内蒙古地区宫颈癌患者人乳头瘤病毒16感染分型及其人类白细胞抗原-DRB1、人类白细胞抗原-DQB1基因多态性的关系

目的探讨人乳头瘤病毒(HPV)16感染与宿主人类白细胞抗原(HLA)-DRB1、HLA-DQB1等位基因和宫颈癌发生的相关性。方法以聚合酶链反应(PCR)和多重PCR法检测30例宫颈癌、38例正常宫颈组织HPV感染及型别分布;以PCR-SSP法对22例HPV16阳性宫颈癌及35例HPV阴性正常宫颈组织进行HLA-DRB1、HLA-DQB1基因分型。结果HPV16阳性宫颈癌组与HPV阴性正常对照组比较,HLA-DRB1*15、HLA-DQB1*0301/9,10、HLA-DQB1*06基因表型频率显著增加(P<0.05),经统计学校正后,仅HLA-DRB1*15、HLA-DQB1*06等位基因与HPV16阳性宫颈癌之间呈正相关(分别为OR=3.61,95%CI=1.03~13.08;OR=3.63,95%CI=1.03~13.23)。结论HLA-DRB1*15、HLA-DQB1*06等位基因增加了HPV16阳性妇女患宫颈癌的危险性。     

一、二代光敏剂光动力疗法在宫颈上皮内瘤变中的应用

宫颈癌是发病率最高的妇科恶性肿瘤[1],宫颈上皮内瘤变(cervical intraepithelial neoplasm,CIN)是宫颈癌的癌前病变,分为CIN1 ～3三级病变,主要由人类乳头瘤病毒(human papilloma virus,HPV)感染导致[2].目前的指南及共识[3]认为CIN1多为HPV一过性...     

细胞学阴性检出宫颈高级别病变的临床分析

目的 探讨细胞学筛查阴性者发生宫颈高级别病变的危险因素.方法 回顾性分析厦门大学附属妇女儿童医院401例细胞学检查阴性而阴道镜检查检出宫颈高级别上皮内瘤样病变的患者,对其年龄、人乳头瘤病毒(HPV)感染状态、性伴侣数、孕产史及转化区类型进行分析.结果 在宫颈高级别上皮内瘤样病变液基细胞学漏检的患者中,通过阴道镜下活检结...     

女性性工作者宫颈人乳头状瘤病毒感染特征分析

人乳头状瘤病毒（humanpa pillomavirus，HPV）感染是宫颈癌和癌前病变的主要致病因子。目前已经分离出100多种HPV亚型，其中感染生殖道上皮细胞的有40余种。根据致病力的不同，HPV被分为高危型和低危型。不同亚型的HPV感染其致病性不同，其中高危型HPV持续感染与宫颈癌的发生最为密切，是导致宫颈癌发生的主要因素心。我国女性性工作者HPV感染特征的评估较为困难。本研究通过对浙江省湖州地区女性性工作者和普通人群的宫颈HPV感染状态调查，分析本地区女性性工作者和普通人群HPV感染特征。     

HPV 与宫颈癌的研究现状

宫颈癌的发生是多种致癌因素长期协同作用的结果.人乳头瘤病毒(HPV)与宫颈癌的发生密切相关,是引起宫颈癌的主要生物学因素.随着科学技术水平的发展,对HPV导致宫颈癌发生的基因特征和致癌机制进行了大量研究.本文综述了近年来HPV主要型别与宫颈病变之间的关系、致癌机制以及宫颈癌疫苗方面的研究现状.     

