高危型人乳头瘤病毒感染与宫颈病变的关系

目的探讨宫颈病变与高危型人乳头瘤病毒(HR-HPV)感染的关系。方法对572例妇科门诊患者,用液基细胞检测法(TCT)检测宫颈外口及颈管脱落细胞,第2代杂交捕获试验(HC-Ⅱ)检测HR-HPV DNA。对HR-HPV阳性及TCT阳性病例进行阴道镜下定位活检,以病理学结果为确诊标准。结果在572例样本中,TCT检测阳性51例,阳性率8.9%,其中非典型鳞状细胞(ASC)26例,低度鳞状上皮内病变(LSIL)15例,高度鳞状上皮内病变(HSIL)9例,鳞状细胞癌(SCC)1例。HR-HPV DNA阳性者178例,阳性率31.1%。HR-HPV在宫颈未见上皮内病变(NILM)和TCT阳性患者中的感染率分别为27.1%和72.5%,二者比较差异有统计学意义(P<0.05)。201例行阴道镜下宫颈多点活检,病理结果显示:良性病变85例(42.3%),宫颈上皮内瘤样病变(C IN)115例(57.2%),宫颈鳞癌1例(0.5%)。随着病变程度加重,HPV阳性率逐渐增高(P<0.05)。结论HR-HPV感染与宫颈病变及其严重程度密切相关。

Relationship between high-risk human papilloma virus infection and cervical lesions

Objective To explore the relationship between cervical lesions and high-risk human papilloma virus （HR-HPV） infection. Methods Exfoliated cells from external orifice of uterus and neck tube were detected with thin-prep cytology test （TCT）, and HR-HPV DNA was detected with hybrid capture Ⅱ （HC-II） method in 572 gynecology clinical patients. Then cervical biopsy under colposeope was obtained from HR-HPV and TCT positive cases, and the results of histopathologic tests were the final diagnoses. Results In the 572 cases, TCT positive cases were 51, the positive rate was 8.9%, among which atypical squamous cells （ ASC ） were 26 cases, low grade squamous intraepithelial lesion （LSIL） were 15 cases,high grade squamous intraepithelial lesion（HSIL） were 9 cases and squamous cell carcinoma（ SCC）was 1 case. HR-HPV DNA in 178 cases were positive,HR-HPV DNA positive rate was 31.1%. The infection rates of HR-HPV in no intraepithelial lesion or malignant lesions （NILM） and TCT positive patients were 27.1% and 72.5 % respectively （ P 〈 0. 05 ）. The multi-point cervical biopsy under colposeope were tested in 201 cases, with the histopathologic finding： benign lesions were 85 cases （42. 3% ） ,cervical intraepithelial neoplasm（CIN） were 115 cases（57. 2% ） ,and squamous carcinoma of the cervix was 1 ease （0.5%）. When cervical lesions became more serious, HPV positive rate were gradually increased （P 〈 0. 05 ）. Conclusion There is significant correlation between HR-HPV infection and cervical lesion and severity of cervical lesions.