持续感染状态的HPV-16及HPV-58亚型在宫颈上皮内瘤变及宫颈癌中的分布及意义

目的:研究呈持续感染状态的高危型人乳头瘤病毒(HPV-16,HPV-58)在宫颈病变患者中的分布情况及意义。方法:应用分子导流杂交技术分别检测10 477例慢性宫颈炎,3 672例宫颈上皮内瘤变,1 108例宫颈癌患者中呈持续感染状态的HPV-16和HPV-58的分布情况。结果:HPV-16持续性感染在慢性宫颈炎,CINⅠ,CINⅡ/Ⅲ中的阳性率依次为0.41%(95%CI,0.29%～0.53%),3.00%(95%CI,2.26%～3.74%),15.40%(95%CI,13.63%～17.17%),感染率呈逐渐升高趋势,差异有统计学意义(P<0.05)。HPV-58持续性感染在慢性宫颈炎,CINⅠ,CINⅡ/Ⅲ中的阳性率依次为0.56%(95%CI,0.42%～0.70%),2.66%(95%CI,2.36%～3.46%),6.92%(95%CI,5.68%～8.16%),感染率呈逐渐升高趋势,差异有统计学意义(P<0.01)。HPV-16持续性感染与宫颈癌各临床病理参数无明显联系,差异无统计学意义(P>0.05)。HPV-58持续性感染的宫颈癌患者发病年龄高于HPV-58机会性感染或未感染者,差异有统计学意义(P<0.05)。结论:HPV-16及HPV-58持续性感染在宫颈癌前病变发生、发展过程中发挥重要作用,二者有望成为预测CIN进展的风险评估指标。高危型HPV亚型的定期检测对宫颈病变的预测和防治有重要的指导意义。

Distributions and significances of HPV-16 subtype and HPV-58 subtype of persist infection state in cervical intraepithelial neoplasia and cervical cancer

Objective:To research the distributions and significances of high risk human papillomavirus(HPV)-16 subtype and HPV-58 subtype of persist infection state in the patients with cervical lesions.Methods:Molecular diversion hybridization technique was used to detect the distributions of HPV-16 subtype and HPV-58 subtype of persist infection state in 10 477 cases with chronic cervicitis,3 672 cases with cervical intraepithelial neoplasia(CIN),and 1 108 cases with cervical cancer.Results:The positive rate of HPV-16 subtype of persistent infection in chronic cervicitis group was 0.41%(95%CI: 0.29%-0.53%),the positive rate of HPV-16 subtype of persistent infection in CIN I group was 3.00%(95%CI: 2.26%-3.74%),the positive rate of HPV-16 of persistent infection in CINⅡ/Ⅲ group was 15.40%(95%CI: 13.63%-17.17%),the infection rate of HPV-16 subtype showed a gradual increasing trend,there was statistically significant difference among the three groups(P<0.05).The positive rate of HPV-58 subtype of persistent infection in chronic cervicitis group was 0.56%(95%CI: 0.42%-0.70%),the positive rate of HPV-58 subtype of persistent infection in CIN I group was 2.66%(95%CI: 2.36%-3.46%),the positive rate of HPV-58 subtype of persistent infection in CINⅡ/Ⅲ group was 6.92%(95%CI: 5.68%-8.16%),the infection rate of HPV-58 subtype showed a gradual increasing trend,there was statistically significant difference among the three groups(P<0.01).There was no significant correlation between persistent infection of HPV-16 subtype and various clinicopathological parameters(P>0.05).The onset age of cervical cancer in the patients with persistent infection of HPV-58 subtype was statistically significantly older than those in the patients with opportunistic infection of HPV-58 subtype or without HPV-58 subtype infection(P<0.05).Conclusion:Persistent infections of HPV-16 subtype and HPV-58 subtype play important roles in the occurrence and development of cervical precancerous lesion,HPV-16 subtype and HPV-58 subtype are promised to be risk evaluation indexes to predict the progress of CIN.Regular detection of high risk HPV subtypes has important directive significance for prediction,prevention,and treatment of cervical lesions.