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[目的]探讨宫颈上皮内瘤变(CIN)患者生殖道标本中HPV自然分布。[方法]2006年对山西襄垣县妇女进行筛查,收集人群信息,病史和月经史等,并采集宫颈、阴道上、阴道下和外阴部位标本。使用高危型Hybrid CaptureⅡ@(HC-Ⅱ)检测技术和液基细胞学筛查人群,阳性者阴道镜下活检。病理诊断为CINⅠ以上的妇女,使用高危和低危HC-Ⅱ检测生殖道各个部位标本。[结果]共筛查884例女性,病理诊断为CINⅠ以上的研究对象为63例,包括41例CINⅠ、8例CINⅡ和14例CINⅢ,平均年龄为38.5±8.7岁。宫颈到外阴的各部位高危型HPV感染率呈降低趋势(χ2=47.764,P<0.01):宫颈100.0%、阴道上95.2%、阴道下90.5%和外阴55.6%;病毒负荷与生殖道部位相关(Spearman相关系数0.607,P<0.01),RLU/CO中位数值:宫颈217.0、阴道上88.7、阴道下14.5和外阴1.1。低危型HPV宫颈阳性率为4.8%,低于其它部位:阴道上14.3%、阴道下11.1%和外阴6.3%。[结论]CIN患者生殖道的高危型HPV感染率由外及里呈增加趋势,病毒负荷量逐渐增加;而低危型HPV主要感染生殖道下段。
[Objective] To investigate the natural distribution of HPV in genital tract specimens of patients with cervical intraepithelial neoplasia (CIN). [Methods] In 2006, the women of Xiangyuan County in Shanxi Province were screened, and the crowd information, medical history and menstrual history were collected. Cervical, vaginal, vaginal and vulva samples were collected. High-risk Hybrid Capture Ⅱ (HC-Ⅱ) detection and liquid-based cytology screening of the crowd, positive colposcopy biopsy. Pathological diagnosis of CIN Ⅰ above women, the use of high-risk and low-risk HC-Ⅱ detection of genital tract in all parts of the specimen. [Results] A total of 884 women were screened. The pathological diagnosis of CINⅠwas 63 cases, including 41 cases of CINⅠ, 8 cases of CINⅡ and 14 cases of CINⅢ. The mean age was 38.5 ± 8.7 years. The infection rate of high-risk HPV in cervix to vulva was decreased (χ2 = 47.764, P <0.01): 100.0% in cervix, 95.2% in vagina, 90.5% in vagina and 55.6% in vulva; and the viral load was related to genital tract Spearman correlation coefficient 0.607, P <0.01). The median RLU / CO values were 217.0 in the cervix, 88.7 in the vagina, 14.5 in the vagina and 1.1 in the vulva. Low-risk HPV cervical positive rate of 4.8%, lower than other parts: the vagina 14.3%, 11.1% under the vagina and the vulva 6.3%. [Conclusion] The prevalence of high-risk HPV in genital tract of CIN patients tends to increase from the outside and inside, and the viral load gradually increases. However, the low-risk HPV mainly infects the lower genital tract.