多发皮损尖锐湿疣患者不同部位取材样本HPV 基因型的差异性分析

目的　回顾性分析多发皮损尖锐湿疣患者不同部位取材样本HPV 基因型的差异性，进一步掌握多发皮损尖锐 湿疣患者HPV感染的特点。方法　2011 年7 月~ 2019 年7 月西京医院性病门诊多发皮损尖锐湿疣患者184 例（男性88 例， 女性96 例），均采集两处不同部位样本进行HPV 基因分型检测，根据不同取材部位将患者分为四组，即肛周外阴组 42 例、口腔外阴组16 例、不同外阴组125 例和肛周口腔组1 例，最后利用统计分析每位患者HPV 基因型的差异性。 结果　多发皮损尖锐湿疣患者不同部位样本HPV 基因型完全相同69 例（37.5%），少于基因型不同病例115 例(62.5%， 包括不全相同81 例和完全不同34 例），差异有统计学意义（P ＜ 0.05）。肛周外阴组和口腔外阴组差异性结果为外阴 部位HPV 基因型、高危型和低危型的数量多于肛周部位和口腔部位。不同外阴组差异性结果为外阴部位差异主要表现 为相差1 种低危型或高危型。结论　多发皮损尖锐湿疣患者皮损部位不同，其感染HPV 基因型的类型、数量及危险程 度大多不同，外阴部位HPV 基因型较肛周和口腔复杂，不同外阴之间HPV 基因型也存在明显差异。

Analysis of the Difference of HPV Genotypes among Samples Taken from Different Sites of Patients with Condyloma Acuminatum

Objective　To analyse retrospectily the difference of HPV genotypes in different sites of patients with condyloma acuminatum and further grasp the characteristics of HPV infection in clinical patients with multiple CA. Methods　 184 cases (88 males and 96 females) were condyloma acuminatum with multiple lesions, were collected in the venereal outpatient of Xijing Hospital from July 2011 to July 2019.Two samples from different sites were taken and were tested. The patients were divided into four groups according to the different sites, namely 42 cases of the perianal and vulva group, 16 cases of the oral and vulva group, 125 cases of the different vulva group, and 1 case of the perianal and oral group. Finally, the differences of HPV genotypes in each patient were analyzed by statistical software. Results　 There were 69 cases（37.5%）with exactly the same HPV genotypes in different sites of multiple lesions CA, less than 115 cases(62,5%) with different of HPV genotypes, including 81 cases with not exactly the same and 34 cases completely different, and the difference was statistically significant (P< 0.05). The results showed that the number of HPV types, high risk types and low risk types in the vulva were higher than that in the perianal and oral. The difference of Vulva position was mainly concentrated in 1 type of low risk or high risk. Conclusion　The types, quantity and risk of HPV infection might be different in patients with multiple lesions CA. HPV genotypes in Vulva were more complex than those in anus and oral, and there were significant differences in different vulva.