HPV基因分型检测与宫颈病变的相关性研究

目的了解粤西地区妇女21种人乳头瘤病毒(HPV)感染状况,探讨感染HPV不同亚型与不同程度宫颈病变的关系。方法采用核酸分子快速导流杂交基因芯片技术(HybriMax)对5 556例患者进行HPV分型检测,677例经活检证实病变程度。结果 5 556例患者中,HPV阳性者901例(16.2%)。HPV亚型感染率前5位的是HPV52、16、58、531、1。各年龄段患者HPV检出率差异有统计学意义(P<0.05),≥51岁年龄段患者HPV检出率最高。41～50岁年龄段患者感染高危型HPV(HR-HPV)的构成比最高(P<0.05)。HPV感染率随宫颈病变严重程度增加而增加(P<0.05)。高度鳞状上皮内病变(HSIL)中HPV多型感染率最高(P<0.05)。HPV165、8、33型的检出率随宫颈病变的严重程度增加而增加(P<0.05),HSIL组与低度鳞状上皮内病变(LSIL)组相比,比值比(OR)分别为3.391(2.038～5.643)2、.409(1.188～4.888)2、.362(1.081～5.161)。结论本地区人群流行的HPV亚型为HPV52、16、58、531、1。HPV分型检测对宫颈病变的早期诊断与预后有重要意义。HPV165、8、33型致癌性较强,其中感染16亚型风险最大。

The correlation investigation of the genotyping of human papillomavirus with cervical lesion

Objective To study the status of 21 genotypes of human papillomavirus（HPV） infection in women of western Guangdong and the relationship between HPV genotypes and different grade cervical lesion.Methods A total of 5 556 cases were detected for HPV DNA types by DNA flow through hybridization and gene chip（HybriMax）,and cervical biopsies were used for pathological diagnosis in 677 cases.Results Among 5 556 cases,901 cases were HPV positive（16.2%）.The HPV subtype infection rate in top 5 were HPV 52,16,58,53 and 11 in turn.There were statistical significance among the HPV positive rates in different age groups（P0.05）.Old women（≥51 years old） showed the highest HPV infection rate.The constituent ratio of high risk HPV（HR-HPV） types was the highest in 41-50 years old group（P0.05）.The detection rate of HPV increased with the severity degree of cervical lesion（P0.05）.Multiple HPV type infection rate was the highest in high grade squamous intraepithelial lesion（HSIL）group（P0.05）.The detection rates of HPV16,58 and 33 increased with the severity degree of cervical lesion（P0.05）.Compared with low grade squamous intraepithelial lesion（LSIL）group,the odds ratios（OR）of HSIL group were 3.391（2.038-5.643）,2.409（1.188-4.888） and 2.362（1.081-5.161）respectively.Conclusions The popular HPV subtypes in western Guangdong are HPV 52,16,58,53 and 11.The detection of HPV genotypes is of great significance for early diagnosis and prognosis of cervical lesion.HPV 16,58 and 33 are more oncogenic than other HPV types.HPV16 is the most oncogenic genotype.