134例宫颈上皮内瘤变患者HPV分型检测结果分析

目的探讨宫颈上皮内瘤变(CIN)中不同类型人乳头瘤病毒(HPV)的感染及分型情况。方法回顾性研究北京军区总医院妇科门诊134例已经确诊的CIN患者,采用凯普的核酸分子快速导流杂交基因芯片技术对HPV进行分型。结果 1.各级别CIN以HPV高危亚型单一或者多重感染为主;2.在HPV阳性的101例患者中,单一感染者73例(72.28%),双重感染者24例(23.76%),三重感染者3例(2.97%),四重感染者1例(0.99%);3.HPV-16、58感染率最高,分别为30.83%,24.06%。结论 HPV感染以高危型和多重感染为主;随CIN级别的增高,HPV阳性率也是增高的;HPV-16亚型的感染率最高。     

子宫颈上皮内瘤变患者行宫颈环切术对妊娠结局的影响

目的探讨对宫颈上皮内瘤变患者行宫颈环切术对妊娠结局的影响。方法回顾性分析2001年5月～2010年4月对宫颈上皮内瘤变患者行宫颈环切术27例患者的妊娠结局。结果占同期宫颈环切术宫颈环切术手术的13.3%(27/203),患者年龄为23～40岁,中位年龄为30.3岁。27例中,10例因计划生育行人工流产术、1例异位妊娠、2例6～8周自然流产。14例足月分娩,其中阴道分娩9例,剖宫产5例。所有分娩孕妇的分娩孕周均大于38周,新生儿体重2905～4000g。新生儿1minApgar评分:9分2例;10分12例。无新生儿窒息。结论宫颈环切术是治疗宫颈上皮内瘤变的安全有效的方法。只要掌握手术指征和手术切除范围,对其后的妊娠生育是安全的。     

人乳头瘤病毒阳性宫颈癌和宫颈上皮内瘤变患者血浆中miR-34a的表达及临床意义

目的 探究miR-34a在人乳头瘤病毒(HPV)阳性宫颈癌和宫颈上皮内瘤变(CIN)患者血浆中的表达及其对HPV阳性宫颈癌的诊断价值。方法 选取2016年1月至2021年1月期间在本院就诊的HPV阳性宫颈癌患者80例作为宫颈癌组,并选取同一时间与宫颈癌组患者年龄无差异的HPV阳性CIN患者60例作为CIN组,HPV阳性但子宫良性病变者50例作为对照组。通过qRT-PCR检测3组受试者血浆中miR-34a的表达情况,并分析其与HPV阳性宫颈癌患者临床病理特征的关系;检测血浆中CA125和SCCA的表达情况;使用Pearson法分析HPV阳性宫颈癌患者血浆中miR-34a与CA125或SCCA水平的相关性;经ROC曲线评估miR-34a与CA125、SCCA对HPV阳性宫颈癌的诊断价值。结果 宫颈癌组患者血浆中miR-34a表达水平明显低于CIN组和对照组(0.48±0.15vs 0.74±0.28和0.96±0.38,F=50.796,P<0.05),且CIN组低于对照组(P<0.05)。宫颈癌组患者血浆中CA125(U/mL)、SCCA(ng/mL)水平明显高于CIN组和对...     

宫颈瘤变程度与其相对应的HPV基因型分布规律的研究

目的研究不同级别宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN）与人乳头瘤病毒（Human papil-lomavirus,HPV）基因型分布之间的关系。方法收集321例经组织病理学诊断确定为CIN2及以上（CIN2＋）病人的宫颈分泌物标本,其中CIN2 67例,CIN3/ACIS 247例,浸润性宫颈癌7例。采用深圳亚能生物技术有限公司的人乳头瘤病毒（HPV）基因分型检测试剂盒对所选标本进行HPV检测及基因分型。结果在所有321例标本中,HPV阳性300例,阳性率93.5%,两型及两型以上感染138例,占比43.0%。HPV16最常见,检出率为41.1%（132/321）,其次为HPV31,33,52,18和51。HPV16和33的单型感染在CIN3＋中比CIN2更常见,具有统计学差异（P〈0.05）。在包含有HPV16或HPV33的多型感染中,含有HPV16或HPV33的多型感染在CIN3＋中比CIN2更常见,具有统计学意义（P〈0.05）。结论 HPV16和HPV33比其他型别HPV具有更强的潜在致癌性。     