高危型人乳头状瘤病毒的感染状态及分型与宫颈病变发生的相关性研究

目的检测高危型人乳头状瘤病毒(HR-HPV)的感染状态与宫颈病变的发生及发展的相关性。方法对我院门诊2 876例妇女采用液基薄层细胞检测(TCT)、第二代杂交捕获法技术(HC2)-HPV-DNA检测及HPV分型检测,以TCT细胞学正常及高危型HPV阳性的妇女295人为目标人群,随访重复TCT细胞学和HPV基因分型,并对TCT细胞学异常的妇女进行阴道镜下宫颈组织活检。分析不同HPV感染型别、感染状态(持续性感染、间断性感染及感染清除)的TCT异常和宫颈病理异常的发生情况。结果目标群体随访1年,持续性HPV感染的女性与HPV感染清除或间断性感染的妇女相比宫颈病变的发生率无显著差异(P0.05);目标群体随访2年,持续性HPV感染女性比HPV感染清除或间断性感染妇女有更高的宫颈病变发生率(P0.01)。多重HPV感染并不比单一型别感染有更高的宫颈病变发生率(P0.05)。高危型HPV16和HPV18持续感染发生率高,且宫颈病变的发生率增加(P0.05)。结论持续性HPV感染2年以上,尤其HPV16及HPV18的持续性感染,发生宫颈病变的风险明显增加。高危HPV型别及感染状态的甄别更有临床指导意义。     

人乳头瘤病毒感染免疫逃逸机制的研究进展

<正>宫颈癌是全球妇女第二常见的恶性肿瘤,它是第一个被WHO认为100%与人乳头瘤病毒(human papilloma virus,HPV)感染有关的癌症。人乳头瘤病毒高危亚型(如HPV16型、HPV18型)感染与宫颈癌的关系最为密切。HPV逃逸宿主的免疫清除并发展为持续感染是宫颈癌发生的最危险因素,免疫逃逸导致的病毒清除障碍是HPV持续感染的关键环节[1]。本文就HPV感染的免疫逃逸机制及相关研究进展综述如下。     

人乳头状瘤病毒在中晚期宫颈癌患者同步放化疗疗效监测中的临床意义

宫颈癌的发病率在全世界女性恶性肿瘤中居第二位,在发展中国家居首位,尤其是年轻妇女宫颈癌发病率近年来有上升趋势。高危型人乳头瘤病毒（HPV）生殖道持续感染是宫颈癌发生和发展的重要因素。目前国内外研究较多的是HPVDNA在宫颈癌早期筛查中的应用及在宫颈上皮内瘤变手术前后的变化,     

5-氨基酮戊酸光动力治疗宫颈人乳头瘤病毒感染的护理体会

人乳头瘤病毒（human papilloma virus,HPV）感染除可引起女性尖锐湿疣外,宫颈HPV的感染尤其是“高危型”HPV感染是导致宫颈癌及其癌前病变的必要因素[1]。近年来,随着HPV感染率的逐年增高,宫颈鳞状上皮内瘤变（cervical intraepithelial neoplasia,CIN）和宫颈癌的发病率也随之增高并越来越年轻化[2],在临床上常用的激光、冷冻和微波等物理疗法治疗HPV引起的尖锐湿疣,但其对HPV临床感染治疗作用有限,本科室对48例女性宫颈HPV感染者尝试用光动力疗法（photodynamic therapy,PDT）治疗,取得了满意的疗效,现报道如下。     

女性HPV感染者配偶阴毛毛囊人乳头瘤状病毒调查分析

目的:探讨男性阴毛毛囊人乳头瘤状病毒(HPV))感染与女性配偶HPV感染的关系。方法:女性HPV感染者21例,其中有8例宫颈癌,5例宫颈不典型增生,5例尖锐湿疣,3例原因不明。本文用PCR体外扩增和DNA反向点杂交相结合的DNA芯片技术对其男性配偶的阴毛毛囊进行HPV检测。结果:女性21例病例中发现其配偶阳性6例,感染率为28.6%。6例男性病例中,HPV亚型与其女性感染的HPV亚型基本一致。结论:男性阴毛毛囊HPV感染可能是配偶HPV感染的感染源之一。     

HPV疫苗预防宫颈癌的应用研究

宫颈癌是女性常见的恶性肿瘤,严重威胁着全世界女性的健康。研究表明高危型HPV的持续感染是诱发宫颈癌的关键因素。随着预防医学研究的推进,HPV预防性疫苗得以问世,并已在全世界诸多国家上市使用,使得未来宫颈癌的预防成为可能。目前已上市的HPV预防性疫苗包括四价疫苗Gardasil、二价疫苗Cervarix、九价疫苗Gardasil 9。本文对HPV预防性疫苗的应用研究进行系统阐述。     

