| 石丹丽,庞小芬,王佳丽,陈昌贤,莫凌昭.人乳头瘤病毒在宫颈病变中的感染分型及其特点[J].,2018,(8):1578-1582 |
| 人乳头瘤病毒在宫颈病变中的感染分型及其特点 |
| Genotypes and Characteristics of Human Papillomavirus Infection in Cervical Lesions |
| 投稿时间：2017-11-10 修订日期：2017-12-12 |
| DOI：10.13241/j.cnki.pmb.2018.08.038 |
| 中文关键词: 人乳头瘤病毒 宫颈癌 CINII-III 基因分型 民族 |
| 英文关键词: HPV Cervical cancer CINII-III Genotype Minority |
| 基金项目:广西自然科学基金项目（2016GXNSFAA380026）；广西医科大学青年科学基金项目（GXMUYSF201625） |
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| 中文摘要: |
| 摘要 目的：了解宫颈病变中人乳头瘤病毒(HPV)的感染分型及特点，为宫颈癌筛查诊治以及HPV疫苗研制提供基础。方法：采用导流杂交技术原理对2010年06月至2016年06月在广西医科大学附属肿瘤医院首诊的1021例患者的宫颈脱落细胞标本进行HPV检测，并按宫颈病变程度分为对照组(正常组)(217例)、CINII-III组(222例)和宫颈癌组(582例)，分析三组的HPV感染特点和型别分布情况及其在不同年龄段(≤35岁、>35岁)和民族(汉族、少数民族)中的感染特点。结果：①62.16%的CINII-III患者处于30-49岁，66.32%的宫颈癌患者处于40-59岁。②对照组、CINII-III组及宫颈癌组HPV感染率分别为20.7%、86.5%、90.5%(p<0.001)。其中，多重感染率分别为11.1%、29.7%、18.0%(p<0.05)。③CINII-III组和宫颈癌组的不同年龄段HPV感染率均高于对照组，宫颈癌组中不同年龄段的感染差异有统计学意义(p<0.0001)，CINII-III组差异无统计学意义(p>0.05)。④三组HPV主要感染型别都是HPV16、58、18、52、33，但是排序先后有差异。其中，HPV33感染率在CINII-III组排第3位且主要参与多重感染，而在宫颈癌中感染率低。三组中汉族与少数民族HPV感染率差异均无统计学意义(p>0.05)，但宫颈癌组中少数民族患者58型感染率明显高于52型。⑤宫颈癌组病理类型与HPV感染相关，鳞癌患者的HPV感染率及多重感染率均高于非鳞癌患者，其中HPV感染差异有统计学意义(p<0.05)。Logistic 回归分析示：宫颈鳞癌组OR=1.966(p=0.042)，95%CI值为1.023-3.775。结论：随着宫颈病变程度的增加，HPV感染增加，且多重感染与宫颈病变密切相关。HPV33可能是癌前病变特殊感染亚型，HPV58 可能是少数民族特有的感染亚型。HPV感染使宫颈癌患者患鳞癌的风险增加。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the classification and characteristics of HPV infections in cervical lesions, providing a scientific basis for cervical cancer screening, diagnosis and treatment, and HPV vaccine development. Methods: The HPV test was performed on the cervical cytological speciments of 1021 patients who were first diagnosed in Guangxi medical university affiliated tumor hospital from June 2010 to June 2016. According to the degree of cervical lesions, they were divided into control (normal cervical cell) group (217), CINII-III group (222) and cervical cancer group (582), analyzing the characteristics of HPV infection and type distribution among three groups, also in different age groups (≤35, >35 years) and ethnic (the Han nationality and ethnic minorities). Results: 1. 62.16% of CINII-III patients were 30-49 years old and 66.32% of cervical cancer patients were 40-59 years. 2. The incidence of HPV infection in the control group, CINII-III group and cervical cancer group were 20.7%, 86.5% and 90.5% respectively (p< 0.001) and the multiple infection rates were 11.1%, 29.7% and 18.0% (p< 0.05). 3. The infection rates of CINII-III group and cervical cancer group were higher than the control group, and differences of different ages were statistically significant in cervical cancer patients (p < 0.0001). The main types of HPV infection were HPV16, 58, 18, 52, 33 in the three groups, but there were differences in the order. HPV33 infection rate in the CINII-III group ranked third and mainly involved in multiple infections, and infection in cervical cancer is low. There was no significant difference in HPV infection rate between the Han nationality and ethnic minorities of the three groups (p> 0.05), but the infection rate of HPV58 was significantly higher than HPV52 in minority cervical cancer patients. 5. The rate of HPV infection and multiple infection in patients with squamous cell carcinoma were significantly higher than those in non-squamous cell carcinoma (p<0.05). The Logistic regression analysis showed that OR = 1.966 (p = 0.042) and 95% CI were 1.023-3.775 in cervical squamous cell carcinoma. Conclusion: With the increasing of cervical lesions, HPV infection increased. Besides, multiple infections and cervical lesions are closely related. HPV33 may be a special infection subtype of precancerous lesions, HPV58 may be a unique infection subtype of ethnic minorities. HPV infection could increases the risk of squamous cell carcinoma in cervical cancer patients. |
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