516例宫颈上皮内瘤变的回顾性分析

目的总结宫颈上皮内瘤变（CIN）的临床表现及诊治过程,探寻防治宫颈癌前病变有效措施。方法回顾性分析2008年6月～2009年12月在四川省人民医院妇科诊治的516例CIN患者的年龄,临床表现,诊断、治疗及随访过程。结果 CIN患者的平均年龄32.4岁,其中CIN I 205例（占39.73%）,CIN Ⅱ246例（占47.67%）,CIN Ⅲ65例（占12.6%）。临床表现上38.18%有不正常阴道流血。经过18个月随访,治愈率99.61%,仅2例CIN Ⅲ未愈,再次手术。结论通过细胞学-阴道镜-组织学的三阶梯检查能更准确及时地发现CIN,而对CIN正规的治疗和随访能有效地阻断其发展为子宫颈癌。     

516例宫颈上皮内瘤变的回顾性分析

目的 总结宫颈上皮内瘤变(CIN)的临床表现及诊治过程,探寻防治宫颈癌前病变有效措施.方法 回顾性分析2008年6月～2009年12月在四川省人民医院妇科诊治的516例CIN患者的年龄,临床表现,诊断、治疗及随访过程.结果 CIN患者的平均年龄32.4岁,其中CIN Ⅰ205例(占39.73%),CIN Ⅱ246例(占47.67%),CIN Ⅲ 65例(占12.6%).临床表现上38.18%有不正常阴道流血.经过18个月随访,治愈率99.61%,仅2例CINⅢ未愈,再次手术.结论 通过细胞学-阴道镜-组织学的三阶梯检查能更准确及时地发现CIN,而对CIN正规的治疗和随访能有效地阻断其发展为子宫颈癌.     

宫颈上皮内瘤变病因及诊断的相关研究进展

宫颈上皮内瘤变是宫颈癌的癌前病变,在宫颈上皮内瘤变的治疗原则中,首要目的是预防宫颈癌的发生发展,早期筛查出高级别宫颈上皮内瘤变对于其预后至关重要。本文就宫颈上皮内瘤变的病因及诊断相关研究进展进行综述。     

女性HPV感染与宫颈鳞状上皮内病变

目的 研究女性HPV感染与其宫颈鳞状上皮内病变关系,为临床预防宫颈癌发生发展提供基础数据.方法 537例HPV感染阳性患者样本来源于解放军第210医院妇科门诊,分析患者感染HPV基因亚型与数量及患者年龄数据,研究其与患者宫颈鳞状上皮内病变统计学关系.结果 单一高危亚型HPV感染患者宫颈鳞状上皮内病变发病率高于单一低危亚型HPV感染患者,差别有统计学意义(P＜0.05).单一高危亚型HPV感染患者4种具体宫颈鳞状上皮内病变发病率均高于低危亚型HPV感染患者,其中ASC-H及LSIL发病率差别有统计学意义(P＜0.05).不同类型多重HPV感染患者宫颈鳞状上皮内病变发病率差别未见统计学意义(P＞0.05).多重HPV感染患者宫颈鳞状上皮内病变发病率高于单一HPV感染患者,差别有统计学意义(P＜0.05).多重HPV感染患者ASC-US发病率高于单一HPV感染患者,差别有统计学意义(P＜0.05).HPV感染患者宫颈鳞状上皮内病变发病率在41 ～ 50年龄组最高,65.04％(80/123),与其它各年龄组比较差别均有统计学意义(P＜0.05).结论 HPV感染基因亚型种类、数量及感染者年龄均与宫颈鳞状上皮内病变发生有一定关联,其中高危亚型HPV感染、多重HPV感染与中年妇女三种因素,与宫颈鳞状上皮内病变发生发展关系密切.     

LEEP术治疗宫颈上皮内瘤变的疗效分析

目的探讨高频电波刀环形电切除术（LEEP）治疗宫颈上皮内瘤变（CIN）的临床疗效。方法回顾性分析127例患者的临床资料,观察手术前后病理结果、手术时间、出血量和并发症等情况。每3-6个月及3个月后,每TCT或阴道镜复查的结果。结果手术平均时间3.5 min,术中平均出血10 mL;手术成功率91.3%,并发症发生率8.6%;术前与术后病理诊断结果一致占81.1%,所有手术标本切缘均阴性。结论 LEEP手术时间短,术中出血少,是治疗宫颈上皮内瘤变的首选方法。     

宫颈环形电切术治疗宫颈上皮内瘤变的临床病理分析

目的 探讨宫颈环形电切术(LEEP)治疗宫颈上皮内瘤变(CIN)的优点.方法 术前采用宫颈刮片或宫颈液基薄层细胞学检查及宫颈活组织病理检查,对其中确诊的105例宫颈CIN患者采用LEEP治疗,然后对标本进行病理分析.结果 本研究中,患者平均年龄35.2岁,平均妊娠次数3.1次,手术时间平均11.2min,出血量平均15.3ml;术前与LEEP术后病理检查结果的对照表明,LEEP术后标本更完整,可取得更准确的诊断.结论 LEEP术是治疗宫颈CIN的一种简便、安全、有效、可取得精确病理诊断的方法.     

