尖锐湿疣患者病损部位高危型人乳头瘤病毒的检测及其临床意义

目的了解尖锐湿疣(CA)患者高危型(16、18型)人乳头瘤病毒(HPV)的感染情况及其临床意义。方法应用实时荧光定量聚合酶链反应(FQ-PCR)对41例CA患者(扁平形16例,乳头形/菜花状25例)病损部位进行HPV16、18型DNA检测,又根据其发病次数分为初发和复发2组,分别有29例和12例,观察高危型HPV的感染率、病毒DNA含量及各组间的差异。结果CA患者高危型HPV的感染率为43.90%,与对照组(3.85%)比较差异有显著性(P<0.01)。扁平形和乳头形/菜花状CA患者高危型HPV的阳性率分别为18.75%和60.00%,2组比较也有明显差异(P<0.01);2组间病毒DNA含量比较差异无显著性(P>0.05)。初发和复发者HPV16、18型感染率及其DNA含量检测结果差异均无显著性(P>0.05)。25例乳头形/菜花状CA患者的疣体组织阳性率为36%,其表面分泌物的阳性率为52%。结论CA患者高危型HPV的感染率显著高于普通人群。乳头形/菜花状CA中高危型HPV感染率较扁平形明显升高。CA的复发与否可能与高危型HPV的感染无必然联系。同时检测疣体组织和分泌物的高危型HPV可提高检出率。

The detection of high-risk human papilloma virus in patients with condyloma acuminatum and its clinical significance

Objective To study high-risk human papiloma virus(HPV,16/18) in patients with condyloma acuminatum(CA) and its clinical significance. Methods 41 new and relapsed patients including 16 flat and 25 mammillated CA were tested for HPV 16,18 by the fluorescent quantitative polymerase chain reaction(FQ-PCR) and analyzed the positive rate and the difference between the groups. Results The infection rate of high-risk HPV in patients with CA was 43.90%,which was significantly different from control(3.85%,P<0.01).The infection rate of high-risk HPV in patients with flat and mammillated CA was 18.75% and 60.00% respectively.The infection rate of the two groups was found significantly different(P<0.01);But DNA copies of HPV 16,18 did not show difference between the two groups(P>(0.05).) The infection rates and HPV 16,18 DNA copies were found no difference between new and relapsed patients(P>0.05). The positive rate of high-risk HPV was 36% in the wart of 25 patients with mammillated CA,which was 52% in the secretion around the wart. Conclusions The patients with CA have more possibility to be infected with high-risk HPV than the common people.And the infection rate of high-risk HPV in mammillated CA is higher than that of flat CA.The relapse of CA might not associate with the high-risk HPV infection.It is helpful to detect high-risk HPV in both the wart and the secretion around the wart for higher positive rate.