CIN和宫颈鳞癌与人乳头瘤病毒感染的相关性研究

目的探讨人乳头瘤病毒（HPV）基因型、负荷量与宫颈上皮内瘤变（CIN）和宫颈鳞癌发生发展的相关性。方法选取2005年9月至2010年12月本院宫颈上皮内瘤变或宫颈鳞癌住院患者共124例为研究对象。采用杂交捕获Ⅱ代和导流杂交基因芯片技术检测124例患者HPV感染情况，分析CIN和宫颈鳞癌与HPV感染的关系，并对影响CIN和宫颈鳞癌的相关多因素进行Logistic回归分析。结果HPV总检出率75．8％，其中CINⅠ、CINⅡ、CINⅢ和宫颈鳞癌组HPV阳性率分别为44．4％、70．0％、95．7％和76．2％。高度鳞状上皮内病变（HSIL）及以上组HPV阳性率（84．5％）高于低度鳞状上皮内病变（LSIL）组（44．4％）。高危型HPV负荷量由高到低依次为CINⅢ、宫颈鳞癌、CIN11、CINI组。高危型HPV混合或单型别感染占97．9％。HPV阳性为CIN和宫颈鳞癌病变程度的影响因素。结论高危型HPV感染是宫颈鳞癌的主要致病因素，高危型HPV负荷量可能与宫颈鳞癌的发生和发展相关。

Analysis of relationship between intraepithelial neoplasia or cervical squamous cell carcinoma and infection of Human papilloma virus

Objective To explore the relationship of human papilloma virus (HPV) genotype and loading dose with development of cervical intraepithelial neoplasia (CIN) or squamous cell carcinoma of the cervix ( SCC),and explore the relationship of HPV genotype and CIN or SCC.Methods One hundred and twenty four patients in Sun Yat-sen Memoral Hospital of Sun Yat-sen University with CIN or SCC from September 2005 to December 2010 were selected in this study.HPV DNA was detected by Hybrid capture Ⅱand flow-through hybridization and gene chip.The relationship between the infection of HPV and CIN or SCC was analyzed.The influencing factors of CIN or SCC were analyzed by logistic regression.Results The total detection rate of HPV was 75.8％,and it was 44.4％,70.0％,95.7％ and 76.2％ in CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and SCC group,respectively.The detection rate of HPV in high-grade lesion group ( 84.5％ ) was higher than low-grade lesion group(44.4％ ).The median of HPV load decreased in order as CIN Ⅲ,SCC,CIN Ⅱ and CIN Ⅰgroup.Infection of multi-genotypes or single genotype of high-risk HPV accounted for 97.9％.In logistic regression,HPV loading dose had significant influence on degree of cervical lesion.Conclusions Infection of HPV is a main etiological factor for SCC.There is some kind of correlation between HPV loading dose and development of SCC.