HPV亚型在宫颈疾病中的分布特点

目的:探讨HPV亚型在宫颈疾病谱中,即从正常宫颈(慢性宫颈炎)、宫颈上皮内瘤变(CINⅠ、CINⅡ和CINⅢ)到宫颈癌连续发展中的分布特点。方法:回顾分析2005年6月～2008年6月在我院妇科因宫颈疾病就诊的189例患者HPV亚型检测的结果。结果:HPV总感染率56.1%(106/189),复合感染率22.6%(24/106)。正常者HPV感染率19.1%(12/63),检测到的HPV亚型主要是HPV52,58,53,16和33。CINⅠ者HPV感染率57.9%(22/38),最常见的HPV亚型是HPV52,其次是HPV58,16,33和18。CINⅡ者HPV感染率70.5%(31/44),HPV52,16,58,33和18等亚型最常见。CINⅢ者HPV感染率89.3%(25/28),HPV亚型以HPV16,52,58,31,33为主。宫颈癌患者,HPV阳性率100%(16/16),HPV16检测率最高,其次是HPV18,52,58和33。结论:宫颈疾病谱中最常见的高危型HPV亚型是HPV16。不同宫颈病变中HPV亚型感染的差异可能反映了其潜在转归能力,同时提示临床医师应关注宫颈疾病患者高危HPV亚型情况。

Type specific distribution of HPV along the full spectrum of cervical diseases

Objective:To explore the distributional trend of different types of human papillomavirus(HPV) along with the spectrum of cervical diseases from normal cervical(including chronic cervicitis),cervical intraepithelial neoplasia 1(CINⅠ),cervical intraepithelial neoplasia 2/3(CINⅡ/Ⅲ) to cervical cancer(CC).Methods:HPV gene types of 189 cases who got cervical disease between June,2005 and June,2008 were analyzed retrospectively.Results:The rate of HPV-infection was 56.1%(106/189),multiple infection rate was 22.6%(24/106).The prevalence of HPV infection in the normal,CINⅠ,CINⅡ,CINⅢ and CC was 19.1%(12/63),57.9%(22/38) 70.5%(31/44),89.3%(25/28) and 100%(16/16),respectively.The order of type-specific prevalence was HPV52,HPV58,HPV53,HPV16 and HPV33 in the normal,HPV52,HPV58,HPV16,HPV33 and HPV18 in CINⅠ;HPV52,HPV16,HPV58,HPV33 and HPV18 in CINⅡ,HPV16,HPV52,HPV58,HPV31 and HPV33 in CINⅢ while the distribution order in CC was HPV16,followed by HPV18,HPV52,HPV58 and HPV33.Conclusion:The most common high risk HPV subtype in the spectrum of cervical diseases is HPV16.The step-wise distributional changes of HPV types along with the cervical diseases spectrum reflect their transformational capability at different steps of cervical carcinogenesis and will call clinical physician attention to high risk HPV type.