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目的探讨宫颈癌及其癌前病变的发生与人乳头瘤病毒(HPV)负荷量的关系。方法选取2014-01—2015-12复旦大学附属上海市第五人民医院病理科各类宫颈活检存档蜡块标本147例,其中正常宫颈组织20例,低级别鳞状上皮内病变(LSIL)52例,高级别鳞状上皮内病变(HSIL)46例,宫颈鳞状细胞癌(SCC)29例。通过基因芯片对23种HPV亚型进行检测分型;再通过Real-time PCR方法对其中80例标本进行HPV定量分析,检测HPV负荷量。结果 147例宫颈活检标本HPV总检出率为73.5%,检出HPV亚型14种,其中高危亚型12种,低危亚型2种。高危亚型检出率最高前4位分别为HPV16(33.3%)、HPV31(6.1%)、HPV52(6.1%)以及HPV58(5.4%);随着宫颈病变程度的逐渐加重,HPV负荷量逐渐升高,LSIL组、HSIL组以及SCC组的HPV负荷量均明显高于宫颈正常组织组,差异均显著(P<0.05)。但LSIL组、HSIL组以及SCC组相互之间HPV负荷量差异不显著(P>0.05)。结论 HPV负荷量与宫颈癌前病变及宫颈癌病程的发生关系密切,但尚不能作为判定宫颈病变严重程度的指标。
Objective To investigate the relationship between cervical cancer and its precancerous lesions and human papillomavirus (HPV) load. METHODS: A total of 147 wax specimens of cervical biopsies were collected from Department of Pathology, Shanghai Fifth People’s Hospital affiliated to Fudan University from January 2015 to December 2015, including 20 normal cervical tissues and 52 low-grade squamous intraepithelial lesion (LSIL) , 46 cases of high-grade squamous intraepithelial lesion (HSIL) and 29 cases of cervical squamous cell carcinoma (SCC). Twenty-three HPV subtypes were detected by gene chip, and the HPV load was detected by Real-time PCR in 80 of them. Results The total HPV positive rate of 147 cervical biopsy specimens was 73.5%. There were 14 HPV subtypes detected, including 12 high-risk subtypes and 2 low-risk subtypes. The top four high-risk subtypes were HPV16 (33.3%), HPV31 (6.1%), HPV52 (6.1%) and HPV58 (5.4%) respectively. With the gradual increase of cervical lesions, High, LSIL group, HSIL group and SCC group of HPV load were significantly higher than the normal cervical tissue group, the difference was significant (P <0.05). However, there was no significant difference in HPV load between LSIL group, HSIL group and SCC group (P> 0.05). Conclusion The load of HPV is closely related to the occurrence of cervical precancerous lesions and cervical cancer, but it can not be used as an index to judge the severity of cervical lesions.