。多因素logistic回归模型分析结果显示,HPV16 E2低表达、E6高表达及E2/E6低比值可导致CINⅡ/Ⅲ[OR(95%CI)值分别为11.11(1.63~75.56)、8.00(1.28~50.04)、9.75(1.22~77.72)]和SCC[OR(95%CI)值分别为14.22(2.11~95.88)、10.33(1.67~64.00)、12.38(1.56~97.91)]的患病风险增加;hnRNP E2低表达可导致CINⅡ/Ⅲ、SCC风险增加[OR(95%CI)值为3.35(1.39~8.10)、5.53(1.54~19.88)]。GMDR模型交互作用分析结果显示,hnRNP E2低表达、HPV16 E2低表达、HPV16 E6高表达在CINⅡ/Ⅲ和SCC组均存在交互作用(P值均<0.05)。结论HPV16早期基因的异常表达和hnRNP E2低表达均可能增加宫颈癌变的发病风险,且在宫颈癌变的发生发展中存在交互作用。     

高危型HPV持续感染对宫颈癌前病变进展的影响

目的探讨高危型HPV持续感染对宫颈癌前病变进展的影响。方法选取2014年1月-2017年1月天津市第五中心医院和兰州市第一人民医院诊治的420例高危型人乳头状瘤病毒(HPV)感染者作为研究对象,随访2年并记录宫颈癌前病变进展情况。其中HPV分型采用荧光PCR法检测;宫颈细胞学采用液基薄层细胞(TCT)检测,可疑异常者转诊阴道镜检查和或组织病理学检查。结果 420例高危HPV者中,其中初感染者中比例较高的是16型(100/420,23. 81%)、52型(75/420,17. 86%)、18型(70/420,16. 67%)和58型(64/420,15. 24%);HPV16型、18型和58型在初感染、持续1年感染和持续2年感染上比较,差异均有统计学意义(均P<0. 05)。随访2年,420例高危HPV感染中,进展组和维持/逆转组分别为40例和380例,两组持续感染率比较,差异有统计学意义(P<0. 05)。进展组和维持/逆转组初次性行为年龄和性伴侣人数比较,差异均有统计学意义(均P<0. 05),但年龄、初潮年龄、各阴道炎发生率比较,差异均无统计学意义(均P>0. 05)。将初次性行为年龄、性伴侣人数、高危HPV持续感染情况纳入Logistic多因素回归模型分析,发现高危HPV持续感染及HPV16型持续感染是导致病理进展的独立危险因素(P<0. 05),其相对风险分别为2. 183倍和1. 687倍。结论高危HPV感染可导致宫颈癌前病变,尤以高危HPV持续感染及HPV16型持续感染风险最大,临床应予以密切关注。     

Epidemiology and genotype distribution of human papillomavirus (HPV) in women of Sardinia (Italy)

The human papillomavirus (HPV) infection is necessary for the development of cervical cancer. Our study aims to evaluate the rate of HPV circulation in our population, to identify the prevalent genotypes and to establish correlation with cervical abnormalities. Furthermore, the awareness of women about HPV issues was investigated.This study included 864 women attending the Oncologic Prevention Service for their routine Pap test screening or the Health Promotion Mother-Child Service for counselling about sexual activity, from July 2006 to September 2007. All the participants gave their informed consent to be enrolled in the study and were invited to fill in a questionnaire about the socio-cultural state, sexual activity and awareness about HPV. The women samples were tested for HPV-DNA and HPV genotypes: any type of HPV-DNA was detected in 31.0% of the women; single or multiple infections sustained by HPV-16 or HPV-18 represented 43.5% of all HPV infections, accounting for infections in 11.8% of the recruited women. The HPV and high-risk HPV (HR-HPV) prevalence significantly declined in women older than 46 years. The Pap test result was available in 490 women; 48.1% of the Pap test positive women had also an HPV infection and among these 22.7% were infected by HPV-16 and/or HPV-18 genotype, while 51.9% (94/181) were HPV negative. The analysis by binary logistic regression showed that genotype 16 and/or 18 is a risk factor for the Pap positive test with a odds ratio (OR) of 2.9 (95% C.I. 1.4–5.9) and 3.6 (95% C.I. 1.58–8.42) respectively, while age is a protective factor (OR 0.97, C.I. 95% 0.96–0.99); furthermore, the mean age at the first sexual intercourse and the mean number of partners since the beginning of sexual activity, were statistically associated with the risk of HPV infection. More than half of women were aware about HPV, its sexual transmission and of its correlation with cervix cancer.Our findings evidenced that HPV infection is frequent in women aged 18–46 years in Sardinia and particularly that 16 and 18 HPV genotypes are detectable in more than 40% of the infected women. The proportion of women informed about HPV issues is sufficient to guarantee an aware approach to HPV vaccination.