安徽地区17 160例健康体检女性人乳头瘤病毒感染状况及基因分型

目的探讨安徽地区健康体检女性感染人乳头瘤病毒（HPV）发生率及病毒亚型分布，为宫颈癌的防治提供依据。 方法采用聚合酶链反应（PCR）反向点杂交技术对2018年4月至2018年12月合肥金域医学检验实验室有限公司接收的不同年龄段的健康体检女性宫颈脱落细胞样本进行HPV基因分型检测，根据基因型检测结果分析HPV及其亚型在女性人群中的潜在感染率、各基因型检出率和不同年龄段分布。 结果17 160例健康女性体检样本中，HPV基因检测阳性者共2 990例，总阳性率为17.42%（2 990/17 160）。17种高危型和6种低危型HPV均被检出。其中单一基因型检出者占73.71%（2204/2 990），二重基因型检出者占19.03%（569/2 990），三重基因型检出者占5.55%（166/2 990），四重（43例）、五重（7例）和六重（1例）基因型检出共占1.71%（51/2 990）。2 204例单一基因型感染样本中，高危型感染者1 829例（82.99%）。常见的高危HPV亚型依次为HPV52（20.07%、367/1 829）、HPV16（16.84%、308/1 829）、HPV53（9.84%、180/18 29）、HPV18（8.26%、151/1 829），此4种高危型HPV检出率占总高危型的55.00%（1 006/1 829）；其他13种高危型HPV分布于其他823例患者。低危型HPV共检出375例，以HPV81亚型最常见（40.00%、150/375），其次为HPV42亚型（22.13%、83/375）和HPV43亚型（17.33%、65/375）。其他3种低危型分布于其余23例患者。二重HPV感染者中，均为高危亚型感染者390例（68.54%），均为低危亚型感染者10例（1.76%），高低危亚型混合感染者169例（29.70%）。三重感染中，高危亚型感染者73例（43.98%），低危亚型感染者2例（1.20%），高低危亚型混合感染者91例（54.82%）。四重及以上HPV感染中，高危亚型感染22例（43.14%），低危亚型感染0例（0.00%），高低危混合感染29例（56.86%）。无论单一HPV感染还是多重HPV感染，均以高危型HPV感染为主。21～25岁、26～30岁、31～35岁、36～40岁、41～45岁、46～50岁、51～55岁、56～60岁、≥ 61岁年龄组体检者HPV阳性检出率差异有统计学意义（χ² = 28.701、P < 0.001）。 结论安徽地区健康体检女性HPV感染以单一感染和高危感染为主，高危型HPV感染率从高至低依次为HPV52、HPV16、HPV53和HPV18；不同年龄分层HPV感染率存在差异。     

Human papillomaviruses in urological malignancies: A critical assessment

ObjectivesInfection with human papillomaviruses (HPVs) is intimately associated with anogenital tract malignancies including cervical and vulvar cancer, a subset of oropharyngeal cancers and certain types of skin cancer. A number of urological tumors have likewise been suggested to be associated with high-risk HPV infection; however, many studies are hampered by a limited number of detection methods. The goal of this review article is to define a set of key criteria when implicating a virus in a human cancer and to apply these criteria to HPV infection in urological cancers.Materials and methodsWe performed a survey of the literature to corroborate the evidence to support a causal relationship between HPV infection and major urological malignancies.ResultsA number of previous reports have implicated HPVs in urological malignancies including penile, prostate, and bladder cancer. Most reports, however, rely only on a limited number of detection methods and frequently use contamination-prone polymerase chain reaction based methods. To firmly establish a link between a viral infection and a human malignancy, it is paramount that an array of techniques is employed and that the virus is ultimately traced by either direct visualization or, in the case of viral genome that has integrated into the host genome, detection of viral genes and gene products as well as functional cellular perturbations. In any case, seroepidemiological studies are likewise crucial to support the evidence. Such evidence for a role of HPV in urological malignancies based on currently available techniques is only present for penile squamous cell carcinomas.ConclusionsAn increasing number of immunocompromised patients as well as novel developments in patient care may change the spectrum of HPV-associated neoplasms. This is examplified by results demonstrating a role of HPVs in rare urothelial carcinomas with squamous differentiation in patients with neurogenic bladder. Hence, it is important to keep HPV infection in mind when confronted with unusual disease manifestations of the urogenital tract.     

