人乳头瘤病毒16型内变异株与宫颈病变

摘要

目的 研究患宫颈上皮内瘤变(Cervical intraepithelial neoplasia,CIN)的汉族妇女中人乳头瘤病毒(Human papillomavirus,HPV)16型内变异株的类型及其在临床上的意义.方法 随机收集中日友好医院妇科门诊就诊的77例感染HPV16的汉族患者的宫颈脱落细胞DNA,用PCR法扩增HPV16型包含E6和E7基因的DNA片段并测序.通过对测序得到的E6基因序列与GenBank下载的参考株的比对,研究77例汉族患者中HPV16变异株的类型并探讨其与CIN的关系.结果 纳入研究的77例患者中,最小年龄21岁,最大年龄56岁,平均年龄36.39±6.86岁.其中,CIN Ⅱ级以下病变16例(占比20.8%),CIN Ⅱ级及以上病变61例(占比79.2%).HPV16型内变异株只有亚洲株和欧洲株两种,亚洲株38例,欧洲株39例.经χ~2检验,χ~2=0.0034,P>0.05,尚不支持亚洲株与欧洲株的致癌作用不同.结论 虽然本研究未发现HPV16型亚洲株与欧洲株的致癌作用不同,但本研究发现77例汉族患者感染的HPV16型内变异株以亚洲株和欧洲株为主,故我们有理由推测,HPV16型内变异株在我国汉族妇女中的分布以亚洲株和欧洲株为主,而其他变异株,特别是高致癌的亚美株并不常见.%Objective To study the distribution of human papillomavirus type 16 (HPV16) variants and their clinical significance in Han women with Cervical Intraepithelial Neoplasia (CIN). Methods Randomly making a collection of DNA samples of cervical cells from 77 Han out-patients infected with HPV16, PCR amplification of HPV16 DNA fragments containing E6 and E7 genes and sequenced. To study the HPV16 variants types in these out-patients and explore the relationship between the HPV16 variants and CIN by comparing the E6 genes sequenced with the reference strains downloaded from the GenBank. Results Among 77 patients, the minimum age is 21 years old, the maximum age is 56 years old, and the average age is 36.39±6.86 years old. 61 patients (accounting for 79.2% ) were diagnosed as CIN Ⅱ and higher grade lesions while 16 patients (accounting for 20.8% ) as CIN Ⅰ. In this research, only European variant and Asian variant were found by Parsimony analyses of the sequences. There are 38 Asian variants and 39 European variants. With χ~2 test, χ~2=0.0034, P=0.9535 > 0.05, it suggested that there was no enough evidence to support Asian- and European- variants had the different risk in the cause of cervical intraepithelial neoplasia and cervical cancer. Conclusion It was not found Asian- and European- variants of HPV16 had different effect on the cervical cancer, but found only two major variants-Asian- and European-variants in Han people in this research. So we have reason to speculate that there are two major HPV16 variants(Asian- and European- variants) in China's Han women, while other variants, especially high cancer-causing Asian/American variant are not common.