陕西地区宫颈病变妇女HPV感染状况研究

目的研究陕西省妇女宫颈不同病变人乳头状瘤病毒(HPV)感染状况及亚型分布特征。方法采用聚合酶链反应(PCR)体外扩增和DNA反向点杂交相结合的DNA芯片技术,对1 871例宫颈不同病变脱落细胞标本进行HPV基因分型检测。结果单一型别HPV感染在健康人群中前6位亚型为81、52、16、58、43和33型;慢性宫颈炎为16、81、43、42、11和58型;宫颈上皮内瘤变(CIN)为16、52、58、33、56和81型;宫颈鳞癌为16、58、18、52、33和56型。多重感染中HPV16亚型最为常见,占35.55%;其次为52和58型,分别占19.20%和17.30%。总体HPV多重感染常见亚型为16、58、52、18、56和33型,共占81.24%。在宫颈不同病变中仍以单一亚型感染最为常见,二重感染占多重感染的70.53%。宫颈鳞癌中主要存在HPV高危单一亚型(63.14%)、高危多重亚型(18.91%)和高低危多重亚型(17.95%)感染,与慢性宫颈炎和CIN相比,差异有统计学意义(P0.01)。结论 HPV16、58、18、52、56和33亚型均应作为陕西省HPV预防的重点高危亚型。

Study of HPV infection among women with cervical lesions in Shaanxi area

Objective To investigate the human papillomavirus (HPV) infection situation and subtypes distri-bution characteristics among women with different cervical lesions in Shaanxi province .Methods The exfoliated cell specimens from 1 871 cases of different cervical lesions were detected the genotyping by adopting the gene chip tech-nology of PCR in vitro amplification combined with reverse dot hybridization .Results The top 6 subtypes in single genotype HPV infection were the subtypes 81 ,52 ,16 ,58 ,43 and 33 ;which in chronic cervicitis were the subtypes 16 , 81 ,43 ,42 ,11 and 58 ;which in cervical intraepithelial neoplasia (CIN) were subtypes 16 ,52 ,58 ,33 ,56 and 81 and which in cervical cancer were subtypes 16 ,58 ,18 ,52 ,33 and 56 respectively .The most common HPV subtype of mul-tiple infection was HPV16 ,accounting for 35 .55% and followed by HPV52(19 .20% ) and HPV58(17 .30% ) .The common HPV subtypes of multiple infection in overall specimens were the subtype16 ,58 ,52 ,18 ,56 and 33 respec-tively and accounted for 81 .24% .The single subtype infection was still most common in different cervical lesions . The double HPV infections accounted for 70 .53% of all multiple HPV infections .The HPV infection in cervical ca-ner included high-risk single subtype (63 .14% ) ,high-risk multiple subtypes (18 .91% ) and high-low risk multiple subtypes (17 .95% ) ,which showed the statistical difference compared with chronic cervicitis and CIN (P<0 .01) . Conclusion The subtype 16 ,52 ,58 ,18 ,56 and 33 should serve as the focal high-risk subtypes in the HPV prevention of Shaanxi province .