某医院机会性筛查女性人乳头瘤病毒感染流行病学分布及对人乳头瘤病毒疫苗认知调查

目的调查医院门诊机会性筛查女性人乳头瘤病毒（HPV）感染流行病学分布和对预防性疫苗的认知情况,为本院宫颈病变防治提供依据。 方法收集2017年1月至2017年12月于湖北医药学院附属随州医院妇科门诊行HPV筛查的女性患者的流行病学资料,采用问卷调查以了解其对HPV感染及疫苗接种的认知情况。 结果本院门诊机会性筛查女性HPV感染率为16.55%（143/864）。不同年龄组女性HPV感染率差异有统计学意义（χ² = 23.61、P < 0.001）。HPV感染基因型以单一型感染多见（73.43%）;多重感染占26.57%（38/143）;高危型感染占70.63%,以HPV 16型、58型和52型多见,低危型占29.37%,以HPV 81型、11型和42型多见。在问卷调查中,女性对于HPV感染的认知与年龄和文化程度有关（χ² = 70.89、70.63,P均< 0.001）,与居住地无关（χ² = 1.85、P = 0.17）。27.39%（309/1 128）人群知晓HPV感染,20.12%（227/1 128）知晓HPV疫苗,37.59%（424/1 128）人群愿意接种HPV疫苗,其中仅12%（51/424）愿意自费接种;疫苗价位是影响HPV疫苗接受度的主要因素。 结论本医院机会性筛查女性人群HPV感染率较高,同时对HPV认知和预防意识较低。应加强HPV筛查的普查力度,积极推广HPV疫苗的知晓率和接受度。     

流式细胞术在高危16型和18型人乳头状瘤病毒感染诊断中的价值

目的探讨流式细胞技术在高危16型、18型人乳头状瘤病毒（HPV）感染诊断中的临床价值。 方法选取2013年1月至2017年1月于深圳市人民医院筛查的200例女性作为研究对象,征得所有受试者知情同意后对其行流式细胞技术诊断和荧光定量聚合酶链式反应（FQ-PCR）诊断,比较两种方法的诊断价值。 结果两种诊断方法下正常者、宫颈上皮内瘤变（CIN）Ⅰ期者16型和18型HPV E6蛋白阳性率差异无统计学意义（P均> 0.05）;流式细胞技术诊断CIN Ⅱ期、Ⅲ期、宫颈癌者阳性率低于荧光PCR诊断,差异有统计学意义（P均< 0.001）。流式细胞技术诊断≥ CIN Ⅱ宫颈病变的敏感度、特异度和准确率分别为87.5%（35/40）、98.2%（157/160）和96.0%（192/200）;荧光定量PCR诊断≥ CIN Ⅱ宫颈病变的敏感度、特异度和准确率分别为85.0%（34/40）、96.9%（155/160）和94.5%（189/200）,差异均无统计学意义（P均> 0.05）。 结论流式细胞技术操作简便,可有效避免样品交叉感染所致的假阳性,提高HPV感染诊断的准确性。     

