高危型人乳头瘤病毒负荷量与各级宫颈病变的关系

目的：采用第2代杂交捕获法检测高危型人乳头瘤病毒（high—risk human papillomavirus，HR—HPV）的负荷量，研究其与宫颈各级病变的关系。方法：2006年1月2008年1月检测HR—HPV阳性的患者956例，同时行薄层液基细胞学检查、阴道镜下活检及病理学检查。结果：956例患者HPV感染高发年龄段在25～44岁。55岁以上妇女病毒负荷量较低，与其他组相比差异有显著性（P〈0．05），细胞学异常者（包括不典型鳞形细胞，低度鳞状上皮内瘤变，高度鳞状上皮内瘤变，鳞癌，不典型腺细胞，腺癌）HPV-DNA负荷量（645．70±751．92 Pg·mL^-1）明显高于细胞学正常者（389．92±566．67Pg·mL）（P〈0．05）。在病理确诊的慢性宫颈炎组HPV—DNA负荷量较低，与其他各组比较有显著性差异（P〈0．01），在湿疣组、宫颈上皮内瘤样病变（CIN）组、鳞癌组间差异无显著性（P〉0．05），在各级CIN组间（CIN Ⅰ，Ⅱ，Ⅲ）差异亦无显著性（P〉0．05），HPV病毒负荷量与宫颈痛变严重程度无明显相关性。结论：25～44岁的妇女是HPV—DNA筛查的重点人群，HPV—DNA阳性并且HPV-DNA含量高者为宫颈癌的高危人群，但HPV-DNA的负荷量尚不能作为判别宫颈病变程度的指标。

The Correlation between Viral Load of High-risk Human Papillomavirus and Different Stage of Cervical Lesion

Objective： This study was performed to investigate the correlation between viral load of high-risk human papillomavirus （HR-HPV） and different stage of cervical lesion. Methods： The hybrid capture Ⅱ （HC Ⅱ ） method was used to examine the viral load of high-risk human papillomavirus. The restrospective study was carried out in 956 women with HR-HPV positive, they received examinatins of Liquid-based Cytology and colposcopy/pathology analysis from January, 2006 to January, 2008 in cervical disease center. Results： Among 956 patients, the high-risk age of HPV-infection was between 25-44 years, the viral load was lower in the group above 55 years then others（P〈0.05）. The viral load was higher in abnormal cytology group （include ASC, LSIL, H SIL, AGUS, squamous carcinoma and adenoearcinoma） （645. 70 ± 751.92 pg · mL^-1）than that in normal cytology group （389.92 ± 566.67 pg · mL^-1 ）（P〈0.05）. According to the pathological diagnosis, the HR-HPV load was lower in chronic cervicitis group than those in other groups （P〈0.01）, there were no significant difference of HR-HPV load among the cervical condyloma group, the CIN group and the cervical carcinoma group（P〈0.05）, and no significant difference of HR-HPV load among differernt CIN stage group（CIN Ⅰ,Ⅱ,Ⅲ）（P〉0.05）. There was no significant correlation between the HR-HPV load and the severity of cervical lesion. Conclusion： Women with 25-44 years are the focus of HPV screening, high load of HR-HPV is high-risk population of cervical carcinoma, but the load of HR-HPV could not be used as predictors of the severity of cervical lesion.