宫颈癌与癌前病变组织中HPV-16的整合感染状态

目的探讨宫颈癌及宫颈癌前病变中人类乳头瘤病毒16型（HPV-16）整合人宿主基因组的发生情况。方法选取252例宫
颈病变组织，其中宫颈癌48例，宫颈上皮内瘤样病变（CIN）204例，包括CINⅠ125例、CINⅡ46例、CINⅢ33例，另取因子宫肌
瘤行全子宫切除术的正常宫颈上皮20例为对照，采用重叠定量PCR检测HPV-16感染标本中病毒整合状态。结果宫颈癌中
HPV-16阳性感染31例，占宫颈癌患者总数的65.6%（31/ 48），其中HPV-16整合感染18例，占HPV-16阳性宫颈癌患者的58.1%
（18/31）；在CINⅠ、CINⅡ、CINⅢ中，HPV-16阳性感染率分别为19.2%（24/125）、34.8%（16/46）、42.4%（14/33），整合感染率分别
为16.7%（4/24）、18.8%（3/16）、35.7%（5/14）；与不同级别CIN病变相比，宫颈癌患者的HPV-16整合感染率明显增加，差异具有
统计学意义。结论HPV-16整合感染状态与宫颈病变严重程度呈正相关，在HPV DNA检测基础上联合应用高危HPV感染状
态的检测有利于提高宫颈癌筛查的靶向性并早期预测宫颈病变的转归。

Study of integrated state of HPV-16 infection in cervical cancer and precancerous tissues

Objective To investigate the prevalence of physical state of HPV-l6 DNA in cervical cancer and cervical precancerous
carcinoma. Methods Multiplex PCR was adopted to detect the physical state of HPV in samples from 252 patients with
cervical carcinoma, including 48 samples of cervical cancer, 204 cervical intraepithelial neoplasia (CIN ) (125 CIN I, 46 CIN II
and 33 CIN III) and 20 normal samples from the subjects with hysteromyoma undergoing hysterectomy, respectively. Results
Among 48 patients with cervical cancer, 31 (65.6%) were infected with HPV-16. Eighteen among 31 (58.1%) HPV-16 infected
patients with cervical cancer were found to have integrated infection of HPV-16. The positive rates of HPV-16 infection in the
patients with CIN I, CIN II and CIN III were 19.2%, 34.8% and 42.4%, and the integrated infection rates of HPV-16 were 16.7%,
18.8% and 35.7%, respectively. Compared with patients with different grades of CIN, the integrated rate of HPV-16 infection in
those with cervical cancer was significantly elevated. Conclusion Among the patients with HPV-16 infection, the integrated
state of HPV-16 is positively correlated with the severity of cervical lesions. Combined HPV typing test and detection of
integrated viral state contribute to predicting the prognosis of patients with cervical precancerous lesions and increasing the
accuracy of screening cervical cancer on the basis of HPV DNAdetection.