Infections of the Genital Tract: Human Papillomavirus–Related Infections

ContextThe human papillomaviruses (HPVs) are a major global health burden, playing a part in diseases ranging from genital warts to malignancies such as penile cancer in men and cervical cancer in women.ObjectiveTo explore the molecular biology and epidemiology of HPV infection; the diseases linked to it; and current prevention strategies, including the potential role of vaccination.Evidence acquisitionThe relevant papers, reviews, and guidelines pertaining to the topics were collected for the purpose of this review from PubMed and online guidelines resources including the European Association of Urology and the Centers for Disease Control and Prevention.Evidence synthesisThe current knowledge on genital HPV in men is explained and summarised.ConclusionsThere is an urgent need for more data on the incidence and persistence of HPV at the different anatomic sites, the incidence of external genital lesions, and the types of HPV in these lesions. This will allow a more comprehensive understanding of the natural history of HPV infection and its progression to both benign and malignant disease in men and will help formulate the development and implementation of vaccination programs.Patient summaryThis review explores the molecular biology and epidemiology of human papillomavirus (HPV) infection; the diseases linked to it; and current prevention strategies, including the potential role of vaccination. There is an urgent need for more data on the incidence and persistence of HPV at the different anatomic sites, the incidence of external genital lesions, and the types of HPV in these lesions.     

Low prevalence of human papillomavirus infection of the cervix in renal transplant recipients

BACKGROUND.: An increased risk of anogenital tract malignancies has beennoted among renal transplant recipients. A high prevalence ofhuman papillomavirus (HPV) infection of the cervix in the femalerenal-transplant population has been assumed based on increasingevidence suggesting that HPV infection is the major risk factorfor cervical intraepithelial neoplasia (CIN) and cervical cancer.It has been assumed that immunosuppression leads to either areactivation of latent HPV or a reduction in the host's abilityto contain a primary HPV infection, thereby increasing the riskof CIN and cervical cancer. The objective of this study wasto evaluate the prevalence of human papillomavirus (HPV) infectionin a population of iatrogenically immunosuppressed renal transplantrecipients. METHODS.: Twenty-one women were recruited from the renal transplant clinicat Presbyterian Hospital and underwent a gynaecological examinationwhich included colposcopy, a Papanicolaou smear, and a cervicovaginallavage. Lavage samples were analysed for HPV DNA using L1 consensusprimers and the polymerase chain reaction (PCR). RESULTS.: No cases of cervical intraepithelial neoplasia (CIN) were detectedin this cohort of 21 immunosuppressed renal transplant recipients.HPV DNA was detected in only a single patient. CONCLUSIONS.: Our data suggests that HPV infection is not highly prevalentamong older, cytologically normal renal transplant recipients,particularly those who are currently monogamous or not presentlysexually active. This study suggests that recent sexual behavioursare more important than past behaviours as a determinant ofHPV status in transplant recipients, and also suggests thateducation concerning the avoidance of high-risk sexual behaviouris an important part of the care of the female renal transplantrecipient. Our data is consistent with previous work suggestingthat the incidence of CIN is declining in transplant recipients,and it also suggests that the prevalence of HPV infection maybe declining as well.     

Anti-papillomavirus vaccines and prevention of cervical cancer: progress and prospects

Human papillomaviruses (HPV) cause the development of various cutaneous and mucosal lesions. Some genotypes play a role in the genesis of cervical cancer, which is the second most common cancer in women. HPV types 16 and 18 account for 60 to 72% of all HPV-associated cervical cancers, while types 6 and 11 cause genital warts. Despite the various escape strategies viruses use to fight the natural immune system, more than 90% of the infections clear spontaneously. It should therefore be possible to prepare prophylactic vaccines. The HPV major capsid protein L1 self-assembles into virus-like particles (VLP). Immunization after parenteral vaccination with it provided very good protection against experimental infection in different animal models. The first clinical trials revealed the satisfactory tolerance and excellent immunogenicity of these vaccines. Two vaccine approaches were selected: one based on protection against cervical cancer from a bivalent VLP L1 vaccine containing the two genotypes most frequently involved in cervical cancer (type 16 and 18) and the other, protecting against warts as well as cervical cancer, with a quadrivalent HPV VLP L1 vaccine containing genotypes 6, 11, 16 and 18. Initial results with these vaccines show an efficacy of more than 90% against infection and 100% against the onset of dysplastic lesions. Despite these hopeful results, a vaccined strategy sould still be defined. Meanwhile, the cytology screening program should be carried on until the beginning of the vaccination.