四川地区HPV亚型及多重感染与宫颈癌前病变的关系初探

目的 检测四川地区HPV不同亚型及多重感染在不同宫颈病变中的感染情况，评价多重感染与宫颈癌前病变〔宫颈上皮内瘤变（CIN）〕的关系。方法 回顾分析2006年6月至2012年5月在我院门诊就诊的1 226例宫颈病变患者（均有病理活检结果），采用PCR-反向点杂交法检测HPV 23种亚型均为阳性结果，分为宫颈炎组、宫颈湿疣组、CINⅠ组、CINⅡ组、CINⅢ组进行分层分析。结果 ①宫颈炎组、宫颈湿疣组、CINⅠ组分别与CINⅡ、CINⅢ组相比较，低危型HPV构成比增加（P<0.01），高危型HPV构成比降低（P<0.05）。 ②宫颈湿疣组低危型HPV感染主要为HPV6、HPV11，其他4组主要为HPV42、HPV43。③高危型HPV感染前4位为HPV58、HPV16、HPV52、HPV18，宫颈炎组HPV16型的构成比（11.0%）低于CINⅡ（20.3%）和CINⅢ组（20.2%）（P<0.01），HPV58型的构成比（15.9%）低于CINⅡ组（21.4%）（P<0.05）。④宫颈湿疣组HPV多重感染率（68.8%）高于宫颈炎组（23.1%）、CINⅠ组（26.1%）、CINⅡ组（27.8%）、CINⅢ组(27.1%)，差异均有统计学意义（P<0.01）；而后4组间差异没有统计学意义（P>0.05）。结论 四川地区HPV病毒感染有一定的地域性特点，各种宫颈病变中低危型主要为HPV42、HPV43， 高危型主要为HPV58、HPV16、HPV52、HPV18， 病毒的多重感染似乎并不是导致宫颈病变进展的重要因素。

Relationship of Human Papillomavirus Subtypes and Multiple Infection with Different Cervical Precancerous Diseases in Sichuan Province

Objective To investigate the relationship of human papillomavirus (HPV) subtypes and multiple infections with different cervical precancerous diseases. Methods Retrospective study was done to review 1 226 patients with different cervical lesions who were pathologically diagnosed and scanned for HPV 23 subtypes with positive results from June 2006 to May 2012. These patients were divided into the following groups, chronic cervicitis, cervical condyloma, cervical intraepithelium neoplasia grade Ⅰ（CINⅠ） , grade Ⅱ(CINⅡ)，gradeⅢ (CINⅢ). Results There were significant differences in the proportion of HPV low risk types and high risk types between cervicitis, condyloma, CINⅠgroup and CINⅡ+Ⅲ groups （P<0.05）. HPV low risk types in condyloma group were mainly 6 and 11 subtype, while the other four groups were 42 and 43 subtype. The four most prevalence high risk types were 58，16，52，18 subtype. The infection rates of HPV16 were significant different in cervicitis（11.0%）, CINⅡ（20.3%）, and CINⅢ （20.2%）(P<0.01), and the infection rates of HPV58 was quite different between cervicitis （15.9%） and CINⅡ（21.4%）(P<0.05). HPV multiple infection rate in condyloma （68.8%） was significant different from that of cervicitis （23.1%）, CINI （26.1%）, CINⅡ（27.8%）and CINⅢ (27.1%)（P<0.01）；while the rest four groups were not significantly different （P>0.05）. Conclusion There is a unique epidemiologic characteristic of HPV infection in Sichuan Province. The HPV low risk types were mainly 42 and 43, and high risk types were mainly 58,16,52,18. It seems that HPV multiple infection is not the leading cause of progression of cervical disease.