HPV分型及高危八型定量检测在宫颈病变中的意义

目的分析宫颈病变中的人乳头瘤病毒的亚型分布及病毒载量的情况，以及其与宫颈疾病进展的关系。方法潮州中心医院就诊的220例液基细胞学检查异常的患者行阴道镜检查及组织病理学检查。收集宫颈脱落细胞标本，运用HybriMax导流杂交技术检测HPV的21个亚型，运用实时荧光PCR定量检测八个高危亚型的病毒载量。结果220例样本中，HPV感染率为87.3％，其中HPV16是最主要的基因型（50．91％），随着宫颈病变程度的增高，总HPV感染率和HPV16感染率逐渐升高。HPV58，HPV33，HPV52，HPV31和HPV18是仅次于HPV16的五种基因亚型，其检出率分别为22．73％，11．82％，11．36％，5．9％和4．54％。高危HPV亚型的病毒载量与宫颈病变的严重程度呈正相关（1=0．373，P〈0．001）。结论尽管HPV52和HPV58是该地区HPV感染的主导亚型，但在宫颈病变患者中HPV感染以HPV16为主，而与宫颈癌最相关的是HPV16和HPV18。病毒载量是一个潜在的确定子宫颈癌及癌前病变的辅助指标。

The detection of HPV genotyping and viral load of eight high risk human papillomavirus in cervical lesions

Objective The aim of this study is to determine the prevalence and distribution of HPV infection with cervical neoplasia in Chaozhou area and evaluate the association between the viral load of eight high risk human papillomavirus and risk of cervical intraepithelial neoplasia （CIN） and cervical cancer. Methods 220 cases of abnormal liquid-based cytology women from Chaozhou central hospital were examinated with colposcopy and histopathological. Cervical specimens were tested for 21 HPV types using a MY09/MY11 L1 consensus primer PCR method with specific dot blot hybridization and viral load of eight high risk genotypes were tested by real-time PCR. Results Overall HPV infection prevalence was 87.3%（192/220） and HPV16 was the most prevalent genotype with a detection rate of 50.9% in our study. The detection rates of HPV and HPV16 raised with increasing of severity of cervical disease （P〈0.05）. HPV58, HPV33, HPV52, HPV31 and HPV18 were the five most popular genotypes just less than HPV16 with detection rates of 22.73%, 11.82%, 11.36%, 5.9% and 4.54%, respectively. The viral load of high risk HPV was positive correlate with the severity of CIN and cervical cancer（r=0.373, P〈0.001）. Conclusion Although HPV52 and HPV58 were the advantage genotypes of HPV infection in Chaozhou region, HPV 16 was the main genotype of HPV infection in women with cervical lesion in this area, and the most related to cervical cancer were HPV16 and HPV18. The viral load of eight high risk human papillomavirus was a potential auxiliary indicators of cervical cancer and precancerous.