546例宫颈上皮内瘤变患者人乳头瘤病毒感染状况分析

摘要

目的：探讨徐州地区宫颈上皮内瘤变（ CIN）患者人乳头瘤病毒（ HPV）感染及亚型分布情况。方法将阴道镜下多点活检病理诊断确诊的CIN病例546例分为CINⅠ、CINⅡ、CINⅢ三组（ CINⅡ-CINⅢ归为CINⅢ），分析3组HPV感染及亚型分布情况。结果①546例患者HPV感染率86．08％（470/546），其中CINⅠ级68．92％（129/187）、CINⅡ级91．71％（166/181）、CINⅢ级98．31％（175/178），HPV感染率随病变程度的增加而增加，差异具有统计学意义（P＜0．05）。②HPV单一感染率71．06％（334/470），多重感染率28．94％（136/470）。3组间HPV单一及多重感染的分布情况比较，差异均无统计学意义（ P＞0．05）。③共检出19种HPV 亚型（ HPV42、43型未检出），感染率排在前6位的亚型分别为16、58、31、33、52、18型；其中CINⅠ级为16、52、58、18、31、66型， CINⅡ级为16、58、31、33、11、52型，CINⅢ级为16、58、33、31、52、18型。 HPV16型感染率随病变等级升高而升高，差异具有统计学意义（P＜0．05）。结论徐州地区CIN 高发年龄段为31～50岁；HPV感染率随CIN等级的增高而增加；HPV16型是主要致病型，排在前6位的常见亚型为16、58、31、33、52和18型；HPV多重感染与CIN病变程度无直接相关性。%Objective To investigate the infection rate and genotyping of human papillomavirus ( HPV) among pa-tients with cervical intraepithelial neoplasia (CIN) in Xuzhou.Methods 546 CIN patients who were diagnosed by col-poscopic biopsy were divided into three groups according to their grades (CINⅠ, CIN II and CIN III).Then, the infec-tion rate and genotyping of each group were analyzed .Results The infection rate of HPV was 86.08%(470/546), de-tailing 68.92%(129/187) for CINⅠ, 33.15%for CINⅡ(166/181), and 98.31%for CINⅢ(175/178).As the disease deteriorates, so is the rising of HPV infection rate (P<0.05).The single infection rate of HPV was 71.06%(334/470), in contrast with a multiple infection rate of 28.94%(136/470).No statistically differences were found be-tween the single and multiple infection rates of HIV of the three groups (P>0.05).In the current study, 19 HPV sub-types were detected (except HPV 42 and 43).Among them were subtypes 16, 58, 31, 33, 52 and 18 with top six rank-ings, especially subtypes 16, 52, 58, 18, 31 and 66 for CIN Ⅰ, subtypes 16, 58, 31, 33, 11 and 52 for CIN Ⅱand subtypes 16, 58, 33, 31, 52 and 18 for CINⅢ.As the disease deteriorates, so is the rising of HPV16 infection rate (P<0.05).Conclusions The highest proportion of CIN is detected among patients with age of 31-50 years.The infec-tion rate of HPV increases as the rising of CIN grades .HPV 16 is considered the main pathological subtype , followed by subtypes 16, 58, 31, 33, 52 and 18, according to their infection rates .No direct correlation was found between HPV multiple infection and CIN grades .