Factors affecting residual/recurrent cervical intraepithelial neoplasia after cervical conization with negative margins

To identify factors for predicting residual or recurrent cervical intraepithelial neoplasia (CIN) after cervical conization with negative margins. A total of 172 patients with histologically verified high‐grade squamous intraepithelial lesions who underwent conization with negative margins were recruited at the General Hospital of Tianjin Medical University from December 2006 to January 2016. Follow‐up comprised clinical examination, a liquid‐based cytology test, a human papillomavirus (HPV) DNA genotyping test, colposcopy assessment, and if indicated, colposcopy‐directed punch biopsy. The Kaplan‐Meier method was used to analyze the median recurrent time, whereas log‐rank tests and Cox regression models were used to determine the predictors of residual/recurrent CIN. Fourteen residual/recurrent cases (8.1%) were identified in 172 patients. In univariate analysis, cytologic abnormalities on follow‐up (P = .000), conization method (P = .017), HPV positivity at any visit (P = .000), persistent HPV infection postconization (P = .000), persistent infection with the same HPV genotype (P = .000), and HPV positivity at 18 months after conization (P = .000) were predictive factors of residual/recurrent CIN. The results of multivariate analysis further revealed that persistent HPV infection postconization (P = .035), HPV positivity at 18 months after conization (P = .017), and cytologic abnormalities on follow‐up (P = .000) had an increased risk of residual/recurrent CIN. During follow‐up, patients with persistent HPV infection or cytologic abnormalities were at high risk of residual/recurrent CIN and should be identified for close surveillance and monitoring. Meanwhile, patients with HPV who became negative within 18 months after treatment had a low risk of recurrence.     

Prevalence and genotype distribution of human papillomavirus in women with cervical cancer or cervical intraepithelial neoplasia in Henan province,central China

To evaluate the prevalence of human papillomavirus (HPV) infection and its genotype among women with cervical lesions in Henan Province, central China. A total of 1317 cervical scrapes from patients with cervical intraepithelial neoplasia 1 (CIN1) (n = 91), CIN2/3 (n = 466), and cervical cancer (CC; n = 760) were collected from 2013 to 2018, and then tested for HPV genotypes using polymerase chain reaction followed by flow-through hybridization assay. The prevalence of HPV was 62.64% for patients with CIN1, 86.91% for patients with CIN2/3%, and 89.21% for patients with CC. In total, the HPV prevalence was 86.56%, and the most common HPV type was HPV16 (58.77%) followed by HPV58 (10.33%), 18 (7.67%), 52 (6.61%), and 33 (5.54%). In this study, the high-risk HPV cumulative attribution rate of nine-valent vaccine coverage was markedly higher than that of bivalent or quadrivalent vaccine coverage in each histopathological category or overall (P < .001). Single HPV infection was the main infection category in each histopathological diagnosis, and the total infection rate was 65.83% (867/1317; P < .001). The prevalence of HPV16 or single HPV infection increased with the severity of cervical lesions (P < .001). HPV16, 58, 18, 52, and 33 may be predominant high-risk factors for cervical lesions in Henan Province. The nine-valent prophylactic HPV vaccine is more effective than a bivalent or quadrivalent vaccine for protecting women from CC in the region.     

Genotyping of human papillomavirus in cervical intraepithelial neoplasia in a high-risk population

Infection with the human papillomavirus (HPV) is responsible for 99.7% of cervical cancers, the second most prevalent neoplasia in women worldwide and the fifth leading cause of death by cancer in this population. In Chile, the incidence rate is 14.4 cases per 100,000 women per year and it is considered a significant public health problem. The natural history of cervical cancer begins gradually from low-grade and high-grade squamous intraepithelial lesions to an invasive disease. In this study the frequency of HPV types was determined by HPV genotyping with reverse line blot hybridization in 200 cytobrushes of women with preneoplastic lesions in a high-risk population. HPV DNA was found in 89% of the lesions (83.3% of low-grade squamous intraepithelial lesions and 93.6% of high-grade squamous intraepithelial lesions). Multiple HPV infections were found in 14.4% and 15.5% of low- and high-grade lesions, respectively. HPV 16 was the most frequent genotype in single infections, followed by HPV 18. These results show that most of the preneoplastic lesions of the cervix (60%) were associated with HPV 16 and/or HPV 18, supporting the implementation of an HPV vaccination program in this high-risk population.     

