临沂地区女性宫颈鳞癌和癌前病变组织中高危型HPV感染状况分析

目的分析临沂地区宫颈鳞癌和癌前病变组织中高危型人乳头瘤病毒(HR-HPV)的感染状况和分布特点,以期为临沂地区宫颈癌防治和疫苗接种提供一定的理论依据。方法选取2017年2月—2018年9月临沂市人民医院病理科诊断的宫颈鳞癌和癌前病变活检或手术切除标本191例,应用聚合酶链式反应(PCR)结合Taqman技术对其进行15种高危型HPV分型检测。结果191例患者中,共检出HR-HPV阳性患者164例,HR-HPV总感染率为85.86%,感染率随宫颈病变程度加重而升高,其中宫颈鳞癌组HR-HPV感染率最高(53/56,94.64%),低级别鳞状上皮内病变(LSIL)组与高级别鳞状上皮内病变(HSIL)组HR-HPV感染率分别为67.92%(36/53)和91.46%(75/82)。LSIL组与HSIL组HR-HPV感染率比较差异具有统计学意义(χ²=12.203,P=0.000),LSIL组与宫颈鳞癌组HR-HPV感染率比较差异具有统计学意义(χ²=12.974,P=0.000)。感染频次前5位的HPV型别依次为HPV16(107/208,51.44%)、HPV58(21/208,10.10%)、HPV52(14/208,6.73%)、HPV18(12/208,5.77%)、HPV31(11/208,5.29%)。<30岁组LSIL所占比例最高(59.09%);HSIL在30~39岁组、40~49岁组及50~59岁组所占比例均最高,分别为48.15%、40.00%及46.67%;≥60岁组宫颈鳞癌所占比例最高,为66.67%。164例HR-HPV阳性宫颈病变患者均以单一型别HPV感染为主,其中HSIL组单一感染率最高(64/75,85.33%)。结论临沂地区宫颈鳞癌和癌前病变组织中最常见的HR-HPV感染亚型为HPV16、58、52、18、31,HR-HPV感染尤其是HPV16、58感染与宫颈鳞癌和癌前病变的发生、发展密切相关,应重点加强对该人群的健康管理。

Analysis on high-risk human papillomavirus infection in cervical squamous cell carcinoma tissue and precancerous lesion tissue in Linyi region

Objective To analyze the infection status and distribution characteristics of high-risk human papillomavirus(HR-HPV)in cervical squamous cell carcinoma tissue and precancerous lesion tissue in Linyi region,provide a certain theoretical basis for prevention and treatemnt of cervical cancer and vaccination in Linyi region.Methods From February 2017 to September 2018,191 specimens of cervical squamous cell carcinoma tissue and precancerous lesion tissue after biopsy or surgical resection were selected,and polymerase chain reaction(PCR)combined with Taqman technique were used for 15 kinds of high-risk HPV genotyping.Results Among 191 cases,164 cases were found with positive HR-HPV,and the total infection rate was 85.86%,which increased with aggravation of cervical lesions.The infection rate in cervical squamous cell carcinoma group was the highest(53/56,94.64%),and the infection rates in low-grade squamous intraepithelial lesion(LSIL)group and high-grade squamous intraepithelial lesion(HSIL)group were 67.92%(36/53)and 91.46%(75/82),respectively.There was statistically significant difference in infection rate of HR-HPV between LSIL group and HSIL group(χ²=12.203,P=0.000),and also between LSIL group and cervical squamous cell carcinoma group(χ²=12.974,P=0.000).The top five HPV types with infection frequency from high to low were HPV16(107/208,51.44%),HPV58(21/208,10.10%),HPV52(14/208,6.73%),HPV18(12/208,5.77%),and HPV31(11/208,5.29%).Among the cases under 30 years old,the proportion of LSIL was the highest(59.09%).The proportions of HSIL in 30-39-year-old group,40-49-year-old group,and 50-59-year-old group were the highest,which were 48.15%,40.00%,and 46.67%,respectively.In≥60-year-old group,the proportion of cervical squamous cell carcinoma was the highest(66.67%).Among 164 cases with positive HR-HPV,single type HPV infection was the main type,and the rate of single type HPV infection was the highest in HSIL group(64/75,85.33%).Conclusion The most common HR-HPV infection subtypes in cervical squamous cell carcinoma tissue and precancerous lesion tissue in Linyi region were HPV16,58,52,18,and 31,respectively.HR-HPV infection is closely correlated with occurrence and development of cervical squamous cell carcinoma and precancerous lesion,especially HPV16,58,health managemnt of the population should be enahnced.