多重实时PCR检测高危型人乳头瘤病毒感染

目的 调查不同宫颈病变组妇女生殖道13种高危型HPV(HR HPV)感染情况,分析HR HPV感染与宫颈病变的关系.方法 选择深圳市宝安区妇幼保健院宫颈专科门诊患者350例,利用TCT技术检测其宫颈上皮细胞学状况,根据细胞学结果分组.采用多重实时PCR(mRT PCR)检测其生殖道HR HPV感染情况和病毒载量,采用χ2检验或Fisher精确概率法比较各组间HR HPV感染率,采用Kruskal-Wallis或Wilcoxon秩和检验比较各组间HR HPV阳性者的病毒载量,采用Wilcoxon秩和检验比较HR HPV阳性和阴性组的年龄分布情况.结果 未见上皮内病变或恶性病变(NILM)组、意义不明的非典型鳞状上皮细胞增生(ASCUS)组、鳞状上皮细胞低度病变(LSIL)组、鳞状上皮细胞高度病变(HSIL)组的HR HPV阳性例数分别为10例(3.4%)、7例(20.0%)、11例(78.6%)和6例(6/6).NILM组HR HPV阳性率低于ASCUS组、LSIL组,ASCUS组HR HPV阳性率低于LSIL组,差异有统计学意义(χ2值分别为14.43、107.69、14.76,P均<0.01);NILM组低于HSIL组、ASCUS组低于HSIL组,差异有统计学意义(P值分别为0.000 1、0.000 4).NILM组、ASCUS组、LSIL组和HSIL组HR HPV阳性者的病毒载量分别为4.10 (3.38～6.27)、5.33 (3.63～6.66)、5.77 (4.01～7.01)和5.58 (4.19～5.85)(拷贝/ml,lg).将ASCUS组、LSIL组和HSIL组3组合并为宫颈细胞异常组,病毒载量为5.58(3.63～7.01)(拷贝/ml,lg)高于NILM组,差异有统计学意义(U=43.0,P<0.05).HR HPV阳性组平均年龄36(21～56)岁,与阴性组[33(21～58)岁]比较,差异无统计学意义(U=4 544,P>0.05).结论 HR HPV感染与宫颈病变有关;HR HPV病毒载量高低与宫颈病变程度无相关性,但病毒载量越高,存在宫颈病变的可能性越大.HR HPV阳性组与阴性组的年龄分布无差异.

Abstract：

Objective To investigate 13 high-risk types of HPV (HR HPV) infection rates in women with different grades of cervical lesions.Methods A total of 350 women, who were hospitalized in the department of gynecology in Bao′an Maternity & Child health hospital, were enrolled for the study.TCT technology was used to evaluate the cervical epithelium.The group were divided according to the cytology results.Multiplex real time PCR (mRT PCR) was used to detect the viral loads.HR HPV infection rate of different groups were analyzed using χ2 test or Fisher exact test.HR HPV viral loads of patients in different grades of cervical lesion groups were compared using Kruskal-Wallis or Wilcoxon test, and the age distribution of HR HPV positive group and negative group was analyzed by using Wilcoxon test.Results The HR HPV infection rates of NILM, ASCUS, LSIL, HSIL were 3.4% (10/295), 20.0% (7/35), 78.6% (11/14) and 100.0% (6/6), respectively.HR HPV positivity in NILM was lower than ASCUS (χ2=14.43,P<0.01) and LSIL (χ2=107.69,P<0.01), HR HPV positivity in ASCUS was lower than LSIL (χ2=14.76,P<0.01). The median of HR HPV viral loads in NILM, ASCUS, LSIL and HSIL were 4.10 (3.38-6.27), 5.33 (3.63-6.66), 5.77 (4.01-7.01) and 5.58 (4.19-5.85) respectively (copies/ml,lg).Combined ASCUS, LSIL and HSIL groups into cervical lesion group, HR HPV viral load of which was higher than that of NILM (U=43.0, P<0.05).The median Ages of HR HPV positive group and negative group were 36 and 33, respectively.No statistical significance was found between them (U=4 544, P>0.05).Conclusions The present study revealed that HR HPV infection was related to cervical lesion, but there was no correlation between viral load and cervical lesion grade. In additional, no difference in age distribution was found between HR HPV positive group and negative group.

Detection of high-risk human papillomavirus by multiplex real time PCR

Objective To investigate 13 high-risk types of HPV (HR HPV) infection rates in women with different grades of cervical lesions.Methods A total of 350 women, who were hospitalized in the department of gynecology in Bao′an Maternity & Child health hospital, were enrolled for the study.TCT technology was used to evaluate the cervical epithelium.The group were divided according to the cytology results.Multiplex real time PCR (mRT PCR) was used to detect the viral loads.HR HPV infection rate of different groups were analyzed using χ2 test or Fisher exact test.HR HPV viral loads of patients in different grades of cervical lesion groups were compared using Kruskal-Wallis or Wilcoxon test, and the age distribution of HR HPV positive group and negative group was analyzed by using Wilcoxon test.Results The HR HPV infection rates of NILM, ASCUS, LSIL, HSIL were 3.4% (10/295), 20.0% (7/35), 78.6% (11/14) and 100.0% (6/6), respectively.HR HPV positivity in NILM was lower than ASCUS (χ2=14.43,P<0.01) and LSIL (χ2=107.69,P<0.01), HR HPV positivity in ASCUS was lower than LSIL (χ2=14.76,P<0.01). The median of HR HPV viral loads in NILM, ASCUS, LSIL and HSIL were 4.10 (3.38-6.27), 5.33 (3.63-6.66), 5.77 (4.01-7.01) and 5.58 (4.19-5.85) respectively (copies/ml,lg).Combined ASCUS, LSIL and HSIL groups into cervical lesion group, HR HPV viral load of which was higher than that of NILM (U=43.0, P<0.05).The median Ages of HR HPV positive group and negative group were 36 and 33, respectively.No statistical significance was found between them (U=4 544, P>0.05).Conclusions The present study revealed that HR HPV infection was related to cervical lesion, but there was no correlation between viral load and cervical lesion grade. In additional, no difference in age distribution was found between HR HPV positive group and negative group.