Type‐specific human papillomavirus prevalence in cervical intraepithelial neoplasia and cancer in Iran

In Iran, human papillomavirus (HPV) vaccination is not currently included in the national vaccination program and there are no comprehensive approaches to cervical screening program. Regional data on distribution of HPV types in women is important to predict the impact of current HPV vaccines. Although several studies on distribution of HPV types in cervical precancer and cancer have been conducted in Iran, in most of them HPV positive samples were subjected to specific‐primer genotyping (mainly 16 and 18), and leaving the other HPV genotypes almost undetermined. Therefore, the present study aimed to investigate the distribution of HPV types in cervical neoplasia from West and Northwest of Iran. A total of 112 women with atypia, cervical intraepithelial neoplasia, and invasive cervical cancer were included. A PCR assay was performed in all samples to detect the presence of the HPV genome using the GP5+/6+ L1 consensus primer set. All HPV positive samples were subjected for sequencing. In overall, HPV prevalence was 20% in atypica, 44.5% in cervical intraepithelial neoplasia I, 92.3% in cervical intraepithelial neoplasia II‐III, and 98.2% in invasive cervical cancer. The most frequent HPV type was HPV 16 (79.2%), which was followed by HPV types 18, 6, and 33 at the frequencies of 6.5%, 5.1%, and 2.7%, respectively. The least HPV types were found to be 31, 45, 53, 58, and 66. In conclusion, this study shows that the current HPV vaccines could have great impact to reduce the burden of cervical cancer in Iran.     

Distribution of human papillomavirus genotypes among cervical intraepithelial neoplasia and invasive cancers in Macao

Macao is a densely populated city situated in East Asia where a relatively high prevalence of human papillomavirus (HPV) types 52 and 58 has been reported in women with invasive cervical cancer. To provide data for a population‐specific estimation on the impact of HPV vaccines, paraffin‐embedded tissues collected from women with invasive cervical cancer or cervical intrapeitheilal neoplasia grade 2 or 3 confirmed histologically were examined for HPV using the INNO‐LiPa kit. Of the 35 HPV‐positive patients with invasive cancer, one HPV type was detected in 68.6%, and 31.4% were co‐infected with more than one HPV type. Overall, HPV 16, HPV 18, HPV 52, and HPV 54 were the most common types found respectively in 57.1%, 17%, 11.4%, and 8.5% of patients with invasive cervical cancer. Among the 59 HPV‐positive patients with cervical intraepithelial neoplasia grade 2/3, 55.9% hardbored one HPV type, and 44.1% had co‐infections. The common HPV types found included HPV 16 (52.5%), HPV 52 (23.7%), HPV 58 (18.7%), and HPV 33 (17%). Although HPV 11 (a low‐risk type) was also found commonly in invasive cervical cancers (14.3%) and cervical intraepithelial neoplasia grade 2/3 (15.3%), the fact that they all existed as co‐infections with another high‐risk type suggested HPV 11 was not the cause of the lesion. The current vaccines targeting HPV 16/18 are expected to cover 62.9–74.3% of invasive cervical cancers and 32.2–55.9% of cervical intraepithelial neoplasia 2/3 in Macao. Widespread HPV vaccination is expected to reduce substantially the disease burden associated with cervical neoplasia in Macao. J. Med. Virol. 82:1600–1605, 2010. © 2010 Wiley‐Liss, Inc.     

Association between micronucleus frequency and cervical intraepithelial neoplasia grade in Thinprep cytological test and its significance

A micronucleus is an additional small nucleus formed due to chromosomes or chromosomal fragments fail to be incorporated into the nucleus during cell division. In this study, we assessed the utility of micronucleus counting as a screening tool in cervical precancerous lesions in Thinprep cytological test smears under oil immersion. High risk HPV was also detected by hybrid capture-2 in Thinprep cytological test smears. Our results showed that micronucleus counting was significantly higher in high-grade squamous intraepithelial lesion (HSIL) and invasive carcinoma cases compared to low-grade squamous intraepithelial lesion (LSIL) and non-neoplastic cases. Receiver operating characteristic (ROC) curve analysis revealed that micronucleus counting possessed a high degree of sensitivity and specificity for identifying HSIL and invasive carcinoma. Cut-off of 7.5 for MN counting gave a sensitivity of 89.6% and a specificity of 66.7% (P = 0.024 and AUC = 0.892) for detecting HSIL and invasive carcinoma lesions. Multiple linear regression analysis showed that only HSIL and invasive cancer lesions not age, duration of marital life and number of pregnancy are significantly associated with MN counting. The positive rate of high risk HPV was distinctly higher in LSIL, HSIL and invasive cancer than that in non-neoplstic categories. In conclusions, MN evaluation may be viewed as an effective biomarker for cervical cancer screening. The combination of MN count with HPV DNA detection and TCT may serve as an effective means to screen precancerous cervical lesions in most developing nations.