单管多重PCR鉴定HPV基因型方法的建立和临床评价

目的建立单管多重PCR鉴定低危和高危乳突瘤病毒（HPV）的方法以及用临床标本对该方法进行评价。方法设计HPV基因型特异的引物，在一个PCR反应管中PCR扩增来自上皮细胞提取的DNA，然后用毛细管电泳对PCR产物进行分离，根据扩增产物的大小确定相应的HPV基因型。对不同病理期的1094份临床宫颈标本和对照进行了分析。结果一共鉴定了16个HPV基因型，即HPV16，58，52，51，56，31，18，39，66，59，6，33，30，35，45和11。该方法具有高度的灵敏性和可重复性。同对照相比，未知重要意义的非典型鳞状细胞（ASCUS）、低级别表皮内损伤（LSILs）、高级别的表皮内损伤（HSILs）标本HPV检出阳性率分别为60．5％、77．1％和82．2％，而对照为14．4％，其中在HSILs标本HPV16和HPV58检出率最高，并与细胞恶性程度呈正相关。结论单管多重PCR鉴定HPV的方法是稳定的，且可以用于HPV的流行病学的调查。

Establishment and Clinical Evaluation of Multiplex PCR in a Single PCR Tube for Identification of Human Papillomaviruses

Objective To develop a method for identification of human papillomavimses by multiplex PCR in a single PCR tube and to evaluate this method. Methods Multiplex PCR was based on the amplification of HPV DNA by sets of HPV genotype-specific primers, and the genotypes of HPV were visually identified by the sizes of amplicons after they were separated by capillary electrophoresis. We conducted a pilot study to examine the correlation between the prevalence and genotype distributions of HPV and the cytological group classifications for 1094 cervical samples. Results We detected all 16 HPV genotypes （types 16,58,52,51,56,31, 18,39,66,59,6,33,30,35,45and11） with a high sensitivity and a high degree of reproducibility. Compared with the group of samples considered normal （ 14.4% ） , there was a significant increase in the prevalence of HPV in women with atypical squamous cells of unknown significance（ASCUS） （60.5%）,low-grade intraepithelial lesions （LSIL） （77.1% ）, and high-grade intraepithelial lesions （HSILs） （82.2%）. The prevalence and distribution of type 58 were correlated with cytological malignancies ,with the highest prevalence in women with HSILs. Conclusion The novel multiplex PCR method described appears to he highly suitable not only for the screening of cervical cancer precursor lesions but also for the characterization of genotype distributions in large-scale epidemiological studies