妊娠合并子宫颈上皮内瘤变患者高危型HPV感染分析

目的:探讨妊娠期子宫颈上皮内瘤变(CIN)妇女高危型人乳头病毒(HR-HPV)的感染情况。方法:随机选择2011年2月～2012年6月我院收治的妊娠合并子宫颈上皮内瘤变患者150例和宫颈诊断正常的50例妊娠妇女作为研究对象,采用第二代杂交捕获技术(HC-Ⅱ)检测所有病例孕期和产后HPV阳性感染率、种类和载量,采用logistic回归模型分析CIN患者病变程度与HPV的阳性率和载荷量的相关性。结果:CIN感染的主要类型为HPV-16和18,占感染率的81.00%(162/200),正常健康组妊娠妇女感染类型主要为HPV-31、33和35;CINⅠ～Ⅲ组妊娠期和产后的单一感染率和多重感染率均极显著高于对照组(P<0.01);妊娠期和产后CIN患者HPV载荷量均显著高于对照组(P<0.05),CINⅡ和CINⅠ组患者产后HPV负荷量显著低于妊娠期(P<0.05),CINⅢ组和健康组患者产后HPV负荷量与妊娠期无显著差异(P>0.05);CIN病变程度与HR-HPV阳性率和载量的相关系数分别为0.871和0.901,两者均达到显著水平(P<0.05)。结论:妊娠合并CIN患者感染的HPV主要类型为HPV16和HPV18,两者在宫颈癌发生发展中可能起重要作用,宫颈病变的级别与HPV的阳性率和载荷量呈显著正相关,两者可以作为妊娠合并CIN患者早期诊断的临床指标之一。

Analysis of high risk HPV infection in pregnancy patients complicated with uterine cervical intraepithelial neoplasia

Objective: To investigate the high risk HPV infection(HR-HPV) in the pregnancy patients complicated with uterine cervical intraepithelial neoplasia(CIN).Methods: A total of 150 pregnancy cases complicated with CIN and 50 cases of normal cervix in our hospital form February 2011 to June 2012 were randomly selected.Hybrid capture Ⅱ(HC-Ⅱ) was used to detect the positive infection rate,types and the loading amount of the HR-HPV of all cases at pregnancy and the postpartum.The logistic regression model was used to analyze the correlation between the extent lesions of the CIN patients and the positive rates of HPV and the loading amount.Results: The main type of HPV in the CIN group was HPV-16 and 18,accounting for 81%(162/200).The main type of HPV in the normal healthy pregnant women was HPV-31,33 and 35.The single and multiple HR-HPV infection rates of the CIN group at gestational and postnatal were significantly higher than that in the control group(P<0.01).The HR-HPV loading amount of the CIN group at pregnancy and postpartum were higher than that in the control group(P<0.05).The HR-HPV loading amount of the CINⅡand CINⅠ group at postpartum were significantly lower than that at pregnancy(P<0.05);while the HR-HPV loading amount of the CIN Ⅲ group at postpartum had no significant difference compared with pregnancy cases(P>0.05).The correlation coefficients between the lesions extent and the positive rate and the loading amount of the HR-HPV were 0.871 and 0.901,both of which reached a significant level(P<0.05).Conclusions: The main HPV type of the CIN group is HPV16 and HPV18 and plays an important role in the occurrence and development of cervical carcinoma.There is significant positive correlation between the lesions extent and the positive rate and the loading amount of the HR-HPV.The positive rate and the loading amount of the HR-HPV could be used as an early clinical diagnostic index to diagnose pregnancy complicated with CIN