人乳头瘤病毒基因型与宫颈上皮内瘤样病变的关系

目的:通过研究各级别宫颈上皮内瘤变中所感染HPV的基因型,来探讨不同基因型HPV的致病力。方法:对225例经活检证实的宫颈上皮内瘤变(CIN)患者的HPV检测结果进行分组分析,根据病变级别分为CIN I、Ⅱ、Ⅲ3组。225例CIN患者均有细胞学检查结果,HPV检测采用亚能HPV基因分型检测系统进行23种HPV-DNA亚型分析。结果:HPV-16和58亚型感染位居各级别宫颈病变的前两位,两者感染率占48·4%;本组CIN病例HPV亚型感染频度由高到低依次为HPV-16(30·2%)、58(18·2%)、33(8·6%)、18(7·1%)、56(4·9%)、31(4·4%)、11(3·2%)、35(2·2%)、45(1·6%)、6(1·6%)、52、59、68、43、39、66、73、83、42型;HPV-16(57·3%)、58(21·4%)、18(10·7%)、31(9·8%)、35(7·1%)、56(3·6%)亚型居CINⅢ组的前6位,说明这些亚型致病力强,更易导致宫颈的高级别病变;在CINI~Ⅲ级病变中HPV二重或三重感染分别占19·4%、27·9%和16·7%,提示HPV双重或多重感染与宫颈病变级别之间无正相关性。结论:本组CIN患者HPV感染的常见亚型是16、58、33、18、56、31,易导致宫颈高级别病变的亚型是16、58、18、31、35、56,HPV-DNA的分型检测对预测病变进展、评估预后、指导治疗有重要价值。

Relationship Between Human Papillomavirus Genotype and Cervical Intraepithelial Neoplasia

Objective:To investigate the human papillomavirus ( HPV ) genotype detected in patients with cervical intraepithelial neoplasia ( CIN ) and to analyze the pathogenicity of the various HPV genotypes.Methods:The result of HPV detected in 225 patients with CIN confirmed by biopsy was analyzed in group. According to different cervical disease, they were divided into three group: CIN I、Ⅱ、Ⅲ. All the 225 patients had cytological results. Sub-HPV-genotyping system was applied to determine the 23 HPV-DNA types.Results:In different cervical diseases, HPV-16 and 58 are the most common, the infection rate is 48.4% both. The prevalence of HPV types in CIN from highest to lowest order were follow: HPV-16 ( 30.2% ), 58 ( 18.2% ), 33 ( 8.6% ), 18 (7.1% ), 56 ( 4.9% ), 31 ( 4.4% ), 11 ( 3.2% ), 35 ( 2.2% ), 45 ( 1.6% ), 6 ( 1.6% ), 52 , 59 , 68 , 43 , 39 , 66 , 73 , 83 , 42 ; HPV-16 (57.3%) , 58 ( 21.4% ) , 18 (10.7% ) , 31(9.8% ) ,35(7.1% ),56(3.6% ) , were the top six in CIN Ⅲ , which demonstrated the oncogenesis is stronger and more likely to lead to higher grade disease in cervices. Double or multiple HPV type infection in CIN I～Ⅲ occurred at 19.4% , 27.9% , and 16.7% respectively. It hints that double or multiple HPV type no positive relation with different cervical diseases.Conclusion:HPV-16 , 58 , 33 , 18 , 56 , 31 are the most common in patients with CIN, HPV-16 , 58 , 18 , 31 , 35 , 56 have move tendency to lead to higher grade disease in cervices. HPV-DNA genotyping is of great importance in foreseeing progress, assessment of prognosis and instruction of therapy.