外阴上皮内瘤变与HPV 感染型别相关性临床研究

摘要

目的 探讨外阴上皮内瘤变(VIN)中人乳头状瘤病毒(HPV)高危型、低危型的感染情况,以及HPV 各亚型在VIN 病理中的分布情况、各亚型与VIN 分级有无相关性.方法 以人乳头瘤病毒核酸扩增法分型检测各亚型HPV在100例VIN 患者及100例外阴正常皮肤组织中的表达情况,并行统计分析.结果 VIN 组织HPV 感染率远高于正常组织(χ2=45.54,P < 0.05);随VIN 级别增高,HPV 感染率有增高趋势(χ2=8.45,P < 0.05),高危型HPV 感染亦有增高趋势(χ2=6.25,P < 0.05);各级别VIN 两两比较,高危型、低危型HPV 感染构成比均显著不同(均P < 0.05).三种类型VIN 组织中高危型、低危型HPV 感染构成比显著不同(χ2=13.24,P < 0.05),各级别两两比较,VINⅠ组和VINⅡ组、VINⅢ组高危型HPV 感染亚型分布均显著不同(均P < 0.05),VINⅡ组和VINⅢ组高危型HPV 感染亚型分布比较差异均无统计学差异(χ2=1.52,P > 0.05).VINⅠ中以HPV58 感染为主,VINⅡ、VINⅢ中均以HPV16、HPV18 感染为主.经Sperman 等级相关分析,HPV16/18 感染与VIN 等级有相关性(r = 0.65,P < 0.05).结论 HPV 感染与VIN发生、发展可能有关系,HPV 感染型别在不同级别VIN 中有显著差异,HPV16/18 可能与VIN 的进展有联系,治疗HPV 感染可能预防VIN.%Objective To investigate the infect conditions of high -risk type and low -risk type human papilloma virus (HPV) in vaginal intraepithelial neoplasia, each subtype of HPV distribution in the VIN pathology, and whether there being relativity between each subtype and VIN grading. Methods Took 100 VIN patients and 100 normal people, detected the expression with papilloma virus nucleic acid amplification method on their vulvar skin tissues, and then made a statistic analysis. Results The HPV infect rate of VIN tissues was much higher than normal tissues (x2=45.54, P < 0.05); an increasing trend of HPV infection rate (x2=8.45, P < 0.05) and high-risk type HPV infection (x2=6.25, P < 0.05) had been found accompanied with the VIN level; and there had been a notable difference between the infect proportion of the high-risk type HPV and Low-risk HPV by making comparisons between the VIN at different levels. Notable difference of the infect proportion of the high-risk type HPV and Low-risk HPV had been found in each level VIN (x2=13.24, P < 0.05). By having made comparisons between different levels, notable different distribution of high-risk type HPV infection subtype had been found among VIN I , VIN II and VIN IH, and no statistic distributed difference had been found between VIN II HPV infect subtype and VIN IH HPV infect subtype (x2=1.52, P > 0.05). It had been proved that there mainly existed HPV58 infection in VIN I ; there mainly existed HPV16 infection and HPV18 infection in VIN II and VINIH,. And relativity had been found between HPV16/18 infection and VIN level by having Sperman grading correlation analysis (r = 0.65, P < 0.05). Conclusion It maybe have relation between infection of HPV and occurrence and development of VIN, HPV infect subtype has statistic difference in different grade of VIN, HPV16/18 may have relation with development of VIN, treatment of HPV infection can prevent VIN.