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目的:探讨不同级别宫颈病变人乳头瘤病毒(HPV)感染的型别分布及HPV不同亚型感染的致癌性。方法:选择宫颈病变患者436例,按组织病理学结果分为典型HPV感染改变者58例、CINⅠ69例、CINⅡ134例、CINⅢ129例、宫颈癌46例。低度鳞状上皮内病变(LSIL)包括HPV感染改变者和CINⅠ;高度鳞状上皮内病变(HSIL)包括CINⅡ和CINⅢ。采用核酸分子快速导流杂交基因芯片技术(Hybrimax)对所有患者宫颈脱落细胞进行HPV分型,计算不同宫颈病变HPV不同亚型的检出率。结果:436例宫颈病变中常见的HPV亚型(检出率>5.0%)从高到低依次为HPV16(55.73%)、HPV58(18.58%)、HPV33(11.70%)、HPV31(10.78%)、HPV52(7.80%)、HPV53(7.57%)。宫颈癌组依次为HPV16、18、39;HSIL组依次为HPV16、58、33、31、53、52;LSIL组依次为HPV16、58、52、31、53/33、11、68、cp8304、18。HPV16与宫颈病变的级别呈正相关(P=0.000)。结论:沈阳地区宫颈病变常见的HPV亚型是HPV16、58、33、31、52、53型,HPV16致癌性最强。
Objective: To investigate the type distribution of human papillomavirus (HPV) infection of different grades of cervical lesions and the carcinogenicity of different subtypes of HPV infection. Methods: 436 cases of cervical lesions were selected. According to histopathological results, 58 cases were divided into typical HPV infection, including 69 cases of CINⅠ, 134 cases of CINⅡ, 129 cases of CINⅢ and 46 cases of cervical cancer. Low-grade squamous intraepithelial lesions (LSIL) include those with altered HPV infection and CINI; high-grade squamous intraepithelial lesions (HSIL) include CINII and CINIII. The genotypes of cervical exfoliated cells from all patients were genotyped by Hybrimax, and the detection rate of different subtypes of HPV in different cervical lesions was calculated. Results: The HPV subtypes (detection rate> 5.0%) common in 436 cervical lesions were HPV16 (55.73%), HPV58 (18.58%), HPV33 (11.70%), HPV31 (10.78% HPV52 (7.80%), HPV53 (7.57%). Cervical cancer group followed by HPV16,18,39; HSIL group followed by HPV16,58,33,31,53,52; LSIL group followed by HPV16,58,52,31,53 / 33,11,68 cp8304,18 . HPV16 and cervical lesions were positively correlated (P = 0.000). Conclusion: The common HPV subtypes of cervical lesions in Shenyang are HPV16, HPV58, HPV58, HPV31, HPV52, and HPV16, and HPV16 is the most carcinogenic.