性病门诊378例女性宫颈分泌物的HPV基因型分析

目的检测和分析性病门诊女性患者宫颈分泌物中人乳头瘤病毒(HPV)的基因型别。方法收集我院性病门诊就诊的女性患者378例,按患者有无高危接触和宫颈口有无尖锐湿疣症状划分为3组,即有接触有症状组(161例)、有接触无症状组(117例)和无接触无症状组(100例)。取3组患者脱落细胞,采用反向分子杂交法进行HPV基因分型检测。结果性病门诊378例女性宫颈分泌物HPV阳性率为56.61%(214/378),有接触有症状组、有接触无症状组和无接触无症状组的阳性率分别为98.75%(159/161)、40.17%(47/117)和8.00%(8/100),3组分别检出22种、14种和5种HPV基因型别,检出的主要型别是HPV6、11、16、58、56、18、33、68。有接触有症状组和有接触无症状组单一感染和复合感染的感染率差异无统计学意义(P0.05),在多重复合感染中,以二重和三重感染为主,最多发现八重感染。有接触有症状组低危型121例次(76.10%),高危型99例次(62.26%),有接触无症状组低危型35人次(74.46%),高危型26例次(55.32%),两组感染率较高,但差异无统计学意义(P0.05)。结论 HPV6、11、16、58、56、18、33、68是性病门诊女性患者宫颈感染HPV的主要型别,健康体检者中亦能查出,临床应加强对性病门诊女性就诊者宫颈HPV基因的检测,及对HPV阳性患者进行定期的跟踪随访,尤其是高危型和复合感染患者。

HPV genotype analysis of cervical secretions from 378 female patients of venereal outpatient

Objective To explore the human papilloma virus (HPV) genotypes of female cervical secretions in venereal outpatient. Methods Total 378 cases of female patients from STD clinics were recruited. According to the patients with or without high risk exposure and symptoms of condyloma acuminatum, the patients were divided into three groups, namely a group with contact and symptoms (161 cases), a group with contact and without symptoms (117 cases) and a group without contact and symptoms (100 cases). The exfoliated cells were taken and the method of reverse molecular hybridization was adopted to detect the genotype of HPV. Results HPV positive rate of cervical secretions from 378 female cases of venereal outpatient was 56.61% (214/378). Positive rate of the group with contact and symptoms was 98.75% (159/161), and 22 kinds of HPV genotypes were detected, mainly including HPV6 (44.72%), 11(29.19%), 16 (15.53%), 58 (8.69%), 56 (7.45%), 18 (6.83%), 33 (6.83%) and 68 (6.83%). Positive rate of group with contact and without symptoms was 40.17% (47/117), and 14 kinds of HPV genotypes were detected, mainly including HPV6 (17.09%), 11(13.68%), 52 (6.84%), 53 (5.13%), 16 (4.27%), 51(3.42%) and 18 (2.56%). Positive rate of group without contact and symptoms was 8.00% (8/100), and 5 kinds of HPV genotypes were detected, including HPV6 (4.00%), 11(3.00%), 33 (1.00%), 16 (2.00%) and 81(1.00%). Unitary type infection rate and complex infection rate of the group with contact and symptoms and the group with contact and without symptoms had no statistical difference(P>0.05). In the multiple complex infection, three and double infection were the main ones, and the most of them were found to be eight infections. Low-risk type of the group with contact and symptoms was 121cases (76.10%), high-risk pattern was 99 cases (62.26%). Low-risk type of the group with contact and without symptoms was 35 cases (74.46%), high-risk pattern was 26 cases (55.32%). The two groups had high positive rate, but there was no statistical difference(P>0.05). Conclusion HPV6, 58, 56, 11, 16, 18, 33, 68 are primary genotypes of cervical secretions from female cervical in venereal outpatient, which also may be found in healthy examination group. Cervical HPV genetic testing should be strengthened for female venereal patients, and regular follow-up may be carried out on HPV positive patients, especially high risk type and the complex infection patients.