宫颈疾病妇女HPV感染现状及基因型的分布

目的 研究广州地区宫颈疾病妇女人乳头瘤病毒(human papilloma virus,HPV)感染及基因型的分布情况,探讨不同宫颈疾病妇女不同年龄、不同基因型感染与宫颈疾病的关系.方法 采用导流杂交基因分析技术对患者宫颈脱落细胞标本进行HPV检测及基因分型,检测不同年龄组、不同宫颈疾病组的HPV感染率.结果 768例标本中HPV感染率为71.10％,其中单纯HR-HPV感染率为57.40％,单纯LR-HPV感染率为9.40％.其中HR-HPV以HPV16、HPV58、HPV33、HPV18为主,LR-HPV以HPV11、HPV6为主.HR-HPV、LR-HPV感染在各年龄组的构成差异有显著性(P＜0.05).随着年龄的增长,HR-HPV感染的比例逐步增加,而LR-HPV感染比例呈逐步下降趋势.细胞学正常组、CIN Ⅰ组、CINⅡ-Ⅲ组、宫颈癌组患者HPV感染率、HR-HPV感染率、重叠感染率均逐渐升高(P＜0.05);随着CIN级别的增加,HPV16的构成比亦逐渐增加(P＜0.05);CIN患者主要基因型为HPV16、HPV58为主,宫颈癌以高危型HPV16感染为主.Logistic多元回归分析显示HPV16、HPV58、年龄大于45岁是宫颈癌发生的危险因素.结论 HPV在广州地区宫颈疾病妇女生殖道有较高的感染率及重叠感染率;HPV16、HPV58、HPV33高危型感染时宫颈疾病的主要诱因,高危型HPV16/58及年龄超过45岁与宫颈癌的发生有明显的相关性.

Current situation of human papilloma virus infection in women with uterine cervical diseases and its genotype distribution

【Objective】 To study current situation and distribution of human papilloma virus(HPV) genotype from women with uterine cervical diseases in Guangzhou Area,and to analyze the relationship between HPV infection and uterine cervical diseases.【Methods】 The patients came from the first affiliated hospital of Guangzhou Medical College.The HPV and genotype of cast-off cells samples of cervix uteri were detected by flow-through hybridization technique.The relationship between HPV infection and uterine cervical diseases in women and infection rate of HR-HPV(high-risk human papillomavirus) and distribution of some important types of HPV in different subpopulation were analyzed.The relations among the HPV infection and clinical stages,differentiation degree of cervical cancer and its precursors were analyzed.【Results】 It showed 546 patients were HPV positive(71.10%).The type of disease among simple HR-HPV infection group(57.40%) and simple LR-HPV infection group(9.40%) existed significant difference(P <0.01).The infection rate of HR-HPV gradually increased with aging,while the infection rate of LR-HPV step by step decreased.The constituent rate of subtype of HPV was significantly different(P <0.05).The infection rate of HR-HPV of the patients with cervical cancer gradually increased with aging.The infection rate of HPV and the infection rate of HR-HPV in patients with cervicitis and CIN and the cervical cancer were gradually raised(P <0.01).The spectrum of HPV infections in patients with cervicitis was mostly HPV16,HPV58,HPV33,HPV18 and CIN was mainly HPV16,HPV58,and that of cervical cancer was principally HPVI6.The logistic regression analysis showed that HPVl6 infection or HPV58 infection or age over 45 might increase the risk of carcinogenesis of the cervix.The prevalence of HPV16 also increased with increased grade of CIN and transformation to carcinoma.【Conclusions】 The infection rate and superinfection rate of HPV in women with uterine cervical diseases in Guangzhou area were high.The main causes of cervicitis and precancerous lesions are the infection of HPV and intermediate-high risk type(HPV16/58/33).The patients with HPV16 or HPV58 infection or age over 45 years were associated with increase risk of cervical cancer.