宫颈癌前病变及宫颈癌感染人乳头瘤病毒分型及临床意义

摘要

目的 探讨人乳头瘤病毒(HPV)不同亚型在宫颈癌前病变及宫颈癌中的分布情况.方法 232例宫颈癌前病变及宫颈癌患者,其中宫颈癌前病变有194例(包括CIN Ⅰ 83例,CINⅡ65例,CINⅢ46例),宫颈癌38例,采集宫颈脱落细胞标本进行HPV检测.结果 232例患者共检出HPV感染者111例,阳性率为47.84％,其中癌前病变中检出77例(CIN Ⅰ 20例,CINⅡ24例,CINⅢ33例),阳性率为39.69％,宫颈癌患者中检出34例,阳性率为89.47％,HPV感染阳性率宫颈癌前病变与宫颈癌比较有显著性差异(x2=47.36,P＜0.05).CIN Ⅰ患者以HPV 16、HPV 52、HPV33感染率最高,分别为33.33％、20.83％、12.50％,CINⅡ患者以HPV 16、HPV 18、HPV 58感染率最高,分别为27.59％、24.14％、17.24％,CINⅢ患者以HPV 16、HPV 52、HPV 58感染率最高,分别为35.90％、20.51％、20.51％,宫颈癌患者以HPV 16、HPV 18感染率最高,分别为50.00％、41.18％.HPV多重感染者12例(10.81％),其中二重感染9例(8.11％),三重及以上感染3例(2.70％);宫颈癌前病变CIN Ⅰ、CINⅡ、CINⅢ多重感染发生率分别为15.00％ (3/20)、16.67％ (4/24)、15.15％ (5/33),宫颈癌患者均为单一感染.结论 宫颈癌前病变患者以HPV 16、HPV 18、HPV52、HPV58感染率高,宫颈癌患者以HPV 16、HPV 18感染率高,并且宫颈癌前病变多重感染率高于宫颈癌患者.检测HPV感染对宫颈癌前病变及宫颈癌的预防、控制及随访、预后评价有重要意义.%Objective To explore the distribution of human papilloma virus (HPV) different subtypes in precancerous lesions and cervical cancer.Methods 232 cases of precancerous lesions and cervical cancer,including 194 cases of precancerous lesions (including CIN Ⅰ in 83 cases,CIN Ⅱ in 65 cases,CIN Ⅲ 46 cases),38 cases of cervical cancer,cervical cells exfoliated specimens were collected for HPV testing.Results 232 patients were detected,HPV infections in 111 cases,were 47.84％,among them pre-cancerous change in the check out of 77 cases (CIN Ⅰ 20 cases,CIN Ⅱ,24 cases were CIN Ⅲ 33 cases),39.69％ positive,cervical cancer patients in the check out 34 cases,89.47％ were in precancerous lesions and cervical cancer HPV infection between positive significant difference exists (x2 =47.36,P ＜ 0.05).CIN Ⅰ patients with HPV 16,HPV 52,HPV and highest infection rate,of33.33％,20.83％ and 12.50％ respectively,CIN Ⅱ with HPV 16,HPV 18,HPV 58 highest infection rate,of 27.59％,24.14％ and 17.24％ respectively,with CIN Ⅲ HPV 16,HPV 52,HPV 58 highest infection rate,of 35.90％,20.51％ and 20.51％ respectively,cervical cancer patients to HPV 16,HPV and highest infection rate,were 50.00％,41.18％.HPV multiple infections in 12 cases,multiple infection rates in 10.81％ (12/111),including double infection 9 cases,8.11％,more than triple and inflammation (3 cases),2.70％;Cervical cancer CIN lesions before Ⅰ,CIN Ⅱ,CIN Ⅲ multiple infection rate was 15.00％ (3/20),16.67％ (4/24),15.15％ (5/33),cervical cancer patients were single infection.Conclusion Cervical precancerous lesions HPV 16,HPV 18,HPV 52,HPV58 had high infection rates,cervical cancer patients HPV 16,HPV had high infection rates,and cervical cancer lesion before multiple infection rates higher than patients with cervical cancer.Detection of HPV infection in precancerous lesions and cervical cancer prevention,control and follow-up,prognosis have